张伯礼教授运用八珍汤从气血论治胸痹验案举隅

Professor ZHANG Boli's experience in diagnosing and treating chest apoplexy by the theory of qi and blood using Bazhen Decoction

关键词:  八珍汤  气血  胸痹  冠心病  张伯礼

Key words:  Bazhen Decoction  theory of qi and blood  chest apoplexy  coronary atherosclerotic heart disease  ZHANG Boli

摘要:

胸痹之病包含了西医“冠心病”“心绞痛”等心血管疾病，是中医药治疗的优势病种。张伯礼教授根据多年临证经验，认为胸痹心痛主要病机为阳微阴弦，以气血阴阳虚衰为本，以气滞、寒凝、痰浊、血瘀为标，注重对该病本虚标实之辨识，除化痰逐瘀之法治疗标实之证外，尤注重补益气血以治本的重要性。当前诸多医者认为胸痹主要矛盾是血瘀，故多选活血化瘀药物为主要治疗方法，对胸痹的病机及虚实变化认识不足，不识护本，不辨气血，长期使用攻伐活血之品，犯虚虚之戒。文章通过整理验案，体现张伯礼教授以气血论治胸痹的辨证思维。

Abstract:

The chest apoplexy contains coronary atherosclerotic heart disease,angina and other disease of the circulatory system. Based on plentiful clinical experience,Professor ZHANG Boli believes that the theory of yang weakly and yin string is the main pathogenesis of the chest apoplexy. This theory holds the think of rooting on deficiency of qi,blood,yin and yang and manifesting of qi stagnation,cold coagulation,blood stasis and phlegm turbid. He also emphasizes paying attention to the the importance of tonifying qi and blood to treat the root cause,except as resolving phlegm and removing blood stasis. But many doctors think that the main contradiction of chest paralysis is blood stasis. They lack of understanding of the pathogenesis of chest apoplexy and the changes of deficiency and reality. Then they choose the blood-activating and stasis-removing drugs as the main methods and the extensive use of them impair the body. Here,this paper reflects Professor ZHANG Boli's dialectical thinking of qi and blood on treating chest apoplexy by analysising proven cases.