徐浩教授巧用麻黄附子细辛汤治疗病态窦房结综合征经验

XU Hao's Experience in Treating Sick Sinus Syndrome with Mahuang Fuzi Xixin Decoction

病态窦房结综合征是临床常见病证,西医对本病的治疗方法及效果有限。徐浩教授长期从事中西医结合防治心血管疾病的研究,擅用经方,在病态窦房结综合征的临证诊疗中具有独到见解,认为本病病位在心,与脾肾密切相关,多属本虚标实之证,治疗上多以温阳散寒为基本法则,贯穿治疗始终。麻黄附子细辛汤是《伤寒论》中治疗太阴少阴两感的代表方。面对希望保守治疗且辨证属阳虚寒凝的病态窦房结综合征患者,徐浩教授擅用本方治疗,并结合现代药理学研究成果,形成了独特的治疗与用药思路,敢用大剂量,且酌情配伍凉药以使得全方“温阳而不助火”,同时必搭配熟地黄以顾护根本,并在本方基础上随证加减,对减轻症状、改善心电图相关指标取得良效。本文主要对徐浩教授运用麻黄附子细辛汤治疗病态窦房结综合征的临证经验进行探析,以期为本病的诊疗提供借鉴。

Sick sinus syndrome is a common clinical condition,and the method and efficacy of western medicine in the treatment of this disease are limited.Prof.Hao Xu has long been engaged in the research of integrated traditional Chinese and Western medicine for the prevention and treatment of cardiovascular diseases and has unique insights into the clinical diagnosis and treatment of sick sinus syndrome.He believed that the location of the disease is the heart,closely related to the spleen and kidney,most of which is a syndrome of deficiency in origin and excess in superficiality,and therapeutically most of them use Warming Yang and dispersing cold as the basic law throughout the treatment.Mahuang Fuzi Xixin decoction(麻黄附子细辛汤)is the representative prescription for taiyin and shaoyin(太阴少阴).Faced with a sick sinus syndrome patient who hopes for conservative treatment and belongs to Yang deficiency cold coagulation,Prof.Hao Xu was clinically adept at using this formula.He combined the results of modern pharmacology research and formed a unique idea of treatment and medication.He is brave to use large doses,and cold herbs as appropriate to make the whole prescription“Wenyang and not conducive to fire”,while having to be paired with Shudihuang(Rehmannia glutinosa)to take care of the root,as well as plus or minus other herbs with symptoms,thus achieves good results on improving symptoms and electrocardiogram related indicators.In this paper,we mainly explore the clinical experience of Prof.Hao Xu using Mahuang Fuzi Xixin Decoction(麻黄附子细辛汤)to treat sick sinus syndrome,to provide a reference for the diagnosis and treatment of sick sinus syndrome.