摘要
心绞痛是冠状动脉粥样硬化性心脏病的主要表现形式之一,属于中医"胸痹"、"心痛"等范畴。痰瘀互阻是胸痹中较为常见证型,其表现为胸部闷痛,甚则胸痛彻背,喘息不得卧等。仝小林院士认为此类患者以痰瘀互结为态,是"痰"、"瘀"两种状态的叠加,痰浊内生与血脉淤滞两者相互影响,使病情逐渐加重,并以心血管拘挛堵塞为靶,需治疗上行气解郁,通阳散结,祛痰宽胸以调态,在打靶方面,选用理气化瘀药物协助解除脉管痉挛,辅以活血止痛药物缓解症状。用瓜蒌薤白半夏汤加三七、降香、蜈蚣粉为主方进行治疗。瓜蒌薤白半夏汤通阳散结,行气袪痰,从阳结、气滞、痰阻3个方面疏导"痰瘀互阻"之态。降香辛散化瘀、理气止痛,以"气络"为靶,贯通气血,循络理气行瘀;三七化瘀生新,活血定痛,以血络为靶,是治疗心绞痛的核心靶药;蜈蚣走窜通达、通经逐邪,畅通经络,气血得行;三药共打气血瘀滞之靶。针对痰瘀互阻心绞痛,态靶辨证模式不仅能宏观调胸痹痰瘀互阻之态,还可以针对冠脉斑块形成的病理改变精准打靶。"态靶因果"理论是基于中医传统辨证思维与现代医学科技成果相结合的思路,调整患者失衡之态,打击核心病理变化及临床症状之靶,实现中医诊疗的精准化和现代化,临床辨治态靶同调,效如桴鼓。
Theory of‘state-target-cause-prognosis’proposed by Prof.TONG Xiao-lin suggest a prescription model orientated towards multi-targeting treatment.Coronary heart disease with angina pectoris for example,“Gualou-Xiebai-Banxia Decoction”with dalbergiae odoriferae odoriferae lignum,notoginseng radix et rhizoma,scolopendra were suggested corresponding to the syndrome of obstruction of phlegm and blood stasis of the disease according to the theory.The basic formula“Gualou-Xiebai-Banxia Decoction”given a main structure focus on the general pathogenesis,with individual herb targeting specific pathological object.As syndrome of obstruction of phlegm and blood stasis is considered to be the most common syndrome of angina pectoris among clinical practice,it was deemed along with the blockage of cardio vessels to be the target of therapeutic approach.
作者
杨泽
苟筱雯
赵林华
仝小林
ZE Yang;GOU Xiaowen;ZHAO Linhua;TONG Xiaolin(Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)
出处
《辽宁中医杂志》
CAS
2021年第7期1-3,共3页
Liaoning Journal of Traditional Chinese Medicine
关键词
态靶辨证
冠心病
心绞痛
痰瘀互阻
瓜蒌薤白半夏汤
’State-Target’Strategy
Coronary Heart Disease
Obstruction of phlegm and blood stasis syndrome
Gua-Xiebai-Banxia Decoction
