發(fā)布時間：2019-06-03 18:44

【摘要】：目的:本論文主要通過探討痰熱、痰濕、積滯等實邪與心衰發(fā)生、發(fā)展之間的關(guān)系,為心衰的中醫(yī)藥臨床治療提供理論基礎(chǔ),最終達(dá)到能夠延長心衰患者的生存時間,提高患者的生活質(zhì)量的目的。方法:本論文主要通過總結(jié)吾師楊祥坤教授在從事臨床30年間從實邪(痰熱、痰濕、積滯)角度對心衰發(fā)生、發(fā)展、轉(zhuǎn)歸及預(yù)后的認(rèn)識,并且系統(tǒng)剖析了運用大陷胸湯合枳實導(dǎo)滯丸治療實邪壅塞三焦證之心衰的原則。首先,本論文交代了我們研究心衰疾病的背景。然后,本論文主要介紹了我們的研究內(nèi)容。研究內(nèi)容包括心衰的病變臟腑、對實邪的認(rèn)識、實邪壅塞三焦證的臨床特征、實邪壅塞三焦證的病機(jī)、實邪壅塞三焦證的治療。心衰的病變臟腑主要是從病變的部位及其生理病理功能方面來闡述。對實邪的認(rèn)識主要是從痰熱、痰濕、積滯等實邪的產(chǎn)生臟腑、產(chǎn)生機(jī)理、性質(zhì)特點及其臨床表現(xiàn)來闡述。實邪壅塞三焦證的治療主要是從該證的辨證施治、大陷胸湯合枳實導(dǎo)滯丸的組方分析及各味中藥的現(xiàn)代藥理認(rèn)識方面來闡述。最后,本論文通過對典型病例的介紹來驗證吾師楊祥坤教授的上述理論。結(jié)果:通過我們研究發(fā)現(xiàn),臨床上部分心衰患者的病變部位主要在三焦,臨床表現(xiàn)為痰熱、痰濕、積滯等實邪壅塞三焦的癥候,主要為咳喘短氣,不得平臥,喘滿胸悶,痞滿腹脹,嘔吐,大便干結(jié),小便短少,水腫,舌質(zhì)暗紅苔黃脈滑等。心衰之痰熱、痰濕、積滯等實邪壅塞三焦的病機(jī)為心病日久,在各種致病因素的誘發(fā)作用下,引起肺無法通調(diào)水道,且同時引起脾無法運化水液,腎無法主水,形成痰熱、痰濕、積滯等有形實邪,壅塞三焦。結(jié)論:通過臨床觀察,我們認(rèn)為痰熱、痰濕、積滯等實邪壅塞三焦是心衰的一個重要證型,依此辨證予以大陷胸湯合枳實導(dǎo)滯丸治療,對部分心衰患者有較好的臨床療效。
[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.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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