基于不同辨证体系冠心病中医病机研究进展

Research Progress of TCM Pathogenesis of Coronary Heart Disease Based on Different Syndrome Differentiation System

近年来现代医家在古人认识胸痹心痛病机的基础上,结合现代医学手段及临床研究,对冠心病的中医病机探究不断延展深入。该文通过对近5年冠心病中医病机研究方面的文献分析总结,在中医药辨证论治的基础上,以气血津液理论、脏腑理论、络病理论、“阳微阴弦”理论等4个不同维度的辨证体系作为划分,归纳探讨冠心病中医病机发展。总结发现,从气血津液理论来探讨,主要为气虚血瘀、痰浊阻滞;从脏腑理论来探讨,主要为肺气不足、肝郁气滞、脾气亏虚、肾虚血瘀;从络病理论来探讨,主要为络脉瘀阻、络虚不荣、络风内动;从“阳微阴弦”理论来探讨,主要为上焦阳气不足、中下焦阴寒凝结。基于不同辨证体系对冠心病中医病机的分类探讨,以期为中医药治疗冠心病及其病机研究提供参考。

In recent years,on the basis of the ancient people’s understanding of the pathogenesis of chest pain,combined with modern medical means and clinical research,the TCM pathogenesis of coronary heart disease has been extended and deepened. Based on the literature analysis and summary of TCM pathogenesis of coronary heart disease in recent five years,this paper summarized and discussed the development of TCM pathogenesis of coronary heart disease on the basis of TCM syndrome differentiation and treatment,and divided the syndrome differentiation system from four different dimensions:Qi,blood and body fluid theory,Zang-fu theory,collateral disease theory and“weak pulse at Yang and stringy pulse at Yin”theory. In conclusion,from the theory of Qi,blood and body fluid,the main causes are Qi deficiency,blood stasis and phlegm turbidity block. From Zang-fu theory to discuss,mainly for lung Qi deficiency,liver stagnation and Qi stagnation,spleen deficiency deficiency,kidney deficiency and blood stasis;From the theory of collaterals disease,mainly for collateral stasis,deficiency of collaterals,internal movement of collaterals;From the“weak pulse at Yang and stringy pulse at Yin”theory to discuss,mainly for the lack of Yang in the upper coke,cold condensation of Yin in the middle and lower coke. Based on the classification of TCM pathogenesis of coronary heart disease under different syndrome differentiation systems,this paper aims to provide reference for TCM treatment of coronary heart disease and its pathogenesis research.