“血-脉-心-神”一体观指导下的扩张型心肌病辨治思路

Treatment of the dilated cardiomyopathy under the guiderance of‘blood-vessel-heart-spirit’integral view

扩张型心肌病(DCM)是引发心力衰竭的常见原因,临床难治且预后差。现代医学主要针对并发症处理,此时心肌已严重损伤,犹如“渴而凿井,斗而铸锥,不亦晚乎”。从中医整体观角度出发,认为DCM的发生、发展过程伴随着血、脉、心、神俱变的病理过程,故在“血-脉-心-神”一体观指导下谨守病机,分期论治,及早截断疾病进程。初期益气养阴,清透伏邪;迁延期益肾健脾,软坚散结;后期温阳利水,育心保脉。发挥中医药治疗DCM的优势,及时纠正“血-脉-心-神”偏衡状态,抑制病情进展,改善患者症状,提高患者生活质量。

Dilated cardiomyopathy(DCM)is a common cause of heart failure,which is difficult to treat and has a poor prognosis.Modern medicine is mainly based on treatment of complications when the heart muscle is often seriously damaged.It is like‘it is not too late to dig a well when you are thirsty and cast a cone while fighting’.Based on the theory of holistic view of traditional Chinese medicine,the occurrence and development of DCM is accompanied by the pathological process of bloodvessel-heart-spirit.Therefore,under the guidance of the concept of‘blood-vessel-heart-spirit integration’,we should observe the pathogenesis,treat by stages and cut off the disease process as soon as possible.In the early stage,it can be supplementing qi and nourishing yin,clear away the insidious pathogen;in the later stage,it can be invigorating the kidney and spleen,softening and resolving hard masses;in the latest stage,it can be warming yang and promoting diuresis,cultivate the heart and protect the pulse.To give full play to the advantages of traditional Chinese medicine in the treatment of DCM,timely correct the imbalance of‘blood-vessel-heart-spirit’,delay ventricular remodeling,control the progress of the disease,improve the symptoms and the quality of life of patients.