Analysis of the Treatment Strategy of Heart Failure with Preserved Ejection Fraction Based on ZHANG Boli's Theory of “Damp-turbidity and Phlegm-rheum Type of Diseases”

QIN Guangning; JIN Xinyao; LIU Yaoyuan; WANG Kai; JIANG Feng; HUANG Ming

doi:10.13288/j.11-2166/r.2024.01.007

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Analysis of the Treatment Strategy of Heart Failure with Preserved Ejection Fraction Based on ZHANG Boli's Theory of “Damp-turbidity and Phlegm-rheum Type of Diseases”

更新时间：2024-01-09

- Analysis of the Treatment Strategy of Heart Failure with Preserved Ejection Fraction Based on ZHANG Boli's Theory of “Damp-turbidity and Phlegm-rheum Type of Diseases”
- Journal of Traditional Chinese Medicine Vol. 65, Issue 1, Pages: 35-38(2024)
- 作者机构：
  
  1.天津中医药大学，天津市静海区团泊新城西区鄱阳湖路10号，301617
  2.天津中医药大学第一附属医院/国家中医针灸临床医学研究中心
  3.天津中医药大学第二附属医院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2024.01.007
  CLC：
- Received：15 August 2023，
  
  Revised：2023-10-11，
  
  Published：02 January 2024
- 稿件说明：
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秦广宁,金鑫瑶,刘耀远等.基于张伯礼“湿浊痰饮类病”学说浅析射血分数保留的心力衰竭治疗策略[J].中医杂志,2024,65(01):35-38.

QIN Guangning,JIN Xinyao,LIU Yaoyuan,et al.Analysis of the Treatment Strategy of Heart Failure with Preserved Ejection Fraction Based on ZHANG Boli's Theory of “Damp-turbidity and Phlegm-rheum Type of Diseases”[J].Journal of Traditional Chinese Medicine,2024,65(01):35-38.
秦广宁,金鑫瑶,刘耀远等.基于张伯礼“湿浊痰饮类病”学说浅析射血分数保留的心力衰竭治疗策略[J].中医杂志,2024,65(01):35-38. DOI： 10.13288/j.11-2166/r.2024.01.007.

QIN Guangning,JIN Xinyao,LIU Yaoyuan,et al.Analysis of the Treatment Strategy of Heart Failure with Preserved Ejection Fraction Based on ZHANG Boli's Theory of “Damp-turbidity and Phlegm-rheum Type of Diseases”[J].Journal of Traditional Chinese Medicine,2024,65(01):35-38. DOI： 10.13288/j.11-2166/r.2024.01.007.

摘要

张伯礼教授认为射血分数保留的心力衰竭（HFpEF）的核心病机为阳微阴弦，结合“湿浊痰饮类病”学说提出湿浊痰饮类阴邪在HFpEF的各个阶段都能损伤阳气，从而加重阳微阴弦之势，而湿、浊、痰、饮在HFpEF进展恶化过程中发挥了重要的促进作用。故张伯礼教授主张在HFpEF的各阶段重视祛除阴邪、固护阳气，以起延缓阳微阴弦加重之效；提出了“阴邪得祛，阳气得昭”的分期治疗思路；制定了治病求早、祛邪护阳、截断病势、药不远温、兼顾活血的治疗策略，以期丰富中医学治疗HFpEF的理论体系。

Abstract

Professor ZHANG Boli believed that the core pathogenesis of heart failure with preserved ejection fraction （HFpEF） is weak pulse at yang and wiry pulse at

yin

. By referring to the theory of “damp-turbidity and phlegm-rheum type of diseases”， he proposed that

yin

pathogens of damp-turbidity and phlegm-rheum may damage yang

in each stage of HFpEF， thus aggravating the trend of weak pulse at

yang

and wiry pulse at

yin

， which played an important role in the deterioration of HFpEF. Therefore， Professor ZHANG Boli advocated that importance should be attached to the elimination of

yin

pathogen and the protection of

yang

during the various stages of HFpEF in order to delay the aggravation of weak pulse at

yang

and wiry pulse at

yin

； he put forward the idea of staged treatment that “

yin

pathogen should be dispelled and

yang

should be demonstrated”； and he formulated the treatment strategy of treating the disease as early as possible， eliminating pathogens and protecting

yang

， interrupting the disease trend， using warm-like medicinals， and activating blood circulation， to enrich the theoretical system of traditional Chinese medicine in the treatment of HFpEF.

关键词

Keywords

references

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射血分数保留的心力衰竭诊断与治疗中国专家共识制定工作组 . 射血分数保留的心力衰竭诊断与治疗中国专家共识2023 ［J］. 中国循环杂志， 2023 ， 38 （ 4 ）： 375 - 393 .

李霄，金鑫瑶，吕玲，等 . 张伯礼“湿浊痰饮类病证治”学术思想撮要［J］. 中医杂志， 2022 ， 63 （ 17 ）： 1620 - 1624 .

GEVAERT AB ， KATARIA R ， ZANNAD F ， et al . Heart failure with preserved ejection fraction： recent concepts in diagnosis， mechanisms and management ［J］. Heart ， 2022 ， 108 （ 17 ）： 1342 - 1350 .

PERRONE-FILARDI P ， PAOLILLO S ， COSTANZO P ， et al . The role of metabolic syndrome in heart failure ［J］. Eur Heart J ， 2015 ， 36 （ 39 ）： 2630 - 2634 .

郑文科，柴山周乃，江丰 . 张伯礼教授临床用对（队）药经验谈［J］. 天津中医药， 2016 ， 33 （ 8 ）： 449 - 452 .

谢伟，康立源，王硕，等 . 张伯礼治疗冠心病经验［J］. 中医杂志， 2011 ， 52 （ 18 ）： 1539 - 1541 .

董国菊，刘思雨 . 射血分数保留心衰中西医病证结合的分期诊断专家共识［J］. 中华中医药学刊， 2023 ， 41 （ 5 ）： 254 - 258 .

金鑫瑶，张俊华，张立双，等 . 张伯礼分期诊治慢性心力衰竭经验［J］. 中医杂志， 2018 ， 59 （ 19 ）： 1633 - 1636 .

江丰，张磊 . 张伯礼教授痰瘀学说及临证应用经验［J］. 天津中医药， 2014 ， 31 （ 7 ）： 385 - 387 .

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