基于“火热论”及“火郁发之”理论探讨冠脉介入术后心绞痛证治思路

Discussion on the Diagnosis and Treatment of Angina After Coronary Intervention Based on the Theory of“Fire Heat”and“Fiery Depression Requiring Dissipation”

冠脉介入术后心绞痛具有极高的发病率,是目前临床亟须解决的难题。根据冠脉介入术后心绞痛发病时的临床症状将其归属于中医学“胸痹”范畴。文章以刘完素的“火热论”为基点并结合“火郁发之”理论,认为外感邪火是致病的重要因素、内生火热是发病的根本原因,总结出郁热之火、瘀热之火、阴虚内火、热毒之火、湿热之火均为冠脉介入术后心绞痛发病的重要病机,基于此化生出调、清、利、化、导五法以发郁热、泻实火、利湿热、化瘀热、导虚热等大法,为临床辨治本病提供新的思路。

Angina pectoris after coronary intervention has a very high incidence rate and is a difficult problem that needs to be solved urgently.According to the clinical symptoms of angina pectoris after coronary intervention,it belongs to the category of“chest paralysis”in traditional Chinese medicine.Based on Liu Wansu’s“fire heat theory”and combined with the theory of“fire stagnation requiring dissipation”,this paper believes that the exter⁃nal evil fire is an important factor causing the disease,and the internal fire is the root cause of the disease,and summarizes that the fire of depressed heat,the fire of stasis,the fire of yin deficiency and internal fire,the fire of heat toxin and the fire of damp heat are all important pathogenesis of angina pectoris after coronary intervention.