“血不利则为水”理论论治心力衰竭研究

Treating heart failure based on the theory of“Unsmooth blood circulation results in water”

心力衰竭是临床常见难治疾病,是众多心血管疾病常见的直接死亡原因之一,其病因病机与气、血、水关系密切,其发展规律多在本“虚”的基础上产生了“瘀”“水”等病理产物,而“瘀”“水”又可互生,相因为病。张仲景在《金匮要略·水气病篇》中提出的“血不利则为水”这一论点,阐述了血水相因为病的内在联系,与心力衰竭的病机相吻合,同时也为活血利水法的实施提供了理论依据。本文结合心力衰竭的临床表现和病因病机,讨论分析“血不利则为水”的内涵及其在心力衰竭治疗中的应用和机理,认为在心力衰竭的治疗上当兼顾本虚和标实,在益气补虚的基础上灵活运用活血利水法,三者并用,各有侧重,为心力衰竭的临床治疗和实验研究提供理论依据和新的思路。

Heart failure is a common clinical refractory disease,is one of the direct causes of death of many cardiovascular diseases.Its etiology and pathogenesis are closely related to Qi,blood and water.Its development law mostly produces“blood stasis”and“water”and other pathological products on the basis of“deficiency”,while“blood stasis”and“water”can interact with each other and cause diseases.Zhang Zhongjing put forward the famous argument of“Unsmooth blood circulation results in water”in synopsis of the“The Golden Chamber’s Outline of Water and Gas Diseases”.It expounds the internal relationship between blood and water,which is consistent with the pathogenesis of heart failure,and also provides a theoretical basis for the implementation of the method of promoting blood circulation and promoting diuresis.In this paper,the clinical manifestations,etiology and pathogenesis of heart failure are discussed,This paper discusses and analyzes the connotation of“Unsmooth blood circulation results in water”and its application and mechanism in the treatment of heart failure.It is considered that both deficiency and excess should be considered in the treatment of heart failure.On the basis of supplementing Qi and tonifying deficiency,the method of promoting blood circulation and promoting diuresis should be used flexibly.Each of the three methods has its own emphasis,which provides theoretical basis and new ideas for clinical treatment and experimental research of heart failure.