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1.辽宁中医药大学,沈阳 110847
2.辽宁中医药大学 附属医院,沈阳 110000
Received:23 January 2026,
Revised:2026-04-08,
Accepted:14 May 2026,
Online First:18 May 2026,
Published:05 August 2026
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杨帆,张艳,袁子阳等.基于“主客交-络病”理论探讨慢性心力衰竭心室重构的因机证治[J].中国实验方剂学杂志,2026,32(15):245-255.
YANG Fan,ZHANG Yan,YUAN Ziyang,et al.To Explore Etiology, Pathogenesis, Syndrome Differentiation and Treatment of Ventricular Remodeling in Chronic Heart Failure Based on Theory of "Host-guest Interaction-collateral Disease"[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(15):245-255.
杨帆,张艳,袁子阳等.基于“主客交-络病”理论探讨慢性心力衰竭心室重构的因机证治[J].中国实验方剂学杂志,2026,32(15):245-255. DOI: 10.13422/j.cnki.syfjx.20261295.
YANG Fan,ZHANG Yan,YUAN Ziyang,et al.To Explore Etiology, Pathogenesis, Syndrome Differentiation and Treatment of Ventricular Remodeling in Chronic Heart Failure Based on Theory of "Host-guest Interaction-collateral Disease"[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(15):245-255. DOI: 10.13422/j.cnki.syfjx.20261295.
慢性心力衰竭(CHF)是各种心血管疾病的终末结局,发病率和致死率居高不下,一直受到大众的广泛关注。近年来研究表明,心室重构是HF重要的生理病理机制,因此靶向调控心室重构对于CHF的防治具有重要意义。主客交理论与络病理论都是中医学理论体系中重要的组成部分,两者的结合能更丰富中医药辨证论治疾病的体系。主客交理论始见于明代医家吴又可所著《温疫论》,现用来指导多种慢性痼疾的治疗。CHF心室重构的发病过程中,本虚标实,虚实夹杂的病机特点与“主客交”正虚邪聚,络脉失养的内涵高度契合。络病理论则以络脉为核心,强调“络脉通利则脏腑安和”,本病亦属于“络病”范畴。因此该文基于“主客交-络病”理论认为:心气亏虚,络脉失养为发病之本,治应补益心气,濡养脉络,以固其本;痰瘀互结,络脉绌急为发病之键,治当行瘀化痰,通利络脉,以缓其势;浊毒内生,络息成积为发病之局,治需解毒通络,消积散结,以救其危。该文从“主客交-络病”理论切入,对CHF心室重构“虚-瘀-痰-毒-积”的病机演变进行探讨,以期拓宽中医药对CHF心室重构的认知,为延缓心室重构、改善CHF提供理论依据与治疗思路。
Chronic heart failure (CHF) is the end result of various cardiovascular diseases,with high morbidity and mortality,which has been widely concerned by the public. Recent studies have shown that ventricular remodeling is an important physiological and pathological mechanism of heart failure. Therefore,targeted regulation of ventricular remodeling is of great significance for the prevention and treatment of chronic heart failure. The theory of host-guest interaction and the theory of collateral disease are both important parts of the theoretical system of traditional Chinese medicine. The combination of the two can enrich the system of syndrome differentiation and treatment of diseases in traditional Chinese medicine. The theory of host-guest interaction was first seen in the theory of epidemic febrile disease written by Wu Youke,a doctor in the Ming dynasty,and is now used to guide the treatment of various chronic diseases. In the pathogenesis of ventricular remodeling in chronic heart failure,the pathogenesis characteristics of deficiency in origin and excess in superficiality,deficiency and excess are highly consistent with the connotation of "host-guest interaction" deficiency and pathogen accumulation,and collaterals dystrophy. The theory of collateral disease takes collaterals as the core,emphasizing that "collaterals are smooth and the viscera are peaceful". This disease also belongs to the category of "collateral disease". Therefore,based on the theory of "host-guest interaction-collateral disease",this paper holds that the deficiency of heart Qi and the dystrophy of collaterals are the root of the disease. The treatment should supplement the heart qi and nourish the collaterals to consolidate its root, phlegm and blood stasis,collaterals urgent as the key to the disease,the treatment of blood stasis phlegm,dredging collaterals,in order to slow its potential, turbidity and toxin are endogenous,and the accumulation of collaterals is the pathogenesis. The treatment needs to detoxify and dredge collaterals,eliminate accumulation and disperse knots,so as to save the danger. Based on the theory of "host-guest interaction-collateral disease",this paper discusses the pathogenesis evolution of "deficiency-stasis-phlegm-toxin-accumulation" of ventricular remodeling in chronic heart failure,in order to broaden the cognition of traditional Chinese medicine on ventricular remodeling in chronic heart failure,and provide theoretical basis and treatment ideas for delaying ventricular remodeling and improving chronic heart failure.
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