| 引用本文: |
高琨, 王如梦, 鞠建庆, 李立志.基于“腑以通为用”分期论治冠心病[J].湖南中医药大学学报,2025,45(2):312-317[点击复制] |
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| 基于“腑以通为用”分期论治冠心病 |
| 高琨,王如梦,鞠建庆,李立志 |
| (山西中医药大学, 山西 太原 030002;国家中医心血管病临床医学研究中心, 北京 100091) |
| 摘要: |
| 冠心病发病之本在心，心为五脏六腑之大主，与六腑密切相关，脏与腑互为表里，故可从腑论治。隐匿期少阳郁闭，气机不畅；进展期三焦不通，痰浊内生，坚结不散；急性期浊毒内生，腑气郁闭；恢复期脾肾亏虚，正气不足。治疗上当分清标本缓急，以通为补，通补结合。隐匿期疏肝利胆，行气通腑；进展期通利三焦，化痰散结；急性期活血解毒，通腑降浊；恢复期温通补虚，活血利水。该理论通过治腑养脏、增强人体正气、提高抗邪能力，为临床治疗冠心病提供思路和方法。 |
| 关键词: 冠心病 胸痹心痛 腑以通为用 分期论治 治腑养脏 诊疗思路 |
| DOI：10.3969/j.issn.1674-070X.2025.02.017 |
| 投稿时间：2024-06-26 |
| 基金项目:国家自然科学基金项目（82004145）；中国中医科学院西苑医院能力提升项目（XYZX0301-04）；山西中医药大学研究生优硕创新计划项目（2022YS001）。 |
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| Staged treatment of coronary heart disease guided by the principle of“fu organs functioning well in unobstructed state” |
| GAO Kun, WANG Rumeng, JU Jianqing, LI Lizhi |
| (Shanxi University of Chinese Medicine, Taiyuan, Shanxi 030002, China;National Clinical Research Center for Chinese Medicine Cardiology, Beijing 100091, China) |
| Abstract: |
| The root cause of coronary heart disease (CHD) lies in the heart, which governs the five zang organs and six fu organs. The zang organs and fu organs are externally-internally related, thus CHD can be treated from the perspective of the fu organs. During the latent stage, the stagnation and obstruction of the Shaoyang meridian result in disrupted and stagnant qi movement; in the progressive stage, blockage of the sanjiao leads to the internal generation of phlegm and turbidity, followed by the formation of hardness and masses; during the acute phase, endogenous turbid toxins arise, causing stagnation and obstruction of the qi of fu organs; during the recovery period, there is deficiency of the spleen and kidney, and insufficiency of healthy qi. In treatment, it is necessary to distinguish between the root and the manifestations, the urgent and the non-urgent, using the principle of "tonifying through dredging" and combining dredging with tonifying. During the latent stage, soothing the liver and regulating the gallbladder are performed to promote qi circulation and dredge the fu organs. In the progressive stage, unblocking the sanjiao is used to transform phlegm and dissipate masses. In the acute stage, circulating blood removing toxins, and dredging fu organs to purge turbidity are performed. During the recovery stage, warming, dredging, tonifying deficiency, circulating blood, and draining water are applied. This theory provides ideas and methods for the clinical treatment of coronary heart disease by treating the fu organs to nourish the zang organs, invigorating healthy qi, and improving the ability to resist pathogenic factors. |
| Key words: coronary heart disease chest bi-impediment and cardiac pain fu organs functioning well in unobstructed state staged treatment treating the fu organs to nourish the zang organs diagnosis and treatment approach |
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