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| 国医大师翁维良教授治疗冠心病合并血友病验案分析 |
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赵梦杰1,2,3, 王旭杰1, 张菀桐1,2,3, 陆芳1,2,3, 翁维良1,2,3
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1.中国中医科学院西苑医院, 北京 100091;2.中国中医科学院西苑医院中药临床研究与评价重点实验室, 北京 100091;3.国家中医心血管病临床医学研究中心, 北京 100091
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| 摘要: |
| 冠心病合并血友病属于难治性心血管疾病。血友病患者的冠心病发病机制尚不明确，冠心病的药物及外科手术治疗使本身具有出血特性的血友病患者出血风险大大提高，导致此类患者的治疗面临巨大挑战。针对此类患者，翁维良教授灵活应用活血药，疗效显著，冠状动脉狭窄程度及心绞痛症状明显减轻，生活质量显著提高，无出血及心血管不良事件发生。文章分析翁教授治疗冠心病合并血友病验案1则，该病例治疗前期以益气养血活血为主，以防活血出血，后期以活血化瘀为主，加用破血类药物增加逐瘀之力，同时重视疑难病患者的情绪管理和季节用药，整体治疗过程活血而未出血。通过探索翁维良教授对该病的辨证思路、治法选择、用药特点等，为该病的中医药治疗提供思路及参考。 |
| 关键词: 冠心病 血友病 三支病变 益气活血 翁维良 |
| DOI：10.11656/j.issn.1672-1519.2023.11.02 |
| 分类号:R554.1 |
| 基金项目:中国中医科学院科技创新工程重大攻关项目（CI2021A04704）；国家中医药管理局第四届国医大师传承工作室和第二届全国名中医传承工作室建设项目（翁维良国医大师传承工作室）。 |
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| Case analysis of the treatment of coronary heart disease combined with hemophilia by Chinese medicine master Professor WENG Weiliang |
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ZHAO Mengjie1,2,3, WANG Xujie1, ZHANG Wantong1,2,3, LU Fang1,2,3, WENG Weiliang1,2,3
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1.Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing 100091, China;2.NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing 100091, China;3.National Clinical Research Center for Chinese Medicine Cardiology, Beijing 100091, China
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| Abstract: |
| Coronary heart disease(CHD) combined with hemophilia is a difficult-to-treat cardiovascular disease. The pathogenesis of CHD in patients with hemophilia is still unclear. Pharmacological and surgical treatment of CHD has dramatically increased the risk of bleeding in patients with hemophilia, which has bleeding characteristics, leading to significant challenges in treating such patients. Professor WENG Weiliang has applied blood-activating drugs flexibly for such patients with remarkable efficacy. After treatment, the degree of coronary stenosis and angina symptoms were significantly reduced, and the quality of life was improved considerably without bleeding or cardiovascular adverse events. In this paper, we analyze a case of Professor WENG's treatment of CHD combined with hemophilia. In the early stage of treatment of this case, the primary treatment was to benefit qi, nourish blood, and activate blood to prevent bleeding from activated blood. In the later stage of treatment, the main focus was to invigorate blood circulation and remove blood stasis, with the addition of blood-breaking drugs to increase the power of removing blood stasis. At the same time, the emotional management and seasonal medication of the patient with the complex disease were emphasized, and the overall treatment process revitalized the Blood without bleeding. In this study, we explored Professor WENG Weiliang's identification ideas, treatment selection, and medication characteristics of CHD combined with hemophilia to provide thoughts and references for the Chinese medicine treatment of this disease. |
| Key words: coronary heart disease hemophilia three-branch lesion benefitting qi and invigorating blood WENG Weiliang |
