The Treatment of Hypertensive Heart Failure from "Wind Leads to Water Invasion" Theory
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摘要: 水饮和水饮乘肺是高血压兼变证心衰发病的关键病邪证素和基本病机。针对水饮其性趋下如何上凌心肺在心衰发病中的认知难点,提出“饮邪稽伏,风邪引动,水饮上乘”病机论。认为肝肾阴虚,肺脾肾气虚为高血压心衰病的发病基础。肺脾气虚,营卫失调而外风易袭;肝肾阴虚,阴不敛阳而内风易动,肺脾肾虚、输布失职而水饮稽伏。风邪引动,水饮上乘,凌心射肺,发为喘、闷、悸、肿、汗、痞等心衰诸证。提出以“治风为要,调枢为基,防生为重”的治则,以及“调营卫御外风,滋阴津息内风,调肝脾利枢机,泻肺水助肺宣,补心气畅血脉,温肾阳助气化”的治法。Abstract: The key pathogenic factors and the basic pathogenesis of hypertension with concomitant heart failure are water evil and water evil invading the lung. In response to the cognitive difficulties of how water fluid, which tends to descend, ascends and invades the heart and lungs during the onset of heart failure, the pathogenesis theory of "fluid evil accumulates, wind evil instigates, and water fluid ascends and invades" was proposed. It is believed that the yin deficiency of liver and kidney and qi deficiency of lung, spleen and kidney are the basis of the pathogenesis of hypertensive heart failure. The qi deficiency of lung and spleen and imbalance of ying and wei lead to easy attack of external wind; the yin deficiency of liver and kidney and yin not restricting yang cause internal wind to move easily; the deficiency of the lungs, spleen, and kidneys, as well as the dysfunction of transportation and dispersion, lead to the accumulation of water fluid. Induced by wind evil, water fluid invades upwards, leading to invasion of the heart and lungs, resulting in various heart failure symptoms such as asthma, stuffiness, palpitations, swelling, sweating, and obstruction of the chest and abdominal qi. The principle of "treating wind as the main focus, regulating the hub as the foundation, and preventing occurrence as the priority" and the treatment methods of "regulating ying and wei to resist external wind, nourishing yin fluid to extinguish internal wind, regulating the liver and spleen to benefit the hub, purging lung water to help promote lung transport, supplementing heart qi to unblock blood vessels, warming kidney yang to facilitate qi movement" are proposed.
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Key words:
- wind /
- water /
- fluid /
- heart failure /
- hypertension
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