1.首都医科大学附属北京中医医院,北京市东城区美术馆后街23号,100010
2.北京中医药大学
lhx_@263.net
收稿:2023-03-22,
修回:2023-05-10,
纸质出版:2023-10-02
移动端阅览
李明轩,李红典,刘红旭等.从“瘀结生虚”论治心房颤动导管消融术后复发[J].中医杂志,2023,64(19):2041-2044.
LI Mingxuan,LI Hongdian,LIU Hongxu,et al.The Treatment of Recurrence after Catheter Ablation of Atrial Fibrillation from the Perspective of “Stasis Generating Deficiency”[J].Journal of Traditional Chinese Medicine,2023,64(19):2041-2044.
李明轩,李红典,刘红旭等.从“瘀结生虚”论治心房颤动导管消融术后复发[J].中医杂志,2023,64(19):2041-2044. DOI: 10.13288/j.11-2166/r.2023.19.017.
LI Mingxuan,LI Hongdian,LIU Hongxu,et al.The Treatment of Recurrence after Catheter Ablation of Atrial Fibrillation from the Perspective of “Stasis Generating Deficiency”[J].Journal of Traditional Chinese Medicine,2023,64(19):2041-2044. DOI: 10.13288/j.11-2166/r.2023.19.017.
认为“瘀结生虚”是心房颤动导管消融术后复发的重要病机。消融术后以血瘀为主,同时蕴结痰火、气滞、水饮等多种病邪,导致脏腑虚损,心失所养,应重视血瘀结合诸多实邪导致脏腑虚损在房颤导管消融术后复发中的重要地位。提出消融术前应化瘀与补虚并重,注重宁心化瘀、调补内虚以预防术后房颤复发;消融术后房颤复发则应重视化瘀祛邪、调脉补虚,重点关注瘀结痰火、瘀结气滞、瘀结水饮等实性病邪,并兼顾脏腑虚损之象,分别治以化瘀祛痰、降火通脉兼调补心脾,化瘀行滞、通畅气血兼补肺益气,祛瘀化饮、温阳活血兼固本养心为法,达标本同治之目的。
“Stasis generating deficiency” is considered to be an important pathogenesis of recurrence after catheter ablation of atrial fibrillation (AF). Blood stasis is commonly seen after ablation together with various pathogens such as phlegm-fire,
qi
stagnation and retained fluid, and will lead to depletion of
zang
-
fu
(脏腑) organs and then the failure of the nourishment of the heart. Therefore, it is advised to emphasize on the importance of considering
zang
-
fu
organs depletion caused by blood stasis and various excess pathogens in dealing with the recurrence after catheter ablation. The method of dissolving stasis and supplementing deficiency simultaneously has been proposed before catheter ablation, and it is critical to calm heart and dissolve stasis, regulate and supplement internal deficiency so as to prevent the postoperative recurrence of AF. For recurrence of AF after ablation, attention should be paid to dissolving stasis and dispelling pathogens, regulating vessels and supplementing deficiency, as well as the excess pathogens such as stasis binding and phlegm fire, stasis binding and
qi
stagnation, stasis binding and retained fluid, and the depletion of
zang
-
fu
organs should be considered. Accordingly, the method of dissolving stasis and dispelling phlegm, subduing fire and unblocking vessels, regulating and supplementing heart and spleen; dissolving stasis and move stagnation, unblocking
qi
and blood, supplementing lung and boosting
qi
; dispelling stasis and dissolving rheum, warming
yang
and activating blood, consolidating the root and nourishing heart can be used respectively, so as to treat both the root and the branch simultaneously.
KORNEJ J , BöRSCHEL CS , BENJAMIN EJ , et al . Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights [J]. Circ Res , 2020 , 127 ( 1 ): 4 - 20 .
BöRSCHEL CS , SCHNABEL RB . The imminent epidemic of atrial fibrillation and its concomitant diseases-myocardial infarction and heart failure:a cause for concern [J]. Int J Cardiol , 2019 , 287 : 162 - 173 . doi: 10.1016/j.ijcard. 2018.11.123 http://dx.doi.org/10.1016/j.ijcard.2018.11.123 .
LAU DH , NATTEL S , KALMAN JM , et al . Modifiable risk factors and atrial fibrillation [J]. Circulation , 2017 , 136 ( 6 ): 583 - 596 .
MUKHERJEE K , KAMAL KM . Impact of atrial fibrillation on inpatient cost for ischemic stroke in the USA [J]. Int J Stroke , 2019 , 14 ( 2 ): 159 - 166 .
王卓 , 王松云 , 陈卉 , 等 . 心房颤动的心室率控制及管理 [J]. 中国实用内科杂志 , 2023 , 43 ( 2 ): 94 - 96,101 .
中华医学会心电生理和起搏分会 , 中国医师协会心律学专业委员会 , 中国房颤中心联盟心房颤动防治专家工作委员会 . 心房颤动:目前的认识和治疗建议(2021) [J]. 中华心律失常学杂志 , 2022 , 26 ( 1 ): 15 - 88 .
PACKER DL , MARK DB , ROBB RA , et al . Effect of catheter ablation vs antiarrhythmic drug therapy on mortality,stroke,bleeding,and cardiac arrest among patients with atrial fibrillation:the CABANA randomized clinical trial [J]. JAMA , 2019 , 321 ( 13 ): 1261 - 1274 .
HINDRICKS G , POTPARA T , DAGRES N , et al . 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS) :the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC [J]. Eur Heart J , 2021 , 42 ( 5 ): 373 - 498 .
CHERIAN TS , CALLANS DJ . Recurrent atrial fibrillation after radiofrequency ablation: what to expect [J]. Card Electrophysiol Clin , 2020 , 12 ( 2 ): 187 - 197 .
王伟平 , 董玉江 , 高红梅 . 心房颤动的中医诊疗进展 [J]. 中国中医急症 , 2021 , 30 ( 8 ): 1494 - 1496,1500 .
高翔 , 于美丽 , 李金根 , 等 . 徐浩教授从“虚”“瘀”“风”论治阵发性房颤经验浅析 [J]. 中西医结合心脑血管病杂志 , 2016 , 14 ( 15 ): 1813 - 1815 .
杨湖 . 心房颤动中医病名病机及诊治探讨 [J]. 中医研究 , 2009 , 22 ( 5 ): 8 - 10 .
李明轩 , 来晓磊 , 刘红旭 , 等 . 从“脾胃生风”探讨阵发性房颤的中医证治 [J]. 中医杂志 , 2022 , 63 ( 12 ): 1186 - 1188 .
YAMANE T , MATSUO S , DATE T , et al . Repeated provocation of time-and ATP induced early pulmonary vein reconnections after pulmonary vein isolation:eliminating paroxysmal atrial fibrillation in a single procedure [J]. Circ Arrhythm Electrophysiol , 2011 , 4 ( 5 ): 601 - 608 .
LI CY , LI SN , JIANG CY , et al . Atrioesophageal fistula post atrial fibrillation ablation: a multicenter study from China [J]. Pacing Clin Electrophysiol , 2020 , 43 ( 7 ): 627 - 632 .
AKSU T , YALIN K , GULER TE , et al . Acute procedural complications of cryoballoon ablation: a comprehensive review [J]. J Atr Fibrillation , 2019 , 12 ( 3 ): 2208 .
赵健强 . 心房颤动射频消融术后复发危险因素研究 [D]. 杭州 : 浙江大学 , 2021 .
李敏 , 崔文竹 , 董玉江 . 中医辅助治疗房颤的研究现状 [J]. 中国中医药现代远程教育 , 2022 , 20 ( 15 ): 206 - 208 .
张娜 , 张军平 , 徐士欣 . 基于“血脉心神”一体观探析心律失常射频消融术后的病机变化 [J]. 中华中医药杂志 , 2018 , 33 ( 8 ): 3265 - 3267 .
酒俊龙 , 关乐 , 徐跃 , 等 . 心病从脾论治源流考辩 [J]. 中医杂志 , 2016 , 57 ( 23 ): 2066 - 2068 .
李红典 , 李明轩 , 张勉之 . 基于“心肾一体”辨证治疗糖尿病肾病 [J]. 世界中西医结合杂志 , 2023 , 18 ( 1 ): 187 - 190 .
0
浏览量
0
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号