摘要
总结张军平教授治疗冠心病合并甲状腺功能减退症(甲减)的临证经验。认为阳虚是冠心病合并甲减发病的关键病机,并贯穿疾病发展始终。临证以温阳为基本治则,结合病位在血、脉、心、神侧重点的不同,总结出温阳四法辨证施治。脾肾阳虚、气化不利、血运失常者,治宜温阳益肾,以调气血,方用自拟补天方;寒湿阻脉、浊毒内生、心脉痹阻者,治宜温阳化浊,以畅心脉,方用自拟化浊畅脉汤;心体用俱衰,阳虚水泛、饮蓄心包者,治宜温阳利水,以育心体,方用自拟育心保脉方;阳虚致郁,心损神乱者,治宜温阳解郁,以安心神,方用自拟解郁安神汤。
This paper summarized Professor ZHANG Junping's clinical experience in treating coronary heart disease(CHD)combined with hypothyroidism.It is believed that yang deficiency was the root cause of CHD compli⁃cated with hypothyroidism,and also the key pathogenesis throughout its development.Accordingly,combined with the different focuses on the lesions in the blood,pulse,heart and spirit,Professor ZHANG took warming yang as the basic rule and summarized the four methods of warming yang for syndrome differentiation and treatment.When spleen-kidney yang deficiency,disturbance of qi transformation,dysfunction of blood transportation as the pathologi⁃cal basis of CHD combined with hypothyroidism,the self-prescribed Butian Formula(补天方)could be used for warming yang and benefiting the kidney,thereby regulating Qi and blood;when the cold and dampness blocked the blood vessels,and turbidity-toxin generated gradually,resulting in heart vessel obstruction,the self-prescribed Huazhuo Changmai Decoction(化浊畅脉汤)could be used to warm yang and dissolve the turbidity so that to unblock the heart vessels;when the structure and function of the heart fail,edema due to yang deficiency with pericardial fluid retention,the self-prescribed Yuxin Baomai Formula(育心保脉方)could be used to warm yang and excret water,and protect the heart;when yang deficiency led to emotional and mental stagnation,and the heart impair⁃ment aggravated emotional and mental disorders,which resulted in emotional and mental abnormalities,the selfprescribed Jieyu Anshen Decoction(解郁安神汤)could be used to relieve emotional and mental stagnation,and calm mind.
作者
李澳琳
廉璐
陈馨浓
严志鹏
张军平(指导)
LI Aolin;LIAN Lu;CHEN Xinnong;YAN Zhipeng(The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine/National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin,300381;Graduate School of Tianjin University of Traditional Chinese Medicine;Tianjin First Central Hospital)
出处
《中医杂志》
CSCD
北大核心
2024年第3期245-250,共6页
Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81774232)
中医药传承与创新“百千万”人才工程(岐黄工程)(国中医药人教函[2021]203号)
天津市名中医传承工作室专项资助(津卫中[2020]732号)。
关键词
冠心病
甲状腺功能减退症
阳虚
温阳
名医经验
张军平
coronary heart disease
hypothyroidism
yang deficiency
warming yang
experience of famous doctor
ZHANG Junping
