西医辨病与中医辨证相结合的慢性心衰辨证论治

Syndrome Differentiation and Treatment of Chronic Heart Failure Based on the Diagnosis and Treatment of Western Medicine and Traditional Chinese Medicine

[目的]从西医辨病与中医辨证相结合的角度阐述慢性心力衰竭的辨证论治,使慢性心力衰竭的临床辨证更加准确,治疗效果更加理想。[方法]以慢性心力衰竭病情进展的四个阶段为依托,按照中医辨证论治的思路进行遣方用药,使西医辨病与中医辨证在临床诊疗上有机结合。[结果]慢性心力衰竭的前心衰阶段和前临床心衰阶段,临床辨证多为心肺气虚、气阴两虚证;临床心衰阶段,辨证为气虚血瘀证、痰浊水饮内停证;难治性终末期心衰阶段,可辨证为心肾阳衰、水饮泛滥,脾肾阳衰、痰浊内生,甚或阴竭阳脱证。[结论]西医辨病与中医辨证相结合的诊疗模式是现代医学发展的产物,有助于中医临床诊疗。慢性心力衰竭西医辨病分期下对应的中医证型及其论治,使中医辨证论治更具针对性和准确性,有利于提高中医临床诊疗效果。

[Objective] To expound the diagnosis and treatment of chronic heart failure by tranditional Chinese and western medicine, to make the syndrome differentiation and treatment more accurate and the efficacy better. [Method] The progression of chronic heart failure can be divided into four stages, to combine the tranditional Chinese and western medicine to use the traditional Chinese theory to treat the four stages. [Result] Pre-heart failure and pre-clinical heart failure most belong to Qi deficiency of heart and lung syndrome, deficiencies of Qi and Yin syndrome; Clinical heart failure belongs to Qi deficiency and blood stasis syndrome, turbid-phlegm and water-rheum collecting internally syndrome; refractory end-stage heart failure belongs to heartkidney Yang deficiency and water flooding syndrome, spleen-kidney Yang deficiency and endogenous turbid-phlegm syndrome, even depletion of Yin and Yang syndrome.[Conclusion] The pattern of diagnosis and treatment of combind tranditional Chinese and western medicine is the result of the development of modern medicine which contributes to the diagnosis of tradition Chinese medicine. This paper expounds the syndrome differentiation and treatment based on the western medical staging to make the syndrome differentiation and treatment accuracy and the curative effect better.