延年半夏汤治疗胸痹心痛机制初探

Initial Theoretical Analysis of Yannian Banxia Decoctionin the Treatment of Chest Impediment with Heart Pain

延年半夏汤出自《外台秘要》引《延年秘录》,主治腹中痃癖硬急、气满不食、胸背痛,其中痃癖与胸痹心痛病机相通、症状相近,以方测证,此方可用以治疗阳微阴弦之胸痹心痛。通过方证溯源,延年半夏汤由通气汤、吴茱萸汤化裁而来,全方通阳活血、降逆化痰,升降相宜,动静结合,气血同调,心、肺、胃同治,临床加减治疗阳虚寒凝、痰瘀互结之胸痹心痛可取得佳效。

Yannian Banxia Decoction was recorded in Wai Tai Mi Yao quoted from Yan Nian Mi Lu,which is mainly applied to treat abdominal mass(Xuan Pi)and acute pain,inability to eat due to qi fullness,and chest and back pain. Xuan Pi has similar pathogenesis and symptoms with chest impediment and heart pain. According to syndrome differentiation through prescription effect assessment,Yannian Banxia Decoction can be used to treat chest impediment with heart pain which arises and develops by yang debilitation and yin exuberance. Bytracing the prescriptionand syndrome,it turns out that Yannian Banxia Decoction isdeveloped from Tongqi Decoction and Wuzhuyu Decoction. The main treatment methods of the prescription are regulating yang and promoting blood circulation,reducing inverse phlegm,appropriate rise and fall,combination of dynamic and static,qi and blood harmonization,heart,lung,stomach treatment together. The modified prescription can produce good effect on treating yang deficiency cold coagulation,phlegm and blood stasis mutual chest impediment with heart pain.