从血虚论治冠状动脉粥样硬化性心脏病

On the Treatment of Coronary Heart Disease from Blood Deficiency

冠状动脉粥样硬化性心脏病(简称冠心病)的危险因素分内因和外因,外因多为寒、热之邪侵犯于心,使心脉拘急发为本病,内因主要有饮食失节、情志内伤、年老体迈、劳逸失度。临床上该病多从阳衰寒凝、气滞血瘀、痰湿阻滞、气阴两虚等方面论治。除寒凝、血瘀、痰湿、气阴两虚外,血虚亦可导致冠心病的发生与发展,故不仅要从气虚、阳伤、阳衰、阴虚等方面论治冠心病,还应注意血虚导致冠心病发生的情况。从《黄帝内经》《伤寒杂病论》到《景岳全书》都强调了血在人体生理以及病理活动中具有的主导性作用。所以增加对心脏的供给,即从补血、养血的角度来治疗冠心病是其治疗方法之一。在冠心病的中医辨证论治当中,不论是寒凝、血瘀、气滞亦或者是痰阻都不能忽略血虚在本病发生以及发展过程中的重要影响。因此,把握好冠心病"阳微阴弦"、本虚标实的基本病机,以补虚为主,泻实为辅,标本兼顾,才能提升冠心病的临床治疗效果。

The risk factors of coronary atherosclerotic heart disease(referred to as coronary heart disease) can be divided into internal and external factors.The external factors are mostly cold and heat,which invade the heart and make the heart pulse fast.The internal factors are mainly diet disorder,emotional internal injury,old age and improper work and leisure.Clinically,the disease is mainly treated from the aspects of yang failure,cold coagulation,qi stagnation and blood stasis,phlegm dampness block,deficiency of both qi and yin.In addition to cold coagulation,blood stasis,phlegm dampness and deficiency of both qi and yin,blood deficiency can also lead to the occurrence and development of coronary heart disease.Therefore,we should not only treat coronary heart disease from the aspects of qi deficiency,yang injury,yang failure and yin deficiency,but also pay attention to the occurrence of coronary heart disease caused by blood deficiency.From Huangdi′s Internal Classic,Treatise on Cold Damage and Miscellaneous Diseases to The Complete Works of Zhang Jing-yue,the leading role of blood in human physiological and pathological activities is emphasized.Therefore,to increase the supply of heart,that is,to treat coronary heart disease from the perspective of blood supply and nourishing,is one of its treatment methods.In the syndrome differentiation and treatment of coronary heart disease,whether cold coagulation,blood stasis,qi stagnation or phlegm obstruction,the important influence of blood deficiency in the occurrence and development of the disease cannot be ignored.Therefore,to grasp the basic pathogenesis of coronary heart disease: "weak pulse at yang and wiry pulse at yin" and primary deficiency and secondary excess,can improve the clinical therapeutic effect of coronary heart disease by mainly tonifying deficiency and purging excess together.