高荣林运用黄红生脉散治疗冠心病经验

Experience of Gao Ronglin in Using Huanghong Shengmai Powder for Treatment of Coronary Atherosclerotic Heart Disease

高荣林教授从事疑难杂病的临床工作近60年,在辨治冠状动脉粥样硬化性心脏病(以下简称(冠心病)上有独到见解,认为冠心病的病机以正虚(气阴不足)为本,痰瘀所致斑块为标;崇尚"正气存内,邪不可干"经典学说,将传统中药学和现代药理学紧密结合,自创黄红生脉散(黄芪、红景天、党参/西洋参、麦冬、五味子)以治疗冠心病之本,并在辨病基础上辨证论治,"观其脉证,知犯何逆,随证治之"。①痰热证,合二陈汤、小陷胸汤加减;②瘀血证,合丹参饮、三七加减;③气滞胸痛,加郁金等;④胸阳不振,合瓜蒌薤白汤类;⑤伴快速心律失常者,加苦参、甘松等;⑥肝热证为主者,加羚羊角粉等。总之,临床应用以黄红生脉散为基础,随证灵活加减,因时、因地、因人制宜,疗效颇佳。

Professor Gao Ronglin has been engaged in the clinical work of difficult and complicated diseases for nearly 60 years.He has unique insights in the treatment of coronary atherosclerotic heart disease(CHD).He believes that the pathogenesis of CHD is based on positive qi deficiency(inhibition of qi and yin),and the plaque which includes phlegm and blood stasis is the manifestation.He advocates the classic doctrine of"positive qi inside body,pathogens cannot invade",combines TCM pharmacy and modern pharmacology closely,and creates Huanghong Shengmai Powder(Astragali Radix,Rhodiolae Crenulatae Radix et Rhizoma,Codonipsis Radix/Panacis Quinguefolii Radix,Ophiopogonis Radix,and Schisandra Chinensis Fructus)to treat CHD.On the basis of disease differentiation,syndrome differentiation and treatment,he believes"viewing its pulse syndrome,knowing what mistaken therapy was applied,taking targeted treatments".①phlegm-heat syndrome:to combine modified Erchen Decoction with Xiaoxianxiong Decoction and so on;②blood stasis syndrome:to combine modified Danshen Decoction with Notoginseng Radix et Rhizoma and so on;③qi stagnation with chest pain:to combine Curcumae Radix,etc.;④chest-yang dysfunction:to combine Gualou Xiebai Decoction,etc.;⑤with rapid arrhythmia:to add Sophorae Flavescentis Radix,Nardostachyos Radix et Rhizoma,and so on;⑥liver-heat syndrome:to add antelope horn Powder,etc.In a word,Huanghong Shengmai Powder is the basis in clinical application,and it can be flexibly added and subtracted according to the syndrome,time,place and people,with good efficacy.