从"气-血-水"理论探讨心力衰竭患者利尿后口干的辨治策略OA

Heart failure represents the end stage of various cardiovascular diseases,with fluid retention as a core pathological feature.In clinical practice,baseline diuretics are essential in volume overload control.However,diuretic-induced thirst,a critical complication affecting patients'quality of life and prognosis,has long been inadequately addressed.According to traditional Chinese medicine(TCM),the pathogenesis of heart failure is characterized by deficiency of both qi and yin as the root cause and water retention with blood stasis as the branch manifestations.Qi deficiency impairs transportation and transformation,while yin deficiency depletes body fluids.Diuretics promote urination,further consume qi,and damage yin.Therefore,deficiency of both qi and yin is the core pathogenesis of diuretic-induced thirst.As the disease progresses,depression and stagnation of qi movement lead to internal retention of water and dampness,which may turn into heat,manifested as phlegm-heat and dampness-heat.Impaired blood circulation results in blood stasis.Clinically,the condition often presents as a mixture of deficiency and excess,as well as cold and heat,with frequent coexistence of phlegm-heat,dampness-heat,and blood stasis.Based on the above pathogenesis,the therapeutic strategy should prioritize supplementing qi and nourishing yin as the fundamental approach,supplemented by clearing heat,eliminating dampness,regulating qi movement,as well as activating blood and resolving stasis.Medication should integrate dynamic and static herbs,as well as reinforcement and purgation,aiming to nourish yin without retaining dampness,activate blood without harming healthy qi,and promote diuresis without injuring yin,thereby restoring qi and body fluids,and eliminating pathogens while reinforcing healthy qi.Starting with pathogenetic analysis and combining clinical practice,this paper proposes a therapeutic strategy centered on supplementing qi and nourishing yin with adjunctive pathogen-eliminating approaches,with the goal of providing theoretical rationale and clinical reference for TCM-based prevention and treatment of diuretic-induced thirst in patients with heart failure.