从宗气功能失调探讨阵发性心房颤动的辨治

Diagnosis and Treatment of Paroxysmal Atrial Fibrillation Based on the Dysfunction of Zongqi

本文通过梳理中医宗气学说形成背景、发展源流及主要内涵,解析宗气生理功能及其病理状态下的不同表现,并结合阵发性心房颤动(PAF)的中医病机特点,认为“宗气失调、治节不出”为PAF主要病机,“心下空豁,脉律不齐”为PAF具体表现,脉象节律至数变化是PAF临床辨证治的重要参考,宗气亏虚、宗气郁滞、宗气下陷是其常见证型。治疗当以“调补宗气”为根本,通补兼施,包含调和营卫、安神定悸,开郁息风、化瘀通络,培元顾本、升阳举陷等法,并佐以养心、滋阴、温阳之品,气血并治,心神同调,则枢机得利、脏气得平、血脉得利、脏腑得安。

This paper systematically reviews the formation background,developmental origins,and main content of the Zongqi Doctrine in Traditional Chinese Medicine(TCM),thoroughly explicating the physiological functions of Zongqi and its varied manifestations under pathological conditions.By integrating the distinctive etiological characteristics of paroxysmal atrial fibrillation(PAF)according to TCM principles,it posits that"impaired regulation and dysfunction of Zongqi"constitutes a major underlying pathomechanism of PAF,while"emptiness beneath the heart manifesting as irregular pulse rhythm"represents the specific presentation of PAF.Variations in pulse rhythm and rate serve as significant parameters for differential diagnosis and treatment in PAF cases.Common TCM syndromes associated with PAF include Zongqi deficiency,Zongqi stagnation,and sinking of Zongqi.Treatment fundamentally revolves around"adjusting and replenishing Zongqi",employing a combined approach of invigorating and harmonizing Ying-Qi and Wei-Qi,calming the mind and stabilizing palpitations,dispelling stagnation and resolving phlegm,promoting blood circulation and removing stasis,reinforcing primordial Qi to support the root,and lifting Yang to rectify sinking.Complemented with nourishing the heart,enriching Yin,and warming Yang herbs,the therapy simultaneously addresses both Qi and blood,harmonizes the spirit,and thereby restores the function of the body's central regulator,balances visceral Qi,smoothes the circulation of blood vessels,and ensures the well-being of the zang-fu organs.