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马滨, 范虹, 李佼矫, 董洁, 张宇杰, 汪宏亮, 方烨, 田恩成, 时岩.范虹教授基于“阳气窒闭，浊阴凝痞”理论分期论治冠心病合并焦虑抑郁经验[J].湖南中医药大学学报,2026,46(7):1427-1433[点击复制] |
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| 范虹教授基于“阳气窒闭，浊阴凝痞”理论分期论治冠心病合并焦虑抑郁经验 |
| 马滨,范虹,李佼矫,董洁,张宇杰,汪宏亮,方烨,田恩成,时岩 |
| (陕西中医药大学中西医结合学院, 陕西 咸阳 712046;陕西省中医医院心病科, 陕西 西安 710003;中国中医科学院中医临床基础医学研究所, 北京 100700) |
| 摘要: |
| 范虹教授结合经典古籍及自身临床经验，基于“阳气窒闭，浊阴凝痞”论治冠心病（CHD）合并焦虑抑郁，认为其病机关键在于肝失疏泄、气机郁滞，导致阳气受遏、津液代谢障碍，形成“浊凝”的病理状态，其病机演变规律为“气滞痰阻→痰瘀互结→化热生毒→毒损心络→正虚邪恋”。范虹教授主张以“通阳化浊”为CHD合并焦虑抑郁的核心治则，分期动态干预：早期行气解郁、化痰宣痹以助阳运，方选瓜蒌薤白半夏汤合小柴胡汤加减；稳定期理气化痰、祛瘀通阳以消阴积，方选雷氏丹蒌方合柴芩温胆汤加减；急性发作期泻热除闭、解毒通络以散阴痼，方选黄连温胆汤加减；恢复期扶正固本、滋阴温阳以安心神，方选雷氏养心活血汤或自拟归元益心饮加减。临床每获良效，附验案一则以佐证。 |
| 关键词: 冠心病|焦虑|抑郁|阳气窒闭|浊阴凝痞|分期论治|名医经验|范虹 |
| DOI：10.3969/j.issn.1674-070X.2026.07.014 |
| 投稿时间：2026-02-13 |
| 基金项目:中国中医科学院学部委员学术传承与传播专项（CI2022E040XB）；国家中医药管理局国家中医药传承创新中心项目（发改办社会〔2022〕366号）；陕西省西安市科技计划项目（2024JH-YLYB-0188）；国家中医优势专科建设项目。 |
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| Professor FAN Hong's experience in stage-based treatment of coronary heart disease complicated with anxiety and depression based on the theory of "yang qi obstruction and turbid yin congelation with stuffiness" |
| MA Bin, FAN Hong, LI Jiaojiao, DONG Jie, ZHANG Yujie, WANG Hongliang, FANG Ye, TIAN Encheng, SHI Yan |
| (School of Integrated Chinese and Western Medicine, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi 712046, China;Department of Cardiology, Shaanxi Provincial Hospital of Chinese Medicine, Xi'an, Shaanxi 710003, China;Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China) |
| Abstract: |
| Professor FAN Hong, integrating classical ancient medical texts with her own clinical experience, treats coronary heart disease (CHD) complicated with anxiety and depression based on the theory of "yang qi obstruction and turbid yin congelation with stuffiness." She holds that the key pathogenesis lies in the liver's failure to govern the free flow of qi, leading to stagnation of qi movement, which suppresses yang qi and disturbs fluid metabolism, thus forming a pathological state of “turbid congelation." The evolution pattern of pathogenesis follows the sequence of "qi stagnation with phlegm obstruction→intertwined phlegm and blood stasis→heat transforming into toxin→toxin damaging the heart collaterals→healthy qi deficiency with lingering pathogenic factors." Professor FAN advocates "unblocking yang and transforming turbidity" as the core therapeutic principle for CHD complicated with anxiety and depression, and implements dynamic stage-based interventions. In the early stage, the treatment focuses on circulating qi and relieving depression, transforming phlegm and unblocking bi-impediment to assist yang movement, using modified Gualou Xiebai Banxia Decoction combined with Xiaochaihu Decoction. In the stable stage, it emphasizes regulating qi and transforming phlegm, transforming stasis and unblocking yang to eliminate yin accumulation, using modified LEI's Danlou Formula combined with Chaiqin Wendan Decoction. In the acute attack stage, it focuses on clearing heat and removing blockage, resolving toxins and unblocking collaterals to dissipate stubborn yin pathogens, using modified Huanglian Wendan Decoction. In the recovery stage, it centers on reinforcing healthy qi to strengthen the body, nourishing yin and warming yang to calm the heart spirit, using modified LEI's Yangxin Huoxue Decoction or her self-formulated Guiyuan Yixin Drink. This clinical approach consistently yields satisfactory therapeutic effects, and a verified medical record is attached as evidence. |
| Key words: coronary heart disease|anxiety|depression|yang qi obstruction|turbid yin congelation with stuffiness|stage-based treatment|famous physician's experience|FAN Hong |
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