【作者】 宋军；

【导师】 路志正； 曹洪欣；

【作者基本信息】 中国中医科学院 ， 中医内科学， 2008， 博士

【摘要】 冠心病是在冠状动脉粥样硬化的基础上导致血管腔狭窄,冠状动脉供血不足,心肌急性、短暂性缺血、缺氧所引起的临床综合征,属于中医学“胸痹”范畴。目前本病是危害人们健康的常见疾病,其发病率和死亡率均较高。导师路志正教授通过60余年的临床研究率先提出胸痹与脾胃关系尤为密切,其发生、发展、治疗、转归、预后,都与脾胃的功能状态密切相关。本课题选取路老治疗的88例胸痹病例,将每一病例录入名老中医临床信息采集系统,并进行数据的转化、处理。分别采用频数分析、因子分析、关联规则分析、Logistic回归、相关性分析、配对t检验等统计方法,系统总结了该病的证候特征及路老从脾胃论治本病的辨治规律,以期探讨从脾胃论治胸痹的客观依据,及具体方法,丰富中医药治疗冠心病的理论体系。研究结果表明:胸痹临床表现中,脾胃症状多见,其证候以心脾两虚、中气不足、痰浊内阻、湿热内阻等证居多。这些证候均与脾胃关系密切。胸痹虽与五脏相关,而脾胃在其中的作用尤为重要,脾胃功能失调往往是导致胸痹的主要原因之一。运用调理脾胃法治疗胸痹,包括健脾益气法、清热化湿法、理脾化痰法、温中健脾法、益气养血法等,虽然治法各异,然而从脾胃入手则是其共同特点。综合方药分析充分体现了路老治疗胸痹的调理脾胃以斡旋气机、调理脾胃以化痰祛湿宣痹、调理脾胃以助气血之源、调理脾胃以宁心定志、调理脾胃以安五脏的学术思想,通过调理脾胃,使脾胃健旺则气血化生,脾运一行则痰湿自化,瘀血消,脉道畅,胸阳展而痹自除。调理脾胃法治疗胸痹突出了中医整体观念及治病求本,辨证论治的特点,显著提高了临床疗效。更多还原

【Abstract】 Coronary heart disease (CHD) is a common cardiovascular disease. Its etiology is cavity vascular stenosis, coronary insufficiency, acute or transient ischemia,hypoxia of myocardial caused by coronary atherosclerosis. It belongs to chest stuffiness and pains in Chinese medicine. Now CHD is one of the most common diseases which endanger people’s health. Professor Lu zhizheng holds that relation between CHD and spleen is very close.88 cases of CHD are chosen in this subject,and input them into the old Chinese medicine doctor’s clinical information collection system. Data is analyzed by frequency analysis,factor analysis, analysis of association rules, logistic regression,correlation analysis,paired t test,and so on. The syndrome characteristics of CHD are explored,and summarize regularities in syndrome differentiation for this disease in order to find the objective basis and application method of treating CHD by regulating spleen and stomach. It is concluded thatSymptoms related spleen and stomach are the most symptoms in CHD,and important tcm syndromes types of CHD is damp heat resistance, phlegm resistance, deficiency in heart and spleen, middle qi insufficiency,deficiency of both qi and yin, liver qi stagnation, liver-spleen disharmony, bile-spleen disharmony, phlegm and blood stasis. All of them are related with spleen-stomach. So we hold that CHD is mainly caused by incoor-dination between the spleen and stomach,although it is related with five viscera. Professor Lu proposed to treat CHD by regulating spleen and stomach. It include invigorating spleen and replenishing qi, clearing away damp and heat, regulating spleen and eliminating phlegm, wen zhong and strengthening spleen, replenishing qi and blood,and so on. All of them are embark from spleen and stomach,and have corresponding prescription. Spleen-stomach should receive attention in clinic. Medication reflect professor Lu’s academic features that functional activities of qi is regulated, phlegm and dampness is eliminated, qi blood is generated, mental activity is calm down,five viscera is conditioned by regulating spleen and stomach.We get the satisfied effects in treating coronary by regulating spleen and stomach.更多还原