仲景辨治心阳虚证特点探析_徐立思_孔祥亮_何新慧

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1、·490·辽宁中医杂志2015年第42卷第3期DOI∶10．13192/j．issn．1000-1719．2015．03．017仲景辨治心阳虚证特点探析122徐立思，孔祥亮，何新慧(1．上海市中医文献馆，上海200020;2．上海中医药大学基础医学院，上海201203)摘要:心阳虚证是临床常见证候及最终转归，是导致死亡的主因之一。仲景《伤寒论》和《金匮要略》对于心阳虚证有其独特的辨治规律。心悸、心胸痞满、胸痹心痛和畏寒肢冷是心阳虚证的主症，或可伴见肺系、脾系、肾系等症状，病程较长者还可出现心脾同病或心脾肾同病。按病情程度可分为心阳不振、心阳虚衰和心阳暴脱三个阶段，桂枝甘草汤

2、、真武汤和四逆汤分别是其代表方，桂枝和附子是仲景最常用的两味药。其治疗大法和常用药对精简独到，同时重视五脏相关的整体性，关注外感与内伤等致病因素的特点，其辨治精髓在现代临床仍有很大的指导意义和实用价值。关键词:心阳虚证;张仲景;伤寒论;金匮要略;辨证论治中图分类号:Ｒ222文献标志码:A文章编号:1000-1719(2015)03-0490-04AnalysisonEssenceofSyndromeDifferentiationandTreatmentforHeartYangDeficiencySyndromebyZhongjing122XULisi，KONGXiangli

3、ang，HEXinhui(1．ShanghaiArchiveofTraditionalChineseMedicine，Shanghai200020，China;2．ShanghaiUniversityofTraditionalChineseMedicine，Shanghai201203，China)Abstract:Heartyangdeficiencysyndromeisclinicallycommonandthemaincauseofdeath．ZHANGZhongjinghasitsu-niquerulesindifferentiatingandtreatinghea

4、rtyangdeficiencysyndromeinTreatiseonFebrileDiseasesandSynopsisofPrescrip-tionsoftheGoldenChamber．Themainsymptomsofheartyangdeficiencysyndromearepalpitation，stuffinessandfullnessinchest，anginapectorisandintoleranceofcold，andtheyalsocanbeassociatedwithlungsymptoms，spleensymptomsorkidneysympt

5、oms．Thesimultaneousdiseasesofheart－spleenorheart－spleen－kidneycanbefoundinthelongcourseofheartyangde-ficiencysyndrome．Itcanbedividedintoheartyangdevitalization，heartyangfailureandheartyangcollapseaccordingtotheex-tentofthedisease．TheirrepresentativeprescriptionsareGuizhiGancaoDecoction，Zhe

6、nwuDecoctionandSiniDecoction．CassiaTwigandPreparedCommonMonkshoodDaughterＲootarethemainherbsintreatingheartyangdeficiencysyndromebyZhongjing．Thetherapeuticmethodsandcommonly－usedcoupletherbsareaccurateandunique．Zhongjingpaysattentionontheholismoffivevisceraandthecharactersbetweenexternalco

7、ntractionandinternaldamageanditsessencestillhasagreatvalueinmodernclinicaltreatment．Keywords:heartyangdeficiencysyndrome;ZHANGZhongjing;TreatiseonFebrileDiseases;SynopsisofPrescriptionsoftheGoldenChamber;syndromedifferentiationandtreatment心阳虚证是指由于心阳虚衰、鼓动无力、虚寒内