王彦刚教授从脾胃论治心悸经验浅谈

Treatment of palpitations by spleen and stomach: Prof. WANG Yan-gang’s experience

文章主要对王彦刚教授从脾胃论治心悸的经验进行分析和总结。王彦刚教授认为心与胃二者相辅相成,紧密相连。首先,在生理上,二者位置相邻、经络相通、气血生化相因。其次,在病理上,可出现“母病及子”的临床表现,心悸之症的发生与脾胃疾病的发生发展密不可分。故临床治疗心悸时不应只单纯考虑是由心脏本身的病变所致。最后,在治疗上,王彦刚教授认为脾胃为全身气机升降之枢纽,指出脾胃失调是疾病之本,心失所养、心神受扰为疾病之标。强调从胃治心,总结出的心悸治疗八字原则:“标本兼顾,心胃同治”。临床诊疗强调治病求本,调理脾胃。擅用枳实、厚朴、升麻等药梳理脾胃气机;茵陈、石菖蒲等药清化脾胃湿浊。标本兼顾,顾护心脏。佐以夜交藤、合欢皮等药安心神;丹参、酸枣仁等药以养心血。王彦刚教授强调,在治疗中不可拘泥一脏,应做到精确辨证,灵活用药,应整体施治。另附医案一则,以验证。

This paper mainly summarizes Prof.Wang Yan-gang′s experience in treating palpitations from the spleen and stomach.Prof.Wang thought that heart and stomach complemented with each other and were closely correlated.In terms of physiology,they were adjacent in location and were connected by meridians and the operation of qi and blood.In terms of pathology,the clinical manifestations of“disorder of mother-organ affecting child-organ”may occur.The occurrence of palpitations was closely related to the occurrence and development of spleen and stomach disorders.Therefore,the treatment should not simply consider the pathological changes caused by the heart itself.Prof.Wang believed that the spleen and stomach were the pivot of the ascending and descending of qi.He pointed out that disorder of the spleen and stomach was the root,while failing to nourish the heart and harassing heart spirit were the branch.He summarized the principle of“treating the heart and stomach simultaneously by concentrating on both the root and the branch”,emphasizing the treatment of heart by regulating the spleen and stomach.Zhi Shi,Hou Po,Sheng Ma were applied to regulate qi movement;Yin Chen,Shi Xhang Pu were applied to eliminate turbid and resolve dampness in the spleen and stomach,as well as protecting the heart.Ye Jiao Teng,He Huan Pi were applied to tranquilize mind;Dan Shen,Suan Zao Ren were applied to nourish heart blood.Prof.Wang also emphasized that treatment should be made according to different conditions of specific cases,syndrome differentiation should be made accurately and medicine should be applied flexibly.A clinical case was put in the paper.