以卫气营血理论辨治感染性心内膜炎

Differentiation and Treatment of Infective Endocarditis Based on Theory of Wei Qi and Ying Blood

感染性心内膜炎的临床表现及病程演变规律与中医温病学说的卫气营血理论体系极为相似,故其辨证分期可以卫气营血辨证为纲,以发热、脉象、斑疹的辨别为目。临证时若疾病处于卫分证期,则在卫汗之可也,可予辛凉平剂银翘散;若处于气分证期,则到气方可清气,可予小陷胸汤或泻心汤;若处于营分证期,则入营犹可透热转气,可予清营汤加人参、黄芪;若处于血分证期,则入血直须凉血散血,可予犀角地黄汤;若久病及肾,则应注重扶正祛邪,须在补阴的同时注重活血。

The clinical manifestations and the evolution of the disease course of infective endocarditis are very similar to the theoretical system of Wei Qi and Ying Blood in TCM theory of warm disease.Therefore, the syndrome differentiation and staging can be based on the syndrome differentiation of Wei Qi and Ying Blood, combined with distinguishing different cases of fever, pulse manifestation, and rash.If the disease is in the Weifen syndrome stage at the time of clinical diagnosis, then in the period of Weihan, pungent and cool-natured prescription of Yin Qiao Powder can be used.If it is in the Qifen syndrome stage, Xiao Xian Xiong Decoction or Xie Xin Decoction can be given.If it is in the Yingfen syndrome period, Heat should be cleard, and Qing Ying Decoction plus Renshen(Ginseng) and Huangqi(radix astragali) can be used.In the Xuefen syndrome stage, it is necessary to cool the Blood and disperse the Blood when entering the Blood, and Xi Jiao Di Huang Decoction can be given.If the chronic illness affects the Kidney, attention should be paid to strengthen Zheng Qi to eliminate evil factors to promote Blood circulation while nourishing the Yin.