论胸痹包括心肺两脏病机

On the pathogenesis of chest paralysis including both the heart and lungs

目前中医学界多认为胸痹病属于现代医学之冠状动脉粥样硬化性心脏病,但笔者认为,在病位上胸痹应包括心、肺两个脏的疾病;在病机上,二脏有差异,心之病多虚、肺之病多实;在治疗上,二者用药各有侧重,于心则温阳益气通脉、于肺则祛痰化饮理气,一偏补、一重泻。目前中医界对冠状动脉粥样硬化性心脏病治疗偏于活血化瘀疗法,是以泻为主,既非补心,又不属泻肺,实则仅适用于部分冠状动脉粥样硬化性心脏病后期的协同治疗,有以偏概全之嫌,反而易于引发临床冠状动脉粥样硬化性心脏病的治疗进入误区,当仔细甄别。

At present,the Chinese medical profession mostly believes that chest paralysis belongs to the modern medicine of coronary heart disease,but I believe that the location of the disease should include the heart and lung diseases;in the pathogenesis,the two organs have differences,the heart disease is more deficient,the lung disease is more solid;in the treatment,the two organs have their own emphasis on the use of medicine,in the heart is warm yang benefit qi and open the veins,in the lung is to remove phlegm and regulate qi,a partial tonic,a heavy diarrhea.The current treatment of coronary heart disease in Chinese medicine is biased towards blood activation and blood stasis treatment,which is mainly diarrhea,neither tonic heart nor diarrhea lung,which is only applicable to part of the late stage of coronary heart disease synergistic treatment,there is a suspicion of generalization,but easy to trigger the clinical treatment of coronary heart disease into misunderstanding,need to be carefully screened.