基于“干血”论治PCI术后心绞痛

Treatment of Angina Pectoris After PCI Based on Ganxue Disease

经皮冠状动脉介入治疗术后心绞痛是以正虚为本,瘀血为标,火热为核。因虚致瘀,瘀阻化热,热灼血干,渐生“干血”,伏于心络之间,心脉失养,则心绞痛反复发作。针对“干血”深伏心络的病机,提出以攻邪养正为其治则,以润络和血、虫动其瘀、清热防变为其治法,以润药促其行,如地黄、白芍、桃仁等;以虫药配合风药祛其根,如水蛭、全蝎、蜈蚣等;以清热药防其传变,如大黄、黄芩、金银花等。“干血”一祛,心络复灌渗气血之功,心绞痛可缓。

Postoperative angina pectoris after percutaneous coronary intervention therapy is based on Zheng Qi deficiency in root,blood stasis in symptom and Heat as the core.Deficiency leads to blood stasis,and blood stasis can transform into Heat,and then dry blood is produced in the Heart meridians.If there is no enough nourishment in Heart meridians,angina pectoris would recur.In response to the pathogenesis of accumulation of dry blood in the Heart meridians,the principle of treatment is to attack pathogenic factors and to nourish the body.The method of treatment is to moisten the meridians and blood,to remove blood stasis with insect drugs,to clear Heat to prevent transformation.Moisturizing drugs such as Dihuang(Rehmannia glutinosa),Baishao(White peony)and Taoren(Peach kernel)are used to promote Qi movement.Insect medicines and Wind medicines such as Shuizhi(leeches),Quanxie(scorpions)and Wugong(centipedes)are used to remove the evil factors.Heat clearing drugs such as Dahuang(rhubarb),Huangqin(scutellaria baicalensis)and Jinyinhua(honeysuckle)are used to prevent disease transmission.Once the"dry blood"is eliminated,the Heart meridians are reinfused with Qi and blood,and angina can be alleviated.