基于“肺主治节”论述心肺同治快速型心律失常

Based on the"Regulatory functions of lung",the cardiopulmonary co-treatment of rapid arrhythmias is discussed

快速型心律失常临床表现除心系症状外,常伴有气短、胸闷等肺系症状,对患者心理、生活质量产生严重影响,未经及时治疗可导致心力衰竭。快速型心律失常病位在心,与肺密切相关,以宗气亏虚为主要病机,可兼有肺气壅滞、水饮痰瘀互结于心脉,虚实夹杂或转化。基于“肺主治节”理论,从“宗气”“肺气宣降”“痰饮夹瘀”3个方面阐述心肺同治快速型心律失常,治疗应循“补益宗气”“宣肺化饮”“活血化瘀”,可选用升陷汤、生脉散、苓桂术甘汤、小青龙汤、血府逐瘀汤等;药如人参、党参、刺五加、瓜蒌皮、桔梗、葶苈子、桃仁、郁金等,依证择药,且以上药物皆入肺经,对快速心律失常皆有拮抗的药理作用,故临床医生诊治该病时不可忽视“从肺疗心”“心肺同治”。

In addition to the cardiac symptoms,the clinical manifestations of rapid arrhythmias are often accompanied by shortness of breath,chest tightness and other pulmonary symptoms,which have a serious impact on the patient's psychology and quality of life,and can lead to heart failure without timely treatment.The rapid arrhythmia is located in the heart,closely related to the lungs,with the deficiency of Zongqi as the main pathogenesis,which can be combined with lung-qi stagnation,water drinking phlegm stasis in the heart pulse,and the virtual reality is mixed or transformed.Based on the theory of"Regulatory functions of lung",this paper expounds the cardiopulmonary co-treatment of rapid arrhythmias from the three aspects of"Zong Qi","Lung-Qi Descending",and"Phlegm Drinking and Stasis",and the treatment should follow the"Tonic Zong Qi","Clear the lungs and eliminate the phlegm","Blood Activating Stasis",and can choose Sheng Xian Decoction,Sheng Mai Powder,Ling Gui Zhu Gan Decoction,Xiao Qing Long Decoction,Xue Fu Zhu Yu Decoction,etc.;drugs such as Ginseng,Dang Ginseng,Acanthopanax,Trichosanthes Peel,Platycodon,Semen Lepidii,Peach Kernel,Radix Curcumae,etc.,according to the evidence,and the above drugs are all into the lung meridian,and have antagonistic pharmacological effects on tachyarrhythmias.Therefore,when clinicians diagnose and treat the disease,they should not ignore"healing the heart from the lungs"and"treating the heart and lungs together".