心力衰竭中醫病機探析(1)
[摘要] 心力衰竭在中醫中所屬的范疇較多，如喘息、心悸、心痹、水腫以及心水等，其基本病機為陰陽兩虛及心脈瘀滯，心力衰竭患者雖然陰陽均受到破損，但主要以陽虛為主，并伴有一定的陰虛，其疑難重癥為五臟精氣虛衰及功能失調。在臟腑病理上，雖然患者的諸多系統均有虛損性的病變，但其病變的重點主要為心腎；在心力衰竭血瘀證中，其病理特點為陽虛致瘀；氣虛血滯是導致患者體內水液潴留的主要原因。心力衰竭發病的根本原因為心氣虛衰，心氣虛衰發展加重的必然環節為心陽虛衰，并且血瘀在心力衰竭病理環節中占據著重要的地位。心衰病之本為因心氣虛而導致的心陽虛及心陰虛；心衰病之標為因心陽虛而導致的瘀血、痰濁以及水飲。心力衰竭的主要病理機制為心氣虛衰、腎陽虧損以及痰瘀內阻。該研究主要通過對心力衰竭的始動因素、關鍵病機以及病理進行分析，進而得出心力衰竭的中醫病機。
[關鍵詞] 心力衰竭；中醫病機；陰陽兩虛；心脈瘀滯；腎陽虧損
[中圖分類號] R541 [文獻標識碼] A [文章編號] 1674-0742(2015)09(b)-0196-03
[Abstract] Heart failure in TCM belongs in the category of more， such as breathing， heart palpitations， heart impediment， edema， cardiac edema and， the basic pathogenesis is deficiency of both yin and Yang and the heart blood vessels with，) in patients with chronic heart failure (CHF) although the Yin and yang are subject to damage， but mainly to the Yang mainly， and accompanied by a certain degree of yin deficiency， the difficult and severe as the essence of the five zang organs asthenia and functional disorders. In the pathology of Zang Fu organs， although with many systems have a virtual loss of lesions， but the focus of the lesions mainly for heart and kidney； in blood stasis syndrome of heart failure， the pathological characteristics for the deficiency caused by blood stasis， deficiency of Qi and blood stasis is the main cause in patients with fluid retention. The onset of heart failure root cause of heart qi deficiency and failure， heart qi asthenia aggravate the development of inevitable link for heart Yang decline and blood stasis in heart failure pathological link occupies a important position. The heart failure was due to deficiency of heart qi and heart yang deficiency， and deficiency of heart Yin； sign of heart failure is due to heart yang deficiency and blood stasis， phlegm and water to drink. The main pathological mechanism of heart failure of heart qi deficiency， Yang deficiency of the kidney failure and phlegm and blood stasis resistance.This article mainly through the initiating factor of heart failure， the key pathogenesis and pathological analysis， and then draw the TCM pathogenesis of heart failure.
[Key words] Heart failure； TCM pathogenesis； Blood stasis； Yin and Yang of the two virtual heart pulse； With Yang deficiency of the kidney
在臨床上，心力衰竭(CHF)屬于較為常見的危急重癥，其主要是由諸多心血管疾病發展而成，并且其預后效果較差。2001年，美國心臟病學會(AHA)經過統計發現，全美的心力衰竭患者約有500萬人左右，并且每年以50萬人左右的人數不斷上升，每年因心力衰竭而死亡的患者不低于30萬人[1]。心力衰竭對人們的生命造成了嚴重的威脅，目前，心力衰竭的主要治療方式為藥物治療。中醫藥在心力衰竭患者的治療中，不僅具有悠久的歷史，還具有良好的治療效果，對疾病的發展具有延緩作用，提高患者的生活質量[2]。導師趙繼福教授從事中醫心病研究多年，療效顯著，對心力衰竭的中醫病機有自己的見解，現報道如下。 (楊娜)
[關鍵詞] 心力衰竭；中醫病機；陰陽兩虛；心脈瘀滯；腎陽虧損
[中圖分類號] R541 [文獻標識碼] A [文章編號] 1674-0742(2015)09(b)-0196-03
[Abstract] Heart failure in TCM belongs in the category of more， such as breathing， heart palpitations， heart impediment， edema， cardiac edema and， the basic pathogenesis is deficiency of both yin and Yang and the heart blood vessels with，) in patients with chronic heart failure (CHF) although the Yin and yang are subject to damage， but mainly to the Yang mainly， and accompanied by a certain degree of yin deficiency， the difficult and severe as the essence of the five zang organs asthenia and functional disorders. In the pathology of Zang Fu organs， although with many systems have a virtual loss of lesions， but the focus of the lesions mainly for heart and kidney； in blood stasis syndrome of heart failure， the pathological characteristics for the deficiency caused by blood stasis， deficiency of Qi and blood stasis is the main cause in patients with fluid retention. The onset of heart failure root cause of heart qi deficiency and failure， heart qi asthenia aggravate the development of inevitable link for heart Yang decline and blood stasis in heart failure pathological link occupies a important position. The heart failure was due to deficiency of heart qi and heart yang deficiency， and deficiency of heart Yin； sign of heart failure is due to heart yang deficiency and blood stasis， phlegm and water to drink. The main pathological mechanism of heart failure of heart qi deficiency， Yang deficiency of the kidney failure and phlegm and blood stasis resistance.This article mainly through the initiating factor of heart failure， the key pathogenesis and pathological analysis， and then draw the TCM pathogenesis of heart failure.
[Key words] Heart failure； TCM pathogenesis； Blood stasis； Yin and Yang of the two virtual heart pulse； With Yang deficiency of the kidney
在臨床上，心力衰竭(CHF)屬于較為常見的危急重癥，其主要是由諸多心血管疾病發展而成，并且其預后效果較差。2001年，美國心臟病學會(AHA)經過統計發現，全美的心力衰竭患者約有500萬人左右，并且每年以50萬人左右的人數不斷上升，每年因心力衰竭而死亡的患者不低于30萬人[1]。心力衰竭對人們的生命造成了嚴重的威脅，目前，心力衰竭的主要治療方式為藥物治療。中醫藥在心力衰竭患者的治療中，不僅具有悠久的歷史，還具有良好的治療效果，對疾病的發展具有延緩作用，提高患者的生活質量[2]。導師趙繼福教授從事中醫心病研究多年，療效顯著，對心力衰竭的中醫病機有自己的見解，現報道如下。 (楊娜)