首页|期刊导航|北京中医药大学学报|从三阳同病、虚郁并存探讨双心疾病的治疗策略

从三阳同病、虚郁并存探讨双心疾病的治疗策略OA

Treatment strategies for psycho-cardiological disease from the perspective of concurrent three yang disorders with coexisting yang qi deficiency and stagnation

中文摘要英文摘要

双心疾病是心血管与心理障碍共病的复杂综合征,本文基于《黄帝内经》阳气理论,提出三阳同病、虚郁并存是双心疾病的核心病机,认为其病位关键在于太阳(心)、少阳(肝)、阳明(胃)三系功能协同失调,病性属本虚标实,以阳气亏虚为本,阳气郁滞为标,虚郁互为因果,最终导致形神同病,并构建了三阳同治、病证结合的诊疗体系.以三阳同治为总纲,通过通补太阳(以保元汤、四逆汤等温阳益气)、升发少阳(以小柴胡汤、四逆散等疏肝调枢)、和降阳明(以瓜蒌薤白半夏汤、小陷胸汤等化痰通腑)三法协同,以恢复阳气动态平衡.应用时强调病证结合,聚焦冠心病合并心理障碍这一临床常见类型,形成针对疾病不同阶段核心病机的精准治疗方案:慢性期虚郁交织者,治以稳心汤,通补兼施;急性期阳郁脉阻者,治以心梗二号方,通阳开郁;衰竭期真阳衰微者,治以加味稳心汤,温阳补虚.本文为双心疾病的中医诊治提供了系统性的理论指导和临床应用框架.

Psycho-cardiological disease is a complex syndrome of comorbid cardiovascular and psychological disorders.Based on the yang qi theory of the Huangdi Neijing,this article proposes that the core pathogenesis of psycho-cardiological disease is the concurrent three yang disorders with coexisting yang qi deficiency and stagnation.The disease is primarily attributed to the functional disharmony of the three yang systems,including taiyang(heart),shaoyang(liver),and yangming(stomach).The disease is characterized by a fundamental deficiency and superficial excess,with yang qi deficiency as the root cause and yang qi stagnation as the manifestation.The yang qi deficiency and stagnation mutually reinforce each other,ultimately leading to simultaneous illness of the body and spirit.A diagnostic and treatment system that integrates stimultaneous treatments of three yang and disease-syndrome combinations is constructed.Based on treating the three yangs simultaneously as the general guideline,the three methods of unblocking and supplementing the taiyang(using Baoyuan Decoction and Sini Decoction to warm yang and benefit qi),lifting and dispersing the shaoyang(using Xiaochaihu Decoction and Sini Powder to disperse stagnated liver qi and regulate the pivot),and harmonizing and descending the yangming(using Gualou Xiebai Banxia Decoction and Xiaoxianxiong Decoction to resolve phlegm and dredge the bowels)are synergized to restore the dynamic balance of yang qi.Emphasis is placed on combining disease and syndrome,focusing on the common clinical type of coronary heart disease combined with psychological disorders.A precise treatment plan is formulated for core pathogenesis at different disease stages.For patients with a combination of yang qi deficiency and stagnation pathogenesis in the chronic phase,treatment is based on Wenxin Decoction,which combines unblocking and supplementing method.For patients with yang stagnation obstructing the vessel in the acute phase,treatment is based on Xin-Geng-II Formula,which unblocks yang and relieves qi stagnation.For patients with yang decline and exhaustion in the exhaustion phase,treatment is based on modified Wenxin Decoction,which warms yang and supplements deficiency.This article provides a systematic theoretical guidance and clinical application framework for diagnosing and treating psycho-cardiological disease in traditional Chinese medicine.

孟超;李军;王雪娇;谭雨晴;张文杰;黄炫淳;刘一颖;夏潇;李永浩

北京中医药大学研究生院 北京 100029||中国中医科学院广安门医院心血管科中国中医科学院广安门医院心血管科中国中医科学院广安门医院心血管科中国中医科学院广安门医院心血管科北京中医药大学研究生院 北京 100029||中国中医科学院广安门医院心血管科中国中医科学院广安门医院心血管科中国中医科学院广安门医院心血管科中国中医科学院广安门医院心血管科北京中医药大学研究生院 北京 100029

医药卫生

双心疾病虚郁并存阳气理论病证结合中医病机

psycho-cardiological diseasecoexistence of yang qi deficiency and stagnationyang qi theorydisease-syndrome combinationtraditional Chinese medicine pathogenesis

《北京中医药大学学报》 2026 (3)

297-304,8

国家自然科学基金面上项目(No.82474494)国家重点研发计划项目(No.2022YFC3500102)中央高水平中医医院临床研究和成果转化能力提升项目(No.HLCMHPP2023065)中央高水平中医医院临床研究和成果转化能力提升项目(No.CZ40903) National Natural Science Foundation of China(No.82474494)

10.3969/j.issn.1006-2157.2026.03.001

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