治疗冠心病经验课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,国医大师李士懋治疗,冠心病的经验,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,冠心病可导致心绞痛、心功能不全、心梗、心衰,休克、心律不齐,以及室壁瘤、猝死等。,在门诊多见的是冠心病心绞痛、心功能不全、,律不齐、慢性心衰等,这类病人常见的主症有心前区疼痛、胸闷、喘憋、,心悸、短气等,根据这些症状,结合脉舌神色进,行辨证论治,但李老尤以脉诊为重。,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,冠心病的临床表现;,(一)疼痛,(二)胸闷、喘憋、短气,(三)心悸,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,(四)对382例冠心病心绞痛的粗略分类和用方统计,1火热者84例,占22.0%,(1)心经郁热栀子豉汤4例,栀子豉汤加枳实3例,新加升降散,四逆散合栀子豉汤1例,(2)火郁夹瘀升降散加活血之品1例,(3)气血两燔清瘟败毒饮,(4)热+痰小陷胸汤7例,升降散合小陷胸汤3例,黄连温胆汤,黄连温胆汤合滚痰丸,黄连温胆汤合旋覆代赭汤1例,涤痰汤合人参白虎汤,1例,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,(5)热+痰+瘀小陷胸汤合血府逐瘀汤,(6)热+痰+风,汤加息凤之品2例,(7)水热互结木防己汤2例,升降散合己椒苈黄丸,2例,(8)余热未清竹叶石膏汤,1例,(9)热+风白虎汤加息风之品1例,(10)热+湿甘露消毒丹合升降散,菖蒲郁金汤合升降散,11)木火扰心一贯煎1例,贯煎合百合地黄汤,(12)痰瘀热+阴伤,活血化痰汤加清热养阴之品1例,(13)阳盛阴虚玉女煎1例,(14)上热下寒附子泻心汤,(15)痰热+心阳不振,陷胸汤合桂枝、附子,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,2.寒盛(包括虚寒)208例,占54%,(1)寒遏饮蓄麻黄汤1例,麻黄半夏丸,(2)寒袭夹饮小青龙汤10例,小青龙汤加附子,小青龙汤加活血之品10例,小青龙汤合苓桂术甘汤6,(3)寒湿痹阻五积散,(4)寒束热郁防风通圣散1例,(5)心阳虚,柱枝甘草汤加附子3例,桂枝去芍药汤,桂枝加附子汤,桂枝加龙骨牡蛎汤,(6)阳虚血瘀温阳活血12例,7)阳虚饮泛附子理中汤3例,六君子汤加桂枝,苓桂术甘汤合四逆汤18例,苓桂五味姜辛汤,桂甘姜枣麻辛附汤32例,苓桂术甘汤加附子、鸟头27例,真武汤,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,8)心肾阳虚真武汤合小青龙汤2例,真武汤加益气之品,真武汤合泽泻汤,真武汤合桂枝龙骨牡蛎汤,(9)心阳虚+痰瘀痹阻桂枝附子汤加活血化痰之品20例,苓桂术甘汤合血府逐瘀汤,苓桂术甘汤加干姜1例,(10)心阳虚、相火旺,振心阳、泻相火,11)肝虚,乌梅丸19,乌梅丸加活血之品2伤,乌梅丸加化湿之品1例,乌梅丸加风药,例,(12)肝寒+血虚当归四逆汤合温肝汤1例,13)阳虚血弱当归四逆汤2例,(14)阳虚湿盛,清阳不升温阳化湿,升清,15)阴盛痰凝温胆汤加桂枝、附子3例,(16)阳虛阴弱桂枝汤合百合地黄汤1例,(17)心虚+痰桂枝去芍药加蜀漆牡蛎龙骨救逆汤1例,(18)阳虚阴泣+阴虚,苓桂术甘汤合百合地黄汤,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,3邪实(痰、瘀,52例,3.6,1)痰瘀互结生风,活血涤痰息风,(2)痰蕴,涤痰汤,例,(3)湿阻清阳升降散合小柴胡汤,4)痰瘀互结涤痰活血,例,瓜蒌薤白汤加活血之品,(5)气滞痰郁肝风,涤痰息风,3例,(6)血瘀风动血府逐瘀汤加息风之品,(7)血瘀,血府逐瘀汤5例,8)气滞痰郁、清阳不升升降散合涤痰氵,9)湿热蕴阻,清阳不升升降散加化湿之品1例,升阳益胃汤,10)气滞,四逆散合升降散,11)气滞血瘀膈下逐瘀汤1例,(12)风痰瘀天麻钩藤汤1例,半夏白术天麻汤,例,13)气滞,小柴胡汤1例,四七汤1例,(14)支钦,泽泻汤加风药,(15)痰阻阳郁瓜蒌薤白白酒汤,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,(1)阳盛阴虚,复脉汤,玉女煎2例,(2)水亏火旺黄连阿胶汤,2例,(3)阴虚气滞一贯煎合百合地黄汤,(4)气阴两虚炙甘草汤6例,(5)阴虚风动、血脉凝泣三甲复脉汤加活血之品3例,(6)痰瘀互结化热伤阴活血化痰汤加清热养阴之品1例,(7)阴虚阳亢化风,8)心肝血虚酸枣仁汤1例,(9)肾阴虚地黄饮子2例,(10)阴阳两虚桂枝龙牡汤合百合地黄汤1例,(11)肾虚风动济生肾气汤加龟板1例,(12)支饮阴虚苓桂术甘汤合百合地黄汤1例,(13)心阴虚百合地黄汤,2例,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,国医大师李士懋治疗冠心病的思路,5脾肾两虚11例,占2.8%,(1)脾虚肝郁,归脾汤1例,(2)气血不足夹瘀归脾汤加活血之品,1例,(3)脾肾两虚,脾肾双补,2例,鞭丸1例,4)阴阴两虚,桂枝、附子加麦冬、生地1例,(5)痰阻肾虚,补肾涤痰,例,(6)气血不足,黄芪建中汤加龙骨、牡蛎4例,Valadon onry.,ch Asposeslides for NET 4o dient P,Evaluation only.,Created with Aspose Slides for NET 4.0 dient Profilo,71,Copyright 2019-2019Aspose Pty L,