张伯礼教授辨治冠状动脉起源异常术后心力衰竭验案

Professor ZHANG Boli’s experience in treating postoperative heart failure after coronary artery anomalies

关键词:  心力衰竭  冠状动脉起源异常  湿浊  痰饮  临证经验  张伯礼

Key words:  heart failure  coronary artery anomalies  damp-turbidity  phlegm-rheum  clinical treatment experience  ZHANG Boli

摘要:

冠状动脉起源异常是一种复杂的先天性冠状动脉畸形变异，患者多在幼年及青少年时期发生心肌梗死、心力衰竭，甚至猝死。目前该病的治疗手段以外科手术为主，但患者术后仍多存在不同程度心力衰竭，多表现为心脏射血分数下降，可伴随胸闷、心悸及下肢水肿等症状。对于心力衰竭患者，中医药在促进恢复、改善预后方面具有一定优势。文章对张伯礼教授治疗冠状动脉起源异常术后心力衰竭验案一则进行整理，从病机认识、临证思路、遣方用药等方面浅析，体悟张伯礼教授中医临床辨证思路。

Abstract:

Abnormal coronary artery origin is a complex congenital coronary artery malformation. Most patients have myocardial infarction，heart failure，and even sudden death in childhood and adolescence. At present，the treatment of the disease is mainly surgical operation，but most patients still have different degrees of heart failure after surgery，mostly manifested as a decrease in cardiac ejection fraction，accompanied by chest tightness，palpitations and lower extremity edema. For patients with heart failure，traditional Chinese medicine has certain advantages in promoting recovery and improving prognosis. This paper sorted out a case of Professor ZHANG Boli’s treatment of heart failure after the operation of abnormal coronary origin，and analyzed the pathogenesis，clinical thinking，prescription and medication，so as to understand Professor ZHANG’s clinical dialectical thinking of traditional Chinese medicine.