尹小星教授从中医经典论治心律失常疾病

A Brief Analysis of Classic Treatment of Arrhythmia Diseases by Professor YIN Xiaoxing

心律失常临床上常可分为快速性和缓慢性两类,其中快速性心律失常,西医一般采用介入疗法,如治疗室上性心动过速、频发早搏、心房颤动常采用射频消融术的治疗方式,但大部分人群很难接受手术治疗,选择长期口服药物治疗,尤其是阵发性心房纤颤,如房性或室性早搏。缓慢性心律失常,对于一些心室率较低患者,西医一般采取起搏器治疗。中医将心律失常归属于“心悸”“怔仲”范畴,尹小星教授认为心悸是因阴、阳、气、血不足或过胜所致,病理产物包括痰、火、瘀、水等,其也是引起心悸发生的致病因素。临床上在遣方用药中应随证加减,根据阴阳、气血偏衰,标本的缓急,邪正的虚实,做全面分析,对方药进行恰当化裁,符合病机的变化。

Clinically arrhythmia can often be assigned into 2 categories,fast and slow.For tachyarrhythmia,In Western medicine,intervention therapy is usually taken.For example,supraventricular tachycardia,frequent premature beat,and atrial fibrillation are often treated by radiofrequency ablation,but most people find it hard to accept the surgical treatment,choosing long-term oral drug therapy,especially for the patients with paroxysmal atrial fibrillation(PAF)such as atrial or ventricular premature beat.For bradyarrhythmia,like some patients with low ventricular rate,pacemaker is commonly used by Western medicine for the treatment.In traditional Chinese medicine,arrhythmia belongs to the category of"palpitation"and"Zheng Zhong".According to Professor YIN Xiaoxing,the pathogenesis of heart palpitations is caused by deficiency of yin,yang,qi and blood or excessive excess.The pathological products include phlegm,fire,blood stasis and water,which are also the pathogenic factors causing heart palpitations.Clinical prescription should be modified based on the syndrome,and a comprehensive analysis should be conducted according to the condition of yin and yang,qi and blood,the severity of the symptoms and root,the deficiency-excess of evil and vital qi.The prescription should be adjusted appropriately,so that it can be in accordance with the change of pathogenesis.