基于“肺朝百脉、主治节”探讨心房颤动的辨治

Discussion on the differentiation and treatment of atrial fibrillation based on “all vessels converging in lung and lung reqnlating visceral activity”

关键词:  肺朝百脉  主治节  心房颤动  调补宗气

Key words:  all ressels converging in lung  regulating visceral activity  atrial fibrillation  regulate and replenish qi

摘要:

“肺朝百脉、主治节”理论是中医藏象学说的重要内容，是对“血-脉-心-肺”相互作用的高度概括。肺主宗气生血，行治节而调控生命节律，肺损伤可诱导血、脉循行失常，节律紊乱。心房颤动为心体受损，造成血脉失和、心体失养、神不安位，其发生和转归涉及到血、脉、心、肺多个环节相兼共病的病理过程。文章以“血-脉-心-肺”一体观为基点，探讨“肺朝百脉、主治节”与心房颤动间的内在关联，提出治疗上应以调“肺”朝“脉”、调“肺”使“治”为主要原则，稳定期补气益肺、气血并治、加重期和调枢机、痰瘀同调、病进期升阳举陷、解毒防变为主要治则，分阶段动态辨治，同时注重恢复肺功能常态，以求标本同治。

Abstract:

The theory of “all vessels converging in lung and lung reqnlating visceral activity” is an important content of the theory of visceral symptoms in traditional Chinese medicine，and is a high summary of the interaction of “blood-pulse-heart-lung”. The lung governs qi and generates blood，and regulates the rhythm of life according to the rules and regulations. Lung injury can induce the disorder of blood and pulse circulation and rhythm. Atrial fibrillation is the damage of the heart and body，resulting in blood disharmony，heart and body dystrophy，and restlessness of mind. Its occurrence and outcome involve the pathological process of blood，pulse，heart and lung. Based on the concept of “blood-pulse-heart-lung” as a whole，this paper discusses the internal relationship between “all vessels converging in lung and lung reqnlating visceral activity” and atrial fibrillation，and puts forward that the main principle of treatment should regulate “lung” to “pulse”，regulate “lung” to make “treatment”，and the main treatment principles should replenish qi and benefit lung in the stable stage，treat both qi and blood，regulate the pivot mechanism in the aggravating stage，regulate phlegm and blood stasis in the same way，raise yang and sink in the advanced stage，detoxify and prevent change as the main therapeutic principle，which are treated dynamically according to different stages and focus on restoring the normal state of lung function，in order to treat both symptoms and root causes.