首页|"血-脉-心-神"一体观辨治糖尿病心肌病思路探析

"血-脉-心-神"一体观辨治糖尿病心肌病思路探析

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糖尿病心肌病(DCM)早期发病隐匿,易被忽视,延误治疗,后期心肌严重损伤,预后较差.除对症治疗外,目前尚无统一有效的特异性治疗方案.基于"血-脉-心-神"一体观,DCM病程可分为血脉共病,心体受损,体用俱衰、神机失用3个阶段.治疗时,抓住各阶段主要矛盾,辨证施治.在血脉共病阶段,运用活血解毒法,调血畅脉,及早截断病程;心体受损阶段,软坚散结,调气和血以保护心肌、延缓病程;心之体用俱衰,神机失用阶段,育心保脉,调神安神以缓解症状、改善预后.以期为中医药分阶段、全时程防治DCM提供新的思路.
Exploration of thoughts for differentiation and treatment of diabetic cardiomyopathy based on the holism of'blood-pulse-heart-spirit'
Diabetic cardiomyopathy(DCM)was insidious in early onset and is easily overlooked,thereby delaying treatment.Severe myocardial injury occurs at a later stage and has a poor prognosis.There is no uniform and effective specific treatment except to symptomatic treatment.Based on the concept of'blood-pulse-heart-spirit',the course of DCM can be divided into three stages:blood-vessel comorbidity stage;heart damage stage;structural and functional failure,heart and spirit disorder stage.When treating DCM,it is necessary to seize the main contradictions of each stage and therapy with syndrome differentiation.In the stage of blood-vessel comorbidity,the disease course can be truncated early by using the method of promoting blood circulation and detoxicating to regulate blood and smooth the blood vessels.In the stage of heart damage,the method of softening hardness and dissipating mass and harmonizing qi and blood are used to protect the myocardium and delay the disease course.In the stage of structural and functional failure and heart and spirit disorder stage,the method of cultivating the heart and protect the pulse and regulating the mind and tranquilizing is used to relieve symptoms and improve the prognosis.These can provide new ideas for phased and full course prevention and treatment of DCM with traditional Chinese medicine.

Diabetic cardiomyopathy(DCM)Holism of'blood-pulse-heart-spirit'Phased treatmentThoughtsTraditional Chinese medicine

黄旭文、严志鹏、施琦、耿小飞、漫富婧、祁含章、范新彪、朱亚萍、张军平

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天津中医药大学第一附属医院,天津 300381

国家中医针灸临床医学研究中心,天津 300381

糖尿病心肌病 "血-脉-心-神"一体观 分阶段辨治 思路 中医药

中医药传承与创新"百千万"人才工程(岐黄工程)岐黄学者(张军平)专项资助天津市名中医(张军平)传承工作室专项资助

国中医药人教函[2022]6号津卫中[2020]732号

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子：1.135
ISSN：1673-1727
年,卷(期)：2024.39(2)
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