袁肇凯教授辨证治疗心病经验

Professor Yuan Zhaokai's Experiences in Dialectical Treating Heart Diseases

本文主要从病因病机、辨证论治规律及遣方用药特色等几个方面介绍袁肇凯教授治疗心病(冠心病、心律失常、慢性心力衰竭)的经验,疗效显著。袁教授认为冠心病的主要病机为本虚标实,本虚责之于心气阴两虚、阳气不足为主,标实责之于寒凝、气滞、痰阻、血瘀,且诸邪每多夹杂,主张补通二法作为本病防治的重要原则。心律失常辨证的关键在于分清寒热属性,快速性心律失常辨证多为心气阴两虚证治以益气养阳,镇静安神;缓慢性心律失常辨证多为心阳气亏虚证,或心脾两虚证治以温阳养心,复脉安神;慢性心力衰竭的主要病机为心肾阳气虚衰,血瘀水停,临证以强心扶阳、温肾利水为法治疗。

Experiences from professor Yuan Zhaokai in treating heart diseases（coronary heart disease, arrhythmia,chronic heart failure） were introduced through etiology and pathogenesis, differential treating regulations and medication features. Professor Yuan Zhaokai advocates that the main pathogenesis of coronary heart disease is deficiency in origin and enrichment in symptom. The reason of deficient root is deficiency of Qi-Yin in heart and deficiency of Yang, the reason of enrichment in symptom is cold stagnation, Qi stagnation, phlegm stagnation and blood stasis. Professor Yuan advocates both tonifying and clearing methods as the important principle in the prevention and treatment of coronary heart disease. The key of differential treatment of arrhythmia is to distinguish the cold and hot attributes. The main symptom of tachyarrhythmia is mostly deficiency of Qi-Yin in heart, warm heart and tranquilize mind. The main symptoms of chronic arrhythmia is deficiency of Yang in heart, or deficiency in both heart and spleen. The main pathogenesis of chronic cardiac failure is deficiency of Qi-Yang in heart and kidney, and blood stasis causing water retention, treating with strong heart to strengthening Yang and kidney-warming for diuresis.