慢性肺源性心脏病中医诊疗的对策分析

黄元和

[摘要] 慢性肺源性心脏病（简称肺心病）是内科常见病，病情复杂，变化多端，迁延难愈，严重威胁人类的生命健康。近几年中医有关肺心病病因、病机和治疗的报道颇多，笔者参阅相关文献，依据多年临床实践，结合患者的临床表现，从探析肺心病的病因、病机、发病特点入手，根据中医辨证施治的原则总结肺心病的中医治疗方案。传统医学对“肺心病”的治疗有独特的作用，必须全面理解和掌握，从而更好地发挥中医治疗肺心病的现代临床价值，有效提高患者的生命质量。

[关键词] 肺心病；病因病机；发病特点；临床证治；中医疗法；对策分析

[中图分类号] R256.14 [文献标识码] A [文章编号] 1674-4721（2015）09（a）-0128-03

[Abstract] Chronic pulmonary heart disease （referred to as pulmonary heart disease） is a common disease of department of internal medicine，the state of an illness is complex，it is the most changeful and refractory to severely threatens human life and health.In recent years，there have been many reports on the etiology，pathogenesis and treatment of pulmonary heart disease in traditional Chinese medicine （TCM）.Relevant literature was consulted by the author and according to clinical practice of many years，combining with clinical manifestation of patients，TCM treatment plan is summarized beginning with etiology and pathogenesis and pathogenetic characteristics of pulmonary heart disease and according to the principle of TCM syndrome differentiation.Traditional medicine has unique effect on the treatment of "pulmonary heart disease"，it should be understood and mastered comprehensively in order to take advantage of the modern clinical value of TCM treating pulmonary heart disease and effectively improve the quality of life of patients.

[Key words] Pulmonary heart disease；Etiology and pathogenesis；Pathogenetic characteristics；Clinical syndrome and treatment； TCM therapy；Countermeasure

慢性肺源性心脏病（肺心病）是由支气管-肺组织、胸廓或肺血管病变致肺血管阻力增加，产生肺动脉高压，继而右心室结构和（或）功能改变的疾病[1]，其临床以咳嗽气喘、呼吸困难、心悸、发绀、水肿、肝大等为特征，最终多因呼吸道感染导致肺功能衰竭和心力衰竭，病死率较高。中医学无“肺心病”病名，根据本病的特点，属于中医学“咳嗽”“喘证”“肺胀”“痰饮”“水肿”等范畴。近几年有关肺心病中医病因病机和治疗的报道颇多，笔者参阅相关资料、结合自己多年的临床实践，根据中医辨证施治的原则，现将肺心病的中医病因病机和临床证治作一浅显探析，以供临床参考，不当之处，请同道批评指正。

1 肺心病的病因病机

1.1 病因

本病多因咳嗽、哮喘、痰饮诸症，久治不愈，损及内脏，内脏虚损、痰浊阻滞，气机不畅，肺气胀满，失其肃降，进而累及心、肾诸脏，气道滞窒，心肺瘀阻，故出现咳嗽、气喘、呼吸困难，甚则面晦发绀、全身肿，神昏谵语等症。……