从“上下交病，当治其中”探讨阳虚水泛型慢性心力衰竭

Exploring the Chronic Heart Failure Caused by Yang Deficiency and Water Deficiency from the Perspective of “Treating the Disease of Upper and Lower Communication”

摘要: 探讨阐明上下交病、病证纷繁、盘根错结之证，当注重整体、探明病机，治疗慢性心力衰竭从阳虚水泛证，以叶天士《临证指南医案·吐血》中的“上下交病，治在中焦”理论，阐明上下交病的理论基础，以及治中焦在疾病治疗中的重要意义，探讨温阳利水方治疗阳虚水泛证慢性心力衰竭的临床疗效。中焦脾胃作为后天之本，治疗上当注意顾护脾胃，对于人体气血津液的运化有着重要作用。“上下交损，当治其中”上治心衰气虚及心阳虚之面浮神疲乏力，口唇发绀，下肾阳虚水泛之水湿泛滥而肢肿尿少，中治水饮内停之腹胀纳呆，血津外泄。深入探究益气升阳法对于慢性心力衰竭的治疗作用。

Abstract: This article explores and elucidates the syndrome of upper and lower junction disease, complex disease syndromes, and tangled roots. It is important to pay attention to the overall situation and explore the pathogenesis in the treatment of chronic heart failure from the perspective of Yang deficiency and water flooding syndrome. Using the theory of “upper and lower junction disease, treated in the middle jiao” in Ye Tianshi’s “Clinical Guidelines for Medical Cases: Vomiting Blood”, the theoretical basis of upper and lower junction disease is explained, as well as the important significance of treating the middle jiao in disease treatment. The clinical efficacy of Wenyang Lishui Formula in treating chronic heart failure with Yang deficiency and water flooding syndrome is discussed. As the foundation of postnatal development, the spleen and stomach in the middle burner should be taken care of during treatment, which plays an important role in the circulation of qi, blood, and body fluids in the human body. The upper and lower joints are damaged, and it should be treated accordingly. The upper part treats heart failure, qi deficiency, and heart yang deficiency, causing fatigue and weakness, cyanosis of the mouth and lips, and the lower part of the kidney yang deficiency with excessive water and dampness, resulting in swollen limbs and less urine. The middle part treats bloating and stagnation caused by stopping drinking water, leading to blood leakage to in-depth investigate the therapeutic effects of the qi and yang promotion method for chronic heart failure.