心臟衰竭與少陰病之病理探討

THE PATHOLOGIC DISCUSSION OF HEART FAILURE AND SHAOYIN SYNDROME

蔡文興(TSAI, WEN HSIN)

《中醫內科醫學雜誌》 15卷1期 (2017/06) Pp. 1-10

https://doi.org/10.7102/JTCIM.201706_15(1).0001

摘要

心臟衰竭一般意指慢性心臟衰竭（CHF, chronic heart failure）典型症狀通常包含呼吸困難、疲憊無力與下肢水腫。根據心臟血液來源來區分出左心衰竭及右心衰竭。心臟衰竭的症狀程度以紐約心臟學會功能性來分級。冠狀動脈疾病引起左心衰竭現代與古代症狀，本文則以表列來呈現。將心臟衰竭與《傷寒論》之少陰病之主症、真武湯證、四逆湯證與《金匱要略》之胸痹心痛短氣篇及水氣篇進行探討與聯結；並且對於心臟衰竭的心律脈動在中醫脈學上的看法做出闡釋及提出心臟衰竭的病程中的中醫內科的治療思維，以提供中醫同道分享與指正。

關鍵字

心臟衰竭 ； 少陰病 ； 心絞痛 ； 胸痹

並列摘要

Heart failure generally refers to chronic heart failure (CHF). The typical symptoms of chronic heart failure usually include dyspnea, fatigue and lower extremity edema. According to the source of the heart blood, it can be categorized into two types: left heart failure and right heart failure. The degree of the heart failure can be graded by New York Heart Association functional classification. The descriptions of both the modern and Chinese traditional symptoms of the left heart failure induced by coronary artery disease will be showed by the chart in this review article. The main target of this article is to discuss about the link among heart failure, the main symptoms of Shaoyin syndrome in Shaung Han Lun, Zhenwu Tang syndrome, SI NI Tang syndrome and chest pain with shortness of breath in Jin Gui Yao Lue ., We try to explain and put forward to the thinking process of heart failure in the treatment of traditional Chinese medicine and to explain cardiac rhythm of heart failure In the views of Chinese medicine pulse sphygmology.

並列關鍵字

Heart failure ； Shaoyin syndrome ； Angina ； Thoracic obstruction

參考文獻

Dolgin, M,NYH Association,Fox, AC,Gorlin, R,Levin, RI,New York Heart Association,Criteria Committee(1994).Nomenclature and criteria for diagnosis of diseases of the heart and great vessels.Boston, MA:Lippincott Williams and Wilkins.

南京中醫學院(2013)。傷寒論釋義。中國:上海科學技術出版社。

李克光(2012)。金匱要略。台灣:知音出版社。

American Heart Association(2010).2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.International consensus on science circulation.122,S787-817.

曾文宏、謝昌成、簡振宇(2016)。心悸的評估、處理與轉介。家庭醫學與基層醫療。31(5)，153-156。