| 沈昕,陈凯,冯炯,等.范永升教授治疗结缔组织病心脏受累学术经验探析[J].浙江中医药大学学报,2023,47(2):148-152. |
| 范永升教授治疗结缔组织病心脏受累学术经验探析 |
| Analysis of Professor FAN Yongsheng‘s Academic Experience in Treating Heart Involvement in Connective Tissue Disease |
| DOI：10.16466/j.issn1005-5509.2023.02.006 |
| 中文关键词: 结缔组织病 心脏受累 病因病机 中西并治 用药特色 名老中医经验 范永升 |
| 英文关键词: connective tissue disease heart involvement etiology and pathogenesis Chinese and western treatment medication characteristics experience of famous old Chinese medicine FAN Yongsheng |
| 基金项目:科技部国家重点研发计划项目(2018YFC1704102)；浙江省中医药科技计划项目(2020ZB106)；浙江省中青年临床名中医培养项目(浙中医药〔2022〕7号) |
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| 中文摘要: |
| [目的] 总结首届全国名中医范永升教授治疗结缔组织病心脏受累的学术经验。[方法] 通过整理、回顾、分析范教授诊治结缔组织病心脏受累相关医案，从中医病因病机和治则治法、中西并重应用原则、分期辨病辨证相结合等方面，总结归纳范教授诊治结缔组织病心脏受累的学术经验，并列举医案一则予以佐证。 [结果] 范教授认为，结缔组织病心脏受累临床并不少见，属中医“胸痹病”“心水病”“心下悸”等范畴，病因主要与禀赋不足、感受外邪、情志不畅等因素有关，病机为正虚邪侵，心脉痹阻。临证应紧抓心气亏虚、心脉痹阻这个根本病机，治以益气养心、活血通络为主，同时需注意根据心脉痹阻的原因，综合运用清热解毒、活血化瘀、行气化痰、温阳散寒、温化水饮等治法，晚期出现心肾阳虚，则须温肾补火。用药特色为中医辨证与西医辨病相结合，在西医辨病的基础上，灵活运用中医辨证，予以扶正祛邪、补益气血、祛瘀通络、温通心阳、温阳利水等治疗。所举医案中患者处于疾病活动期，证属脾肾阳虚、水湿泛滥，治拟温肾健脾、温阳利水，方用真武汤合苓桂术甘汤加减，临床疗效满意。 [结论] 范教授根据本病的病因病机及临床特点进行辨证论治，临床用药特色鲜明，中西医取长补短，有机结合，提高了本病治疗的有效性，其学术经验值得推广。 |
| 英文摘要: |
| [Objective] To review and summarize the academic experience of Professor FAN Yongsheng， who has been honored as the of first session national famous traditional Chinese medicine masters， in the treatment of heart involvement in connective tissue disease. [Methods] By sorting out， reviewing and analyzing the related medical cases of Professor FAN in the diagnosis and treatment of heart involvement in connective tissue diseases， from the aspects of traditional Chinese medicine(TCM) etiology， pathogenesis， treatment principles and methods， the principle of applying both Chinese and western emphasis， and the combination of staging and syndrome differentiation， the academic experience of Professor FAN in the diagnosis and treatment of heart involvement in connective tissue diseases is summarized and listed. One case is used for supporting this project. [Results] Professor FAN believes that it is common for connective tissue diseases to be involved in the heart， and it belongs to the categories of “chest pain” “heart water disease” and “heart palpitations” in TCM， the pathogenesis is weakness of the positive Qi and the invasion of the negative evil Qi， as well as the heart vessel blockage stasis. In clinical syndromes， it should be focused on the fundamental pathogenesis of deficiency of heart Qi and obstruction of the heart vessels， and the treatment is mainly based on nourishing both Qi and the heart， promoting blood circulation and dredging collaterals. In the next stage， if the deficiency of heart and kidney Yang occurs， it is necessary to warm the kidney and invigorate the fire. The characteristics of medication are the combination of TCM syndrome differentiation and western medicine disease differentiation. On the basis of western medicine laboratory indicators and clinical manifestations， TCM syndrome differentiation is flexibly used to strengthen the body resistance to eliminate pathogenic factors， replenish Qi and blood， remove blood stasis and dredge collateral， warm the heart Yang， warm Yang and promot diuresis. The patient in the mentioned medical case was in the active stage of the disease， and the syndrome is Yang deficiency of the spleen and kidney and flooding of water and dampness. The treatment was warming the kidney and strengthening the spleen， as well as warming Yang and promoting diuresis， and the prescription Zhenwu Decoction and Linggui Zhugan Decoction was used. [Conclusion] Professor FAN carries out syndrome differentiation and treatment according to the etiology， pathogenesis and clinical characteristics of the disease. The clinical medication has distinct characteristics. The organic combination of traditional Chinese and western medicine improves the effectiveness of the treatment of the disease. His academic experience is worthy of popularization. |
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