血府逐瘀汤治疗胸闷变异性哮喘的临床运用探析

Clinical Application of Xuefu Zhuyu Decoction in Treatment of Chest Tightness Variant Asthma

血府逐瘀汤出自清代王清任《医林改错》,治疗“胸不任物、胸任重物”等气滞血瘀所致的多种病状。胸闷变异性哮喘(chest tightness variant asthma,CTVA)是支气管哮喘的一种特殊类型,临床以“胸闷”症状为主,肺功能提示气道激发试验阳性或可逆性气流受限。CTVA患者常因情志、过敏、外感等因素诱发或加重,胸部憋闷,情绪烦躁,抑郁不舒,舌质偏暗,可伴瘀点,舌下络脉迂曲青紫或偏暗。患者体质类型主要涉及气郁质、血瘀质、特禀质,以气滞血瘀、枢机不利、宣降失司、出入失序为核心病机。血府逐瘀汤作为主方治疗CTVA,以理气活血,和调枢机,降逆平喘,终获良效。

Xuefu Zhuyu Decoction traces back to the Yi Lin Gai Cuo written by Wang Qingren in Qing Dynasty,applied to treat various symptoms caused by Qi stagnation and blood stasis,such as chest bearing nothing,chest bearing weight and other diseases caused by Qi stagnation and blood stasis.Chest tightness variant asthma(CTVA)is a special phenotype of asthma with chest tightness.Lung function examination shows that there is a positive airway stimulation test or variable airflow limitation.The symptoms of CTVA patients are chest tightness,agitation,and depression,which often induced or aggravated by emotional,allergic and exogenous factors.Besides,they tend to have signs like dark tongue,petechiae in tongue,tortuous or dark sublingual collaterals.The patients’constitution mainly involves Qi stagnation,blood stasis,and allergy.The core pathogenesis basis of CTVA concludes Qi stagnation,blood stasis,and rust pivot,unordered lung Qi movement of induce and descend.Therefore,Xuefu Zhuyu Decoction,the main therapeutic prescription of CTVA,regulates Qi and activates blood to reconcile the pivot and lower the adverse Qi.