从实邪论治心力衰竭

发布时间：2019-06-03 18:44

【摘要】：目的:本论文主要通过探讨痰热、痰湿、积滞等实邪与心衰发生、发展之间的关系,为心衰的中医药临床治疗提供理论基础,最终达到能够延长心衰患者的生存时间,提高患者的生活质量的目的。方法:本论文主要通过总结吾师杨祥坤教授在从事临床30年间从实邪(痰热、痰湿、积滞)角度对心衰发生、发展、转归及预后的认识,并且系统剖析了运用大陷胸汤合枳实导滞丸治疗实邪壅塞三焦证之心衰的原则。首先,本论文交代了我们研究心衰疾病的背景。然后,本论文主要介绍了我们的研究内容。研究内容包括心衰的病变脏腑、对实邪的认识、实邪壅塞三焦证的临床特征、实邪壅塞三焦证的病机、实邪壅塞三焦证的治疗。心衰的病变脏腑主要是从病变的部位及其生理病理功能方面来阐述。对实邪的认识主要是从痰热、痰湿、积滞等实邪的产生脏腑、产生机理、性质特点及其临床表现来阐述。实邪壅塞三焦证的治疗主要是从该证的辨证施治、大陷胸汤合枳实导滞丸的组方分析及各味中药的现代药理认识方面来阐述。最后,本论文通过对典型病例的介绍来验证吾师杨祥坤教授的上述理论。结果:通过我们研究发现,临床上部分心衰患者的病变部位主要在三焦,临床表现为痰热、痰湿、积滞等实邪壅塞三焦的症候,主要为咳喘短气,不得平卧,喘满胸闷,痞满腹胀,呕吐,大便干结,小便短少,水肿,舌质暗红苔黄脉滑等。心衰之痰热、痰湿、积滞等实邪壅塞三焦的病机为心病日久,在各种致病因素的诱发作用下,引起肺无法通调水道,且同时引起脾无法运化水液,肾无法主水,形成痰热、痰湿、积滞等有形实邪,壅塞三焦。结论:通过临床观察,我们认为痰热、痰湿、积滞等实邪壅塞三焦是心衰的一个重要证型,依此辨证予以大陷胸汤合枳实导滞丸治疗,对部分心衰患者有较好的临床疗效。
[Abstract]:Objective: this paper mainly discusses the relationship between phlegm heat, phlegm dampness, stagnation and the occurrence and development of heart failure, so as to provide a theoretical basis for the clinical treatment of heart failure, and finally to prolong the survival time of patients with heart failure. The purpose of improving the quality of life of patients. Methods: this paper mainly summarizes Professor Yang Xiangkun's understanding of the occurrence, development, prognosis and prognosis of heart failure from the point of view of phlegm heat, phlegm dampness and stagnation during his 30 years of clinical practice. And the principle of using Dashanxiong decoction and Zizhi Zhizhi Pill in the treatment of heart failure caused by solid evil choking three jiao syndrome was systematically analyzed. First of all, this paper explains the background of our research on heart failure. Then, this paper mainly introduces our research content. The research contents include the pathological changes and viscera of heart failure, the understanding of solid evil, the clinical characteristics of solid evil choking three coke syndrome, the pathogenesis of solid evil choking three coke syndrome, and the treatment of solid evil choking three coke syndrome. The pathological changes of heart failure are mainly expounded from the location of the lesion and its physiological and pathological functions. The understanding of real evil is mainly expounded from the formation of viscera, mechanism, characteristics and clinical manifestations of phlegm-heat, phlegm-dampness, accumulation of stagnation and so on. The treatment of solid evil choking Sanjiao syndrome is mainly expounded from the aspects of syndrome differentiation and treatment, the prescription analysis of Dashanxiong decoction and Zizhi Zhizhi pills, and the modern pharmacological understanding of each traditional Chinese medicine. Finally, this paper verifies the above theory of our teacher Professor Yang Xiangkun through the introduction of typical cases. Results: through our study, it was found that the pathological changes of some patients with heart failure were mainly in Sanjiao. The clinical manifestations were phlegm-heat, phlegm dampness, stagnation and so on, which were mainly cough, asthma and shortness of breath, not lying flat, panting full of chest tightness. Full of abdominal distension, vomiting, stool dry knot, short urination, edema, tongue dark red moss yellow pulse slippery and so on. The pathogenesis of phlegm-heat, phlegm dampness and stagnation in heart failure is the long time of heart disease. Under the induction of various pathogenic factors, the lung can not pass through the waterway, and at the same time, the spleen can not transport water fluid, and the kidney can not main water, forming phlegm-heat. Phlegm dampness, stagnation and other tangible real evil, choking Sanjiao. Conclusion: through clinical observation, we think that phlegm-heat, phlegm-dampness, stagnation and other solid evil blocking Sanjiao is an important syndrome type of heart failure. According to this syndrome differentiation, Dachingxiong decoction combined with Zizhi Dazhi Pill has a good clinical effect on some patients with heart failure.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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