郭维琴辨治心肌炎经验

Professor Guo Weiqin’ s experience in differentiating and treating myocarditis

心肌炎是各种非缺血性原因诱发心肌急性、慢性炎症病变,导致心脏功能受损的一种疾病。本病发病隐匿,早期症状不典型,且多反复发作,部分会迁延难愈,可进展为扩心病、心力衰竭甚至死亡。现代医学治疗心肌炎以对症支持治疗为主,结合中医疗法治疗心肌炎可以提高临床疗效。郭维琴认为,心肌炎发病关键在于“正虚邪侵”,治疗上应中西医结合,早期以清热透邪为主,夹湿则治以清热化湿;中、后期益气活血、补益阴阳、调养心神,清热解毒药贯穿治疗始末。本文总结郭维琴辨证论治心肌炎的思路及经验用药。

Myocarditis is referred to a disease that is caused by acute and chronic inflammatory lesions of the myocardium and leads to impaired cardiac function.The disease is insidious in its early stage with the non-typical symptoms,and it often recurs,some of which will be prolonged and difficult to heal and may progress to cardiomyopathy,heart failure and even death.For the treatment of the disease,modern medicine is mainly based on symptomatic and supportive methods,which can be combined with traditional Chinese medicine to better improve its clinical effect.Guo Weiqin believes that the key to the pathogenesis of myocarditis lies in the“pathogen invasion due to deficient vital qi”,and it should be treated with the integrated Chinese and western medicine.In the early stage,it should be primarily treated by clearing heat pathogens.In case complicated with dampness,it should be treated by clearing heat and resolving dampness.In the middle and late stages,methods of replenishing qi and activating blood circulations,reinforcing yin and yang,regulating the mind and spirit are often employed,and heat-clearing and detoxifying drugs run through the whole treatment.Clinically,drugs can be modified according to specific syndromes to ensure a precise medication and a definite curative effect.This paper means to summarize Guo Weiqin’s thought and experience in the treatment of myocarditis based on syndrome differentiation.