| 引用本文: |
张世元, 向勇, 王婷, 李翠云, 熊尚全, 林超.基于“轻可去实”探讨花类药在稳定型心绞痛中的应用[J].湖南中医药大学学报,2026,46(2):348-354[点击复制] |
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| 基于“轻可去实”探讨花类药在稳定型心绞痛中的应用 |
| 张世元,向勇,王婷,李翠云,熊尚全,林超 |
| (福建中医药大学, 福建 福州 350108;福建中医药大学附属人民医院, 福建 福州 350004) |
| 摘要: |
| 稳定型心绞痛（SAP）属中医学“胸痹”“心痛”范畴，以“阳微阴弦”为核心病机，表现为心气亏虚之本与寒凝、气滞、血瘀、郁热、痰浊之标实夹杂。本病迁延难愈，需长期调理，若一味峻攻祛邪，易耗伤心气、损及阴血。中医“轻可去实”理论主张以质地轻清、气味芳香、作用灵动之品，透邪外出而不伤正气，恰契合SAP“通痹而不伤正、祛邪而不耗气”的治疗需求。花类药禀天地清气，质轻上浮，兼具散寒、活血、理气、化痰、清热之功，且性多平和，尤宜于本虚标实之证。本文基于SAP病机特点，结合“轻可去实”理论，针对寒凝、气滞、血瘀、郁热、痰浊五类实邪，提出温阳散寒（天山雪莲、丁香花、灯盏花）、疏肝理气（玫瑰花、代代花、合欢花）、活血通络（凌霄花、西红花、蒲黄）、辛凉清郁（金银花、菊花、蒲公英）、芳香化浊（旋覆花、款冬花、厚朴花）五组花类角药配伍。通过轻清透泄、灵动宣透之法，使痹阻得通、心脉得畅，为花类药在SAP长期管理中的应用提供理论与实践参考。 |
| 关键词: 稳定型心绞痛 轻可去实 花类药 胸痹 角药 |
| DOI：10.3969/j.issn.1674-070X.2026.02.018 |
| 投稿时间：2025-11-04 |
| 基金项目:国家中医药管理局第六批全国中医临床优秀人才研修项目(国中医药人教函[2025]256号);福建省名老中医专家传承工作室建设项目(闽卫中医函[2023]697号)。 |
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| Application of floral herbs in stable angina pectoris based on the theory of “light medicinals eliminating excess” |
| ZHANG Shiyuan, XIANG Yong, WANG Ting, LI Cuiyun, XIONG Shangquan, LIN Chao |
| (Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350108, China;The People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350004, China) |
| Abstract: |
| Stable angina pectoris (SAP) corresponds to the categories of "chest bi-impediment" and "heart pain" in TCM. Its core pathogenesis is characterized by "deficiency of yang with predominance of yin," manifesting as an underlying deficiency of heart qi complicated by excess manifestations, including cold coagulation, qi stagnation, blood stasis, depressed heat, and phlegm turbidity. This condition is chronic and refractory, requiring long-term regulation. Excessive use of aggressive methods to eliminate pathogenic factors may easily consume heart qi and damage yin-blood. The TCM theory of "light medicinals eliminating excess" advocates the use of medicinal substances that are light in quality, aromatic in odor, and agile in action to expel pathogens outward without damaging healthy qi. This precisely aligns with the therapeutic requirement for SAP:"unblocking the impediment without injuring the healthy qi, and dispelling pathogens without depleting qi." Floral herbs, endowed with the clear qi of heaven and earth, are light in quality and tend to ascend. They possess combined functions of dispersing cold, circulating blood, regulating qi, resolving phlegm, and clearing heat. Moreover, their nature is mostly neutral and balanced, making them particularly suitable for patterns of root deficiency with excess manifestations. Based on the pathological characteristics of SAP and guided by the theory of "light medicinals eliminating excess," this study proposes five triple combinations of floral herbs targeting the five major pathogenic factors-cold coagulation, qi stagnation, blood stasis, depressed heat, and phlegm turbidity. These include warming yang and dispersing cold[with Tianshanxuelian (Saussureae Involucratae Herba), Dingxianghua (Caryophylli Flos), and Dengzhanhua (Erigerontis Herba)]; soothing the liver and regulating qi[with Meiguihua (Rosae Rugosae Flos), Daidaihua (Citrus Aurantium Flos), and Hehuanhua (Albiziae Flos)]; circulating blood and unblocking the collaterals[with Lingxiaohua (Campsis Flos), Xihonghua (Croci Stigma), and Puhuang (Typhae Pollen)]; clearing depressed heat with pungent-cool herbs[with Jinyinhua (Lonicerae Japonicae Flos), Juhua (Chrysanthemi Flos), and Pugongying (Taraxaci Herba)]; and resolving turbidity with aromatic herbs[with Xuanfuhua (Inulae Flos), Kuandonghua (Farfarae Flos), and Houpohua (Magnoliae Officinalis Flos)]. Through methods that are light, diffusing, and agile in dispersing and discharging, this approach aims to unblock the impediment and clear the heart vessels, thereby providing both theoretical and practical reference for the application of floral herbs in the long-term management of SAP. |
| Key words: stable angina pectoris light medicinals eliminating excess floral herbs chest bi-impediment triple combination of herbs |
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