张伯礼教授辨治冠状动脉痉挛经验浅析

Experience of Professor ZHANG Boli in treating coronary artery spasm

关键词:  冠脉痉挛  宽胸温阳  化瘀通络  经验  张伯礼

Key words:  coronary artery spasm  wide chest and warm yang  dispelling stasis to unblock collaterals  experience  ZHANG Boli

摘要:

冠脉痉挛是引起多种临床心血管疾病的病理生理状态，多以胸闷、胸痛等症为主，临床较为常见，但目前精准诊断较为困难，机制尚不明确。张伯礼教授临证经验丰富，指出临床上冠脉痉挛患者以心阳不足为本，血瘀为基，多病理因素（痰湿、气滞、肝郁等）兼夹致病，宽胸温阳当为第一要义。在辨治冠脉痉挛所致胸痹时当首辨标本虚实，分清轻重缓急，谨守病机，标本兼顾，随证化裁。

Abstract:

Coronary artery spasm is a pathophysiological state that causes a variety of clinical cardiovascular diseases, mostly with chest tightness, chest pain and other symptoms. It is common in clinical practice, but it is difficult to accurately diagnose and the mechanism is not clear. Professor ZHANG Boli has rich clinical experience, and points out that in clinical coronary artery spasm patients, deficiency of heart yang is the root, blood stasis is the basis, and multiple pathological factors(phlegm dampness, deficiency of qi, liver depression, etc.) are combined with pathogenic factors. Wide chest and warm yang are the first essential meaning. In the treatment of chest paralysis caused by coronary artery spasm, we should first distinguish the deficiency and excess of the specimen, distinguish the severity and urgency, adhere to the pathogenesis, take into account the specimen, and follow the syndrome.