《金匮要略》分期辨治“心病”

"Synopsis of Golden Chamber"(金匮要略) to Distinguish "Heart Disease"(心病) in Stages

《金匮要略》乃"医方之祖,而治杂病之宗也",既有"心病"专篇论述,且有散见他篇的分期辨治。早期-心气不足,胸闷短气,气伤是主要表现,胸闷短气为并发症,治以参麦饮。中期-心阳不足,温煦功能减退,胸闷短气,心中空虚惕惕而动,脉结代等,治以小建中汤、桂枝甘草汤、炙甘草汤、桂枝去芍药加蜀漆牡蛎龙骨救逆汤。后期-痰瘀内阻,胸痹心痛,胸阳不振,阴寒内生,殃及心脉瘀滞不通而出现胸痹心痛,治以瓜蒌薤白白酒汤、栝蒌薤白半夏汤、薏苡附子散、乌头赤石脂丸。冠心病可归属为"胸痹""真心痛""心悸"等范畴,辨证可根据心气、心阳损伤程度早诊断,及时发现,分期诊治,截断病势。研究整理张仲景心病分期论治思路,对防治心病有重要指导意义。

＂Synopsis of Golden Chamber＂（金匮要略） is the ＂ancestor of the medical side, and the sect of the disease＂（心病）, which has a special chapter on ＂heart disease＂, and there are scattered stages of differentiation.Early-lack of heart, chest tightness and shortness of breath, Qi injury is the main performance, chest tightness and shortness of breath for complications, treated with Shenmai drink（参脉饮）. In the mid-term, the heart is not enough, the warming function is diminished, the chest tightness is short, the heart is hollow and the heart is empty, and the pulse is replaced. The treatment is Xiao Jianzhong decoction（小建中汤）, Guizhi Gancao decoction（桂枝甘草汤）, Zhigancao decoction（炙甘草汤）. Late-sputum internal resistance, chest pain, chest and Yang, Yin and cold endogenous, sputum and heart stagnation and stagnation, chest pain, heartache. Cure with Gualou Xiebai Baijiu decoction（瓜蒌薤白白酒汤）, Gualou Xiebai Banxia decoction（瓜蒌薤白半夏汤）, Yiyi Fuzi powder（薏苡附子散）, Wutou Chishizhi pill（乌头赤石脂丸）. Coronary heart disease can be classified into the categories of ＂chest＂, ＂true heart pain＂ and ＂heart palpitations＂. Syndrome differentiation can be diagnosed according to the degree of heart and heart-yang damage, timely detection, staged diagnosis and treatment, and truncation of disease. Studying and sorting out the thoughts of Zhang Zhongjing＇s heart disease and staging, it has important guiding significance for the prevention and treatment of heart disease.