病毒性心肌炎的分期辨治

Differentiation of Viral Myocarditis at Different Stages

对病毒性心肌炎进行深入探讨 ,抓住“虚、毒、瘀”三个病理关键。认识到各期病机特点为 :急性期乃病毒内侵是发病的关键 ;恢复期和迁延期为余邪未尽 ,气阴两虚 ,兼有血瘀 ;后遗症期为脏腑功能失调 ,虚实夹杂。治疗上分急性期为风热犯肺侵心证 ,湿热侵脾攻心证两型 ;恢复期和迁延期为热毒不尽、伤阴耗气证 ,湿毒留恋、伤阳耗气证和气阴两虚、毒瘀互结证三型 ;后遗症期则应儿童和成人分别论治 ,儿童多为气阴两虚 ,虚火扰心 ,成人多为脏腑失调。分期分型辨治 。

In the treatment of viral myocarditis it is important to have a good commend of the three characteristics of pathology-deficiency, toxin, and stagnancy. At the acute stage, virus invades the body being the critical stage. At the stage of convalescence and during the protracted course, pathogens are not fully dispelled, showing deficiency of both qi and yin and concomitant with blood stasis. At the stage of sequel, it reveals dysfunction of zang and fu organs and deficiency complicated with excess. The acute stage is further divided into two types, being respectively invasion of the lung by wind-heat and invasion of the spleen by damp-heat. The stage of convalescence and protraction is further divided into three types: consumption of yin and dissipation of qi because of lingering heat; consumption of yang and dissipation of qi because of lingering dampniess; and deficiency of both qi and yin, and intermittence of toxins and stagnancy. As far as the last stage is concerned, children and adults should be treated differently. The children's viral myocarditis is usually caused by deficiency of both qi and yin, and deficient fire injuring heart, while the adults' is usually caused by dysfunction of zang and fu organs. Satisfactory curative effect can be obtained with syndrome differentiation according to different stages and types.