摘要
报告2例生脉散治疗老年慢性心力衰竭。某男,82岁。胸闷、憋喘反复发作10余年,加重1月。面色晦暗,胸闷、憋喘,无胸痛,无咳嗽咯痰,周身乏力,自汗出,口干,双下肢水肿,纳尚可,眠差,二便调,舌紫黯有瘀斑,舌下脉络青紫,脉弦细数。中医诊断:喘证(气阴两虚,心血瘀阻证),益气养阴,活血化瘀,生脉散合桃红四物汤,人参12g,麦冬30g,五味子9g,桃仁、红花各30g,生地黄20g,当归9g,川芎15g,赤芍20g,柴胡15g,黄精30g,玉竹15g,车前子、冬瓜皮各30g。水煎400m L,1剂/d,嘱患者避风寒,畅情志,节饮食,适劳逸。7剂后复诊,憋喘较前减轻,周身乏力、口干症减,仍时有胸闷,双下肢水肿,舌紫黯,边有齿痕,原方加陈皮15g,茯苓30g。继服7剂后复诊,诸症好转。守方加减继服1月,病情稳定,无复发。某女,78岁。阵发性胸闷、憋喘20年,加重3天。神志清,精神差,胸闷、憋喘,活动后加重,烦躁,自述时有烦热,喜凉,口干,乏力,双下肢水肿。纳眠差,二便调。中医诊断:喘证(气阴两虚证)。治以益气养阴,生脉散,党参、麦冬各30g,五味子9g,石斛12g,炒白术15g,茯苓15g,当归12g,醋制鸡内金9g,焦山楂、麸炒神曲、炒麦芽各12g,三七粉冲服3g。水煎400m L,1剂/d,嘱患者避风寒,畅情志,节饮食,适劳逸。7d后复诊,胸闷、憋喘较前减轻,乏力、双下肢水肿减轻,仍时有烦热、口干,渴喜饮冷。守方加知母15g,秦艽9g。继服7剂后,诸症减轻。守方加减服用半年,随诊,病情稳定,无复发。尤可教授认为慢性心力衰竭辨证属气阴两虚,以生脉散为基础方,标本兼顾,临证加减,收效甚佳。
Report 2 cases of Chronic Heart Failure treated by Shengmai Powder. A male, 82 years old. Bosom frowsty, suppress for recurrent more than 10 years, increase in January. Complexion dark, bosom frowsty, suppress breath, chest pain, cough and expectoration, general fatigue, spontaneous sweating, dry mouth, double leg edema, fair, poor sleep, mainland tones, with dark purple tongue ecchymosis, sublingual veins purple, pulse count. TCM diagnosis： catch certificate（Qi and Yin deficiency, blood stasis resistance）. With qi and nourishing Yin, promoting blood circulation to remove blood stasis, Shengmai Powder（生 脉散） and Taohongsiwu Decoction（ 桃 红 四 物 汤）, ginseng is 12 g, dwarf lilyturf 30 g, schisandra 9 g, peach kernel, safflower each 30 g, rehmannia 20 g, 9g angelica sinensis, rhizoma ligustici wallichii 15 g, 20 g radix paeoniae rubra, radix bupleuri 15 g, huang jing 30 g, jade bamboo 15 g, semen plantaginis, winter melon skin 30 g each. Boiling water 400 m L, 1/d, instruct patients from cold, chang of modern, diet, overwork. After 7 agent appointment, suppress out earlier, the whole body fatigue, dry mouth, still sometimes chest tightness, double leg edema, dark purple tongue, side have teeth marks, the original party plus 15 g dried tangerine or orange peel, poria cocos 30 g. After 7 doses of appointment, the better. The defender to add and subtract in January following suit, in a stable condition, no recurrence. A female, the age of 78. Paroxysmal bosom is frowsty, suppress for 20 years, aggravating for three days. Mind, spirit bad, bosom frowsty, suppress out, after aggravating, irritability, readme have vexed hot, like cold, dry mouth, lack of power, the edema of lower limbs. Poor sleep, mainland. TCM diagnosis： catch certificate（Qi and Yin deficiency）. Born with qi and nourishing Yin, Shengmai powders, codonopsis, radix ophiopogonis each 30 g, schisandra 9 g, 12 g, caulis dendrobii Fried atractylodes 15 g, poria cocos 15 g, 12 g angelica, chicken＇s gizzard-membrane vinegar 9g
出处
《实用中医内科杂志》
2016年第6期77-79,共3页
Journal of Practical Traditional Chinese Internal Medicine
关键词
慢性心力衰竭
老年
喘证
心悸
水肿
生脉散
医学启源
桃红四物汤
气阴两虚
中医药治疗
chronic heart failure
old people
gasp syndrome
cardiopalmus
edema
Shengmai powder（生脉 散）
medicine origin
Taohongsiwu decoction（桃红四物汤）
Qi and Yin deficiency
traditional Chinese medicine treatment
