张明雪教授从阳虚论治冠心病合并慢性肾脏病的经验总结

发布时间：2018-06-12 11:55

本文选题：冠心病 + 慢性肾脏病　；参考：《辽宁中医药大学》2017年硕士论文

【摘要】：冠心病和慢性肾脏病是危害人类健康的常见病和多发病。在临床中,冠心病和慢性肾脏病二者常合而为病,病情复杂,相互影响。近年来,其患病率和死亡率在全球范围内呈持续增长趋势。现代医学对于冠心病合并慢性肾脏病的治疗主要采用对症治疗的措施,中医采用病与辨证相结合的方式在该病的治疗上具有着独特的优势。导师张明雪教授认为冠心病合并慢性肾脏病为本虚标实之证,其中阳气亏虚是其本虚的主要表现形式之一,同时由于阳气亏虚所导致的寒凝、痰饮、瘀血等病理产物亦与本病的发生密切相关。导师在临证之时常从“心悸、胸闷、胸痛、气短”等症状出发,紧扣“畏寒肢冷、腰膝冷痛酸软、夜尿增多或小便不利、颜面虚浮、肢体浮肿甚或全身浮肿”等特征性的临床表现,结合其本虚标实的发病特点,治以“温补心肾、宣痹通脉”之法,将参芪瓜蒌薤白半夏汤、济生肾气丸及二仙汤组合化裁,组成了以人参、黄芪、半夏、瓜蒌、薤白、肉桂、山药、山茱萸、车前子、泽泻、茯苓、仙茅、仙灵脾等为主要成分的基础方,随证加减,取得了良好的临床效果。本文通过总结导师治疗冠心病合并慢性肾脏病的辩证思维、选方遣药、临证经验,进而为冠心病合并慢性肾脏病的临床治疗提供有效的思路和方法。
[Abstract]:Coronary heart disease and chronic kidney disease are common diseases and frequent diseases that endanger human health. In clinic, coronary heart disease and chronic kidney disease are often combined as diseases. In recent years, the prevalence and mortality rate has been increasing in the world. In modern medicine, the treatment of coronary heart disease with chronic kidney disease is mainly based on symptomatic treatment, and TCM has a unique advantage in the treatment of the disease by combining disease with syndrome differentiation. Professor Zhang Mingxue, a tutor, believes that coronary heart disease combined with chronic kidney disease is the syndrome of underlying deficiency and that deficiency of yang qi is one of the main manifestations of this deficiency. At the same time, the cold and phlegm caused by deficiency of yang qi are also caused by phlegm. Blood stasis and other pathological products are also closely related to the occurrence of the disease. The tutor often starts from the symptoms of "palpitations, chest tightness, chest pain, shortness of breath", clasping "cold limbs, cold waist and knee pain, sore and tender waist and knee, increasing urine at night or unfavorable urination, and facial vanity." The characteristic clinical manifestations such as limb edema or even systemic edema ", combined with the characteristics of its original deficiency and standard substance, and the method of" warming up the heart and kidney, promoting Bi and unblocking the veins ", the combination of Shenqi Gualou Xiebai Banxia decoction, Ji Sheng Shen Qi Pill and Erxian decoction, The basic prescription was composed of ginseng, astragalus, Pinellia ternata, Trichosanthes trichosanthis, Allium macrostemon, cinnamon, yam, Cornus officinalis, Fructus plantaris, Radix Alismatis, Poria cocos, Festuca arundinacea and spleen of Xianling. This article summarizes the dialectical thinking of tutor in the treatment of coronary heart disease complicated with chronic kidney disease, chooses the prescription to send the medicine, the clinical experience, and then provides the effective thought and method for the clinical treatment of coronary heart disease complicated with chronic kidney disease.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R259

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