中国中医科学院广安门医院,北京市西城区北线阁5号,100053
huiyuhui55@sohu.com
收稿:2024-05-28,
修回:2024-07-15,
纸质出版:2025-01-02
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杜宜航,段城林,朱雪萍等.从“脾-脉-心-神”一体观辨治心房颤动[J].中医杂志,2025,66(01):89-92.
DU Yihang,DUAN Chenglin,ZHU Xueping,et al.Syndrome Differentiation and Treatment of Atrial Fibrillation based on the Holistic View of "Spleen-Vessels-Heart-Spirit"[J].Journal of Traditional Chinese Medicine,2025,66(01):89-92.
杜宜航,段城林,朱雪萍等.从“脾-脉-心-神”一体观辨治心房颤动[J].中医杂志,2025,66(01):89-92. DOI: 10.13288/j.11-2166/r.2025.01.014.
DU Yihang,DUAN Chenglin,ZHU Xueping,et al.Syndrome Differentiation and Treatment of Atrial Fibrillation based on the Holistic View of "Spleen-Vessels-Heart-Spirit"[J].Journal of Traditional Chinese Medicine,2025,66(01):89-92. DOI: 10.13288/j.11-2166/r.2025.01.014.
从“脾-脉-心-神”一体观探讨心房颤动的病机演变过程,提出脾失健运、血脉失和为其病起之端;痰瘀伏络、心体受损为其病成之基;心神不明、形神失调是其病进之因。针对疾病不同时期的病机变化特点,提出早期治疗以复运中焦、清利血脉为主,方用异功散加减;病情进展期以祛瘀化痰、养心保脉,方用自拟礞石通脉汤加减,而宁心定悸、调神安神则应贯穿其中,方用自拟甲枣宁脉汤或参英定悸汤加减。临床施治着眼于心房颤动整体病程,分期施治,从而实现对其早期干预和整体调治。
Based on the holistic view of "spleen-vessels-heart-spirit" system, this article explores the pathogenesis and progression of atrial fibrillation. It is proposed that the onset of atrial fibrillation is due to failure of the spleen to transport and disharmony of blood vessels; phlegm and blood stasis obstructing the collaterals and damage to the heart structure are the basis of its pathogenesis; the unclear mind and disorder of body and spirit are the causes of its progression. Based on the characteristics of pathological changes in different stages of the disease, it is proposed that early treatment should focus on restoring the middle
jiao
, clearing and promoting blood vessels, using modified
Yigong Powder
(异功散); during the p
rogression of the disease, treatment should remove blood stasis and phlegm, nourish heart and protect the pulse, using self-prescribed modified
Mengshi Tongmai Decoction
(礞石通脉汤); meanwhile, calming mind and stabilizing palpitations, and regulating spirit should be sequentially incorporated, with self-prescribed
Jiazao Ningmai Decoction
(甲枣宁脉汤) or
Shenying Dingji Decoction
(参英定悸汤) and modified as appropriate. Clinical treatment should focus on the whole disease course of atrial fibrillation, implementing stage-based treatments to enable early intervention and holistic regulation.
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