心力衰竭治疗方法及理念转变之争议分析

Analysis of Debates on the Change of Treatment Methods and Concepts of Heart Failure

关于心力衰竭(简称心衰)的病因病机和治疗中国自古以来就有所认识,而随着西医的传入与发展,基础和循证医学使人们更加深入地了解心衰的发病机制,并推动了心衰治疗方法及理念的更新。心衰已由最初的“水钠潴留”的病理生理机制过渡到“血液动力学异常”模式,再到“神经内分泌免疫调节”模式。近年来,人们对心衰综合征有了进一步的了解,同时随着医疗模式的转变及人文医学、哲学、心理学和全科医学的发展,心衰的诊断、治疗和预防理念产生了巨大的改变。

The etiology, pathogenesis and treatment of heart failure have been studied in China since ancient times. With the introduction and development of Western medicine, basic medicine and evidence-based medicine enable us to have a deeper understanding of the pathogenesis of heart failure, and promote the updating of the treatment methods and concepts of heart failure. Heart failure has evolved from the initial pathophysiological mechanism of "water and sodium retention" to the mode of "hemodynamic abnormalities" and then to the mode of "neuroendocrine immune regulation". In recent years, we have gained a better understanding of the syndrome of heart failure, and with the transformation of the medical model and the development of humanistic medicine, philosophy, psychology and general practice, the concept of diagnosis, treatment and prevention of heart failure are greatly changed.