基于“阳化气,阴成形”理论探讨扶阳抑阴法在心肌纤维化辨治中的应用

Exploring the application of the method of tonifying yang and abating yin in the diagnosis and treatment of myocardial fibrosis based on the theory of"yang generating qi,yin constituting the body"

心肌纤维化是多种心系疾病的共同病理表现,起病隐匿,可演变为不可逆心力衰竭,本病的临床诊治目前仍然存在不足。中医药可多层次、多靶点、多通路调治心肌纤维化,对心肌纤维化的治疗具有较大优势,其深层次机制值得进一步探讨。《黄帝内经》“阳化气,阴成形”理论是阴阳含义的具体化,蕴含着深刻的生命观、疾病观,心肌纤维化起始期、进展期、终末期的病理变化符合“阳化气,阴成形”理论,阳化气不足、阴成形太过,构成心肌纤维化的核心病机。本文提出以扶阳抑阴为心肌纤维化治疗原则,施以温阳、通阳、祛瘀、化痰、解毒、利水的治法,以期拓宽心肌纤维化的临床治疗思路。

Myocardial fibrosis is a common pathological manifestation of various heart diseases,with hidden onset and the possibility of evolving into irreversible heart failure.Currently,there is still insufficient diagnosis and treatment of myocardial fibrosis.Traditional Chinese medicine can regulate myocardial fibrosis at multiple levels,targets,and pathways,and has significant advantages in treating myocardial fibrosis.Its underlying mechanisms are worth further exploration.The theory of"yang generating qi,yin constituting the body"in Huangdi Neijing embodies the meaning of yin and yang,containing a profound outlook on life and disease.Pathological changes in the initial,progressive,and final stages of myocardial fibrosis conform to the yin-yang theory of"yang generating qi,yin constituting the body".Insufficient yang generating qi and excessive yin constituting the body constitutes the core pathogenesis of myocardial fibrosis.This article proposes a treatment approach for myocardial fibrosis by tonifying yang and abating yin.The treatment of warming yang,unblocking yang,removing blood stasis,resolving phlegm,detoxifying,and promoting diuresis is applied to broaden the clinical treatment approach for myocardial fibrosis.