胸痹(冠心病)病机演变探微

The discussion of pathogenesis of Xiongbi(DHD)

从整体角度 ,在文献研究的基础上论述了胸痹病机演变的一般规律。认为胸痹病机多见本虚标实 ,心阳虚与心阴虚是胸痹的始发病机 ,为疾病之本 ;痰浊、血瘀是机体阴阳气血津液代谢失调的病理产物 ,一经形成又作为致病因素导致病机发生转变 ,为病机演变的必然过程 ,并常可相兼互化 ,为疾病之标 ;以上病机形成之后常缠绵难愈 ,不易祛除。胸痹病程日久 ,病机日渐复杂 ,常易引起寒凝、气滞和郁热 ,导致胸痹的急性发作或进一步加重 ,经有效治疗后容易逆转 ,为标中之标。以上构成了胸痹病机动态演变的基本规律 ,在治疗上应分清标本主次 ,辨证施治 ,急性期或芳香温通、或行气解郁、或清解郁热以治其标 ,缓解期益气养阴 ,活血化痰以治其本。

The article discuss the general rule of the pathogenesis of Xiongbi(CHD) based on the research on literature.Considering that characteristics of pathogenesis is that asthenia in origin and excess in superficiality,normally the basis is the deficiency of heart Yang and the vacuity of heart Yin,they are asthenia in origin,the retention of phlegm and blood stasis are the production of the metabolic disorder yin and yang,qi and blood and body fluid.They become the etiological factors and induce the transformation of pathogenesis.It is the process of the transformation.They also transfoum mutually and called excess in superficiality.All above are always difficult to cure after formed.After a long time often form cold accumulation,stagnant of Qi and heat retention and cause the acute episode or aggravation.They are the superficiality in superficiality.The principle of treatment is to activate yang with aromatic herbs or promote the circulation of Qi or clear heat retention during the acute stage,reinforce Qi and yin and resolve phlegm and blood stasis during chronic stage. Author's address:1 HeiLongJiang University of Traditional Chinese Medicine,Harbin 150040,China;2 China Academy of Chinese Medicine,BeiJing 100700