汤献文教授从虚、湿、瘀、郁论治冠状动脉慢血流经验OA
Professor Tang Xianwen's clinical experience on treating coronary slow flow from the aspect of deficiency,dampness,blood stasis and stagnation
冠状动脉慢血流(冠脉慢血流)与不良心血管预后直接相关,严重者可引发室性心律失常、心源性休克乃至死亡,危害极大.但其病因与机制迄今未明,现代医学治疗面临困境.中医在治疗该病方面具有独到潜力与优势.汤献文教授认为,冠脉慢血流的病位在心,主要涉及脾、肾二脏.虚、湿、瘀、郁是本病的四大基本病机.其中,虚以心肾阳(气)虚、脾肾阳(气)虚为主;湿有外湿、内湿之分;郁主要为痰郁和气郁;而瘀血则贯穿于疾病发生的全过程.冠脉慢血流证属本虚标实,以阳气亏虚为本,湿邪、瘀血、痰郁、气郁为标,虚、湿、瘀、郁常相互夹杂,彼此相兼为患.治疗上应以温阳补气、祛湿、活血、化痰、解郁为主要原则,同时注重标本结合、虚实兼顾和内外并用.此法在临床上验之甚效,附验案 1 则为证.
Coronary slow flow is directly related to poor cardiovascular prognosis.In severe cases,it could lead to ventricular arrhythmia,cardiogenic shock and even death,causing a huge threat to human health.However,the etiology and mechanism is yet unclear and this puts modern medicine in difficulty but helps to show the unique potential and characteristics of traditional Chinese medicine in coping coronary slow flow.Professor Tang Xianwen believes that the origin of the rise of coronary slow flow lies in the heart,and mainly involves the spleen and kidney.Deficiency,dampness,blood stasis,and stagnation are four basic aspects that form the pathogenesis of coronary slow flow.Among them,deficiency mainly involves Yang(Qi)deficiency of the heart and kidney,as well as spleen and kidney Yang(Qi)deficiency while dampness can be distinguished as external dampness and internal dampness.Stagnation primarily includes Qi stagnation and phlegm stagnation while blood stasis runs through the entire process of the disease.Coronary slow flow is a disease that characterized by root deficiency and manifestation excess.Yang(Qi)deficiency is the main cause of it while dampness,blood stasis,phlegm and Qi staganation are key presenting forms of manifestation excess.Deficiency,dampness,blood stasis,and stagnation could be intertwined and jointly cause harm.The overall treating principle to treat coronary slow flow is nourishing Yang(Qi),draining dampness,promoting blood circulation,resolving the phlegm,and removing the stagnation.Meanwhile,attention should be paid to both the root and manifestations,deficiency and excess using both internal and external treating methods.These ideas and methods have been clinically proven to be effective,as an attached case shown below.
吴佳芸;孙彦波;钟佳男;杨秋红;汤献文
北京中医药大学深圳医院(龙岗),广州 深圳 518172北京中医药大学深圳医院(龙岗),广州 深圳 518172北京中医药大学深圳医院(龙岗),广州 深圳 518172北京中医药大学深圳医院(龙岗),广州 深圳 518172北京中医药大学深圳医院(龙岗),广州 深圳 518172
医药卫生
冠脉慢血流虚湿瘀郁临床经验汤献文教授
Coronary slow flowDeficiencyDampnessBlood stasisStagnationClinical experienceProfessor Tang Xianwen
《四川中医》 2026 (1)
29-33,5
广东省中医药管理局科研课题(20232146)深圳市医疗三名工程(SZZYSM202205015)龙岗区医学重点学科项目.
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