王显治疗扩心病心衰验案1则
A Proved Case of WANG Xian in Treating Chronic Heart Failure Due to Dilated Cardiomyopathy
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1.北京中医药大学东直门医院,北京 100700
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高昂, 王继升, 王显. 王显治疗扩心病心衰验案1则[DB/OL].(2023-09-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41907435&Fpath=home&index=0
GAO Ang, WANG Jisheng, WANG Xian. A Proved Case of WANG Xian in Treating Chronic Heart Failure Due to Dilated Cardiomyopathy[DB/OL].(2023-09-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41907435&Fpath=home&index=0
高昂, 王继升, 王显. 王显治疗扩心病心衰验案1则[DB/OL].(2023-09-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41907435&Fpath=home&index=0 DOI:
GAO Ang, WANG Jisheng, WANG Xian. A Proved Case of WANG Xian in Treating Chronic Heart Failure Due to Dilated Cardiomyopathy[DB/OL].(2023-09-18)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=41907435&Fpath=home&index=0 DOI:
病史摘要,2,孙某,女,69岁。患者12年前开始出现活动后喘憋,休息后缓解。其势日益加剧,近期休息时亦有发作,咳嗽,痰多,色红质黏,心慌,口苦口干,纳可,眠差,神清,精神欠佳,双下肢轻度水肿,小便量少,大便干。医院检查,心脏超声示:射血分数(EF)18%,确诊:扩张性心肌病,心脏瓣膜病,右下肢血栓形成。面色灰暗,苔白,舌质淡暗,脉弦细。轮椅推入诊室。中医诊断 病属喘证,辨证属气阴两虚,痰瘀阻络证。西医诊断 慢性心力衰竭(心功能Ⅳ级),扩张性心肌病。干预措施 王显教授认可传统病机的基础上,认为最终导致本病进展的要素不离“络脉亏虚、心失所养、痰瘀阻络、络风内动”。临证思辨,益气养阴,分消三焦,祛风活血通络。提出“益气养阴、化痰祛湿、活血化瘀、祛风通络”治疗扩心病心衰。该验案以生脉散合小柴胡汤加减用药。疗效转归 患者喘憋症状消失,运动耐力明显改善,由初诊轮椅推入诊室到四诊时可自行步入诊室,心功能由Ⅳ级改善到Ⅱ级。症情平妥。
Summary of case history, Sun, female, 69 years old. Twelve years ago, the patient began to have dyspnea after activities and relieved after rest. In the past 12 years, the situation has been getting worse and worse. Recently, it also broke out during rest. She coughs intermittently. She has a lot of sputum, which is red and sticky. She has intermittent palpitations.She felt her mouth was dry and bitter. Her appetite was normal and her sleep quality was poor. Her mind is clear, but her spirit is not good. She has mild edema in both lower limbs. Her urine volume is small. Her stool was dry. Cardiac ultrasound in the hospital showed: ejection fraction(EF)18%. She was diagnosed with dilated cardiomyopathy, valvular heart disease, and thrombosis of the right lower limb.Her face was gray.Her tongue was dark.Her tongue coating is white. And her pulse felt like a string and thin.She sat in a wheelchair and was pushed into the clinic by her family.,TCM diagnosis, The disease belongs to asthma syndrome, and the syndrome differentiation belongs to deficiency of both Qi and Yin, phlegm and blood stasis blocking collaterals syndrome.,Western medicine diagnosis, Chronic heart failure (grade Ⅳ cardiac function ), dilated cardiomyopathy.,Therapeutic methods, On the basis of recognizing the traditional pathogenesis, Professor WANG Xian believed that the factors that ultimately led to the progress of the disease were "deficiency of collateral vessels, cardiac dystrophy, and internal movement of collateral wind". It is proposed to "replenish Qi and nourish Yin, remove phlegm and dampness, promote blood circulation and remove blood stasis, dispel wind and dredge collaterals" to treat chronic heart failure due to dilated cardiomyopathy.,Clinical outcomes, The patient's asthma symptoms have disappeared. Her exercise endurance has improved. She walked into the clinic. Chronic heart failure (grade Ⅱ cardiac function ).The symptoms are mild.
扩张型心肌病慢性心力衰竭络风内动
dilated cardiomyopathychronic heart failureendogenous collaterals wind
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