牛天福运用治肝通脉法治疗冠状动脉粥样硬化性心脏病心绞痛经验总结

Professor NIU Tianfu’s experience in treating coronary heart disease angina pectoris by the Zhigan Tongmai method

冠状动脉粥样硬化性心脏病(简称冠心病)心绞痛属“胸痹”范畴。受现代作息习惯、工作压力、情志异常等因素影响,冠心病心绞痛患者日益增加,且患病人群越来越年轻化。冠心病心绞痛的病机变化包括“气病”“血病”“络病”“脉病”四个阶段,早期临床仅出现胸闷、气短、乏力、心慌等不适症状,属于现代医学中的亚健康状态,随着病情进展,可见动脉粥样硬化、血管痉挛、血管闭塞甚至坏死等由络脉异常引起的危急重症。治疗应当以“治肝通脉”为原则,分阶段论治。西医治疗该病的方法主要为手术治疗或药物维持,但其会大大降低患者的生活质量和治疗依从性,使得预后较差。导师牛天福以“气血络脉”为理论基础,提出该病早期治肝、中晚期通脉的治疗原则,临床据证加减用药,取得显著疗效。

Coronary heart disease angina pectoris belongs to the category of chest paralysis in TCM.Under the influence of modern work and rest habits,work pressure,emotional abnormalities and other factors,the number of patients with coronary heart disease angina pectoris is increasing,and the affected population is becoming younger and younger.The pathogenesis of coronary heart disease angina pectoris includes four stages:Qi(气)disease,blood disease,collateral disease and pulse disease.In the early clinical stage,there are only chest tightness,shortness of breath,fatigue,palpitation and other uncomfortable symptoms,which belong to the sub-health state in modern medicine.With the progression of the disease,atherosclerosis,vasospasm,vascular occlusion and even necrosis caused by collaterals dysfunction can be seen in patients with critical and severe diseases.The treatment should be based on the principle of treating disease in the liver and dredging the collateral.Western medicine are mainly surgery or drug maintenance,but those methods will greatly reduce the quality of life and treatment compliance of patients,making the prognosis of the patient poor.Based on the theory of Qi,blood,collateral and pulse,the instructor NIU Tianfu proposes the treatment principle of treating the liver in the early stage,and dredging the collaterals in the middle and late stages of the disease.The clinical medication is based on syndrome differentiation and treatment,and the effect is remarkable.