基于“五脏生克制化辨证模式”的心律失常病机及组方探讨

Exploring the pathogenesis and prescription of arrhythmia based on the syndrome differentiation model of the birth-control-inhibition-conversion of five zang

关键词:  心悸  心律失常  连桂宁心汤  五运六气  五脏生克制化辨证模式

Key words:  palpitations  arrhythmia  Liangui Ningxin Decoction  five movements and six qi  syndrome differentiation model of the birth-control-inhibition-conversion of five zang

摘要:

“五脏生克制化辨证模式”是在气化理论、五运六气理论指导下，建立的五脏功能兼顾的辨证模式。该模式以气化为基础，整合自然气化、人体气化、愈病气化过程，通过审视五脏之间的生、克、复关系，准确把握疾病的病机核心，指导临床疾病诊疗。基于“五脏生克制化辨证模式”概括心律失常核心病机为“中轴不健，心肾不交”，即心悸非独心病，实则五脏之气皆病，而以中轴窒塞，水火交通无路为要。治疗以“斡旋中土，交通心肾，枢转气机”为主，连桂宁心汤随证加减，以期为临床辨治心律失常提供参考。五脏生克制化辨证模式全面统筹天人的气化过程，可为临床诊疗心律失常及其他内科疾病提供新的理论指导。

Abstract:

“The syndrome differentiation model of birth-control-inhibition-conversion in the five zang” is established under the guidance of qi transformation theory and the theories of five movements and six qi. This model integrates the functions of the five organs while focusing on qi transformation as its foundation. It synthesizes natural qi transformation，human body qi transformation，and health recovery from illness through qi dynamics. By examining the relationships among the five organs，it accurately identifies the core pathogenesis of diseases to guide clinical diagnosis and treatment. Based on this syndrome differentiation framework，arrhythmia’s core pathogenesis is articulated as “an unhealthy central axis coupled with impaired heart-kidney communication”，indicating that arrhythmia arises not solely from cardiac issues but rather reflects an imbalance in qi across all five zang-organs；key factors include obstruction along the central axis and disruption between water（kidney） and fire（heart）. Treatment emphasizes “regulating spleen and stomach function，facilitating heart-kidney connection，and optimizing qi movement”. Liangui Ningxin Decoction is tailored according to individual symptoms，accompanied to serve as a reference for clinical differentiation and management of arrhythmia. This syndrome differentiation model comprehensively integrates both human and natural processes of qi transformation，offering novel theoretical insights for clinical diagnosis and treatment of arrhythmias alongside other internal diseases.