任寿山治疗慢性心力衰竭对药经验

Ren Shoushan’s experience of applying paired herbs in treating chronic heart failure

本文通过从分析药物性味、归经、功效及临证典型案例论述了任寿山治疗慢性心力衰竭常用对药的临床经验。慢性心力衰竭归属在中医"喘证""心痹""心水""心衰"等范畴,其病因病机错综复杂,病情瞬息万变,属于疑难顽固疾患。老师认为本病基本病机为本虚标实、虚实夹杂。本虚以心、脾、肾为主,标实为水停血瘀。尤其以心肾阳虚、水停血瘀贯穿疾病始终,治疗中扶正祛邪为主,扶正重益气温阳,祛邪重利水化瘀。老师在治疗本病时,谨守病机,继承前人和总结自己经验基础上,惯用验方同时巧妙配伍对药,加强了药物的效能,扩大了治疗范围,达到了气血阴阳并调,脏腑同治,加强主证疗效或治疗兼证、变证,或既病防变、未病先防,进而提高了临床治疗效果,值得传承。任寿山常用对药为黄芪伍党参、白术伍山药、淫羊藿伍仙茅、瓜蒌伍半夏、茯苓伍金钱草、丹参伍白芍、天花粉伍北沙参、绞股蓝伍罗布麻。

In this article, the clinical experience of Ren Shoushan in treating chronic heart failure is discussed through analyzing the flavor of herbal medicine, channel tropism, efficacy and typical clinical cases. Chronic heart failure belongs to the category of“ dyspnea”,“heart obstruction”,“ heart water” and“ heart failure” in traditional Chinese medicine. The pathogenesis of chronic heart failure is complex and the disease is constantly changing, so it is a difficult and stubborn disease. The teacher believes that the basic pathogenesis of this disease is deficient root and excessive branch, and it is also deficiency-excess complicated syndrome. Deficiency root is mainly based on heart, spleen and kidney, while excessive branch is blood stasis and water retention. Especially, heart and kidney yang deficiency, water retention and blood stasis should be run through disease all the while. The main treatment in the disease is strengthening body resistance and eliminating evil. Strengthening body resistance is in favor of supplementing Qi and warming Yang, while eliminating evil will help removing blood stasis and inducing dieresis. On the basis of historical records and his owner experiences, proved recipe is used at the same time, in addition to following the basic pathogenesis, the teacher can also skillfully use compatibility rules of paired herbs in the clinical treatment. Thus, the efficacy of drugs has been strengthened, helped substantially expand treatment coverage. It harmonizes the qi, blood, yin, and yang to achieve efficacy of treating viscera and the main symptoms, which could be result in treating the minor symptoms. Satisfactory clinical results are finally achieved based on the idea of“ prevention before disease onset, prevention of disease from exacerbating”, which is worthwhile for clinical inheritance. Paired herbs are frequently used by Ren Shoushan in the compatibility of Traditional Chinese Medicine, such as Astragali Radix and Codonopsis radix, Atractylodes and Chinese Yam, Epimedium and Curculigo, Fructus trichosanthis and Rhizoma pinelliae, Poria Cocos and Loosestrife, Salvia and White Peony Root, pollen and Radix Glehniae, Gynostemma Pentaphyllum Makino and apocynum.