慢性心力衰竭古今文献研究述评

Ancient and Modern Literature Review of Research into Chronic Heart Failure

古代文献对心力衰竭的命名为心痹、心水、心胀等,其基本病机为本虚标实,以心气、心阳亏虚为本,瘀血阻滞、痰饮内停为标。在整个病程发展中以气喘、心悸、水肿的程度变化为主要证候表现。各医家对心力衰竭的辨治各有特点,诊疗思路与临床经验各异,辨证分型不尽相同,但气阴亏虚多用生脉散,阳虚给予真武汤,痰饮证施以苓桂术甘汤或葶苈大枣泻肺汤,对于心力衰竭病总的治疗原则均以益气养阴、回阳救逆为主,辅以活血化瘀、化痰平喘、利尿消肿。

The ancient literature named heart failure as heart attack,edema with the heart involved,or heart swell,etc.,its basic pathogenesis is deficiency as primary and excess as secondary,with heart qi and heart yang deficiency as primary,while with blood stasis,phlegm fluid retention as the secondary. The changes of asthma,palpitation and edema were the main syndromes in the development of the whole course of the disease. Different doctors have different characteristics of diagnosing and clinical experience of treating heart failure based on different syndrome types,but for deficient qi and yin,Pulse-Engendering Powder is often used. For yang deficiency,True Warrior Decoction is often used. For phlegm fluid retention,Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction; or Descurainiae and Jujube Lung-Draining Decoction is often used. The general treatment principles for heart failure are nourishing qi and tonifying yin,recuperating depleted yang and rescuing the patient from collapse combined with promoting blood circulation to remove stasis,removing phlegm and asthma,promoting diuresis and relieving swelling.