[1]瞿婷婷,张蕊,张冰.名中医张冰基于“调肝理五脏”论治胸痹学术思想及治验[J].陕西中医,2025,46(8):1105-1108,1117.[doi:DOI:10.3969/j.issn.1000-7369.2025.08.019]
　QU Tingting,ZHANG Rui,ZHANG Bing.Famous Chinese medicine ZHANG Bing’s academic thought and treatment verification in treating chest obstruction based on the theory of “regulating the liver and harmonizing the five viscera”[J].,2025,46(8):1105-1108,1117.[doi:DOI:10.3969/j.issn.1000-7369.2025.08.019]
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名中医张冰基于“调肝理五脏”论治胸痹学术思想及治验

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年8期
页码:
1105-1108,1117
栏目:
名中医经验
出版日期:
2025-08-05

文章信息/Info

Title:
Famous Chinese medicine ZHANG Bing’s academic thought and treatment verification in treating chest obstruction based on the theory of “regulating the liver and harmonizing the five viscera”
作者:
瞿婷婷1; 张蕊2; 张冰1
（1.北京中医药大学，北京 102488；2.北京市宣武中医医院，北京 100050）
Author(s):
QU Tingting1; ZHANG Rui2; ZHANG Bing1
(1.Beijing University of Chinese Medicine,Beijing 102488，China;2.Xuanwu Hospital of Traditional Chinese Medicine,Beijing 100050，China)
关键词:
胸痹; 调肝理五脏; 行法; 清法; 补法; 舒肝; 养肝血
Keywords:
Chest obstruction; Regulating the liver and harmonizing the five viscera; Promoting circulation method; Clearing heat method; Tonifying deficiency method; Soothing the liver; Nourishing liver blood
分类号:
R 249
DOI:
DOI:10.3969/j.issn.1000-7369.2025.08.019
文献标志码:
A
摘要:
胸痹是临床常见疾病。胸痹发病与心脉的运行密切相关，心脉瘀阻是胸痹发病的关键，张冰教授认为胸痹的病机演变以“肝”为始动因素。根据肝通过肝气、肝血的功能影响心脉，肝通过调节其他四脏气血影响心脉的病生理关系，提出“调肝理五脏论治胸痹”理论，认为先天禀赋不足，后天情志不调，饮食不节，劳逸失调，致肝气郁滞、肝血不足，继而五脏气血阴阳失和，气滞、血瘀、痰浊等病理产物生成，心脉闭阻、心脉失养为胸痹的根本病机。依据肝直接导致胸痹及肝通过五脏导致胸痹的不同病机演变过程，辨证分型，以“调肝理五脏”为治疗核心，应用“行、清、补”三法论治胸痹，辅以情志调节，临床患者获益良多。
Abstract:
Chest obstruction is a frequently occurring disease in clinical practice.Its onset is closely associated with the circulation of heart vessels,with blood stasis in heart vessels being the crucial factor in its development.Professor ZHANG Bing advocates that its pathogenesis contributes to pathogenic factors of liver.Based on the pathophysiological interactions through which the liver exerts influence on heart vessels via its qi and blood,or by regulating qi and blood of the other four zang-organs,professor ZHANG proposes the theory of “addressing chest obstruction through liver harmonization and zang-organ regulation”,and considers that congenital deficiency along with postnatal factors such as disorder of emotions,irregular dietary habits and imbalance between work and rest induce the stagnation of liver qi and deficiency of liver blood,which triggers disharmony in Qi,blood,Yin,and Yang of five zang-organs,fostering pathological substances such as Qi stagnation,blood stasis,and phlegm-turbidity.Thus,the underlying pathogenesis of chest obstruction lies in the obstruction and malnutrition of heart vessels.According to the distinct pathogenic mechanism of chest obstruction,which may arise directly from liver dysfunction or indirectly through the dysregulation of the five zang-organs,syndrome differentiation is obliged to be employed before treatment.The treatment strategy involves in core principle of “regulating the liver and harmonizing the five viscera”,with the application of three therapeutic approaches (promoting circulation method,clearing heat method,and tonifying deficiency method) along with adjunctive therapy of emotional regulation.The comprehensive approach yields clinical benefits for patients with chest obstruction.

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备注/Memo

备注/Memo:
国家自然科学基金资助项目(82104475)；张冰全国名老中医药专家传承工作室建设项目[国中医药人教函（2022）75号]；中医药传承与创新“百千万”人才工程项目（岐黄工程）岐黄学者项目(1040063320004)；北京中医药薪火传承“新3+3”工程示范案例项目(2023-ZYSF-13)
更新日期/Last Update: 2025-08-08