从“君火以明，相火以位”论治双心疾病的经验

Experience in Treating Double Heart Disease Based on the Theory of “the Sovereign Fire Illuminates, the Minister Fire Positions”

摘要: 基于《素问·天元纪大论》“君火以明，相火以位”理论，探讨双心疾病的中医病机演变及周亚滨教授辨治经验。根据临床症状以及疾病演变过程，可以将双心疾病归属于中医学“胸痹”“郁证”“心悸”“不寐”等病的范畴。周亚滨教授指出，君火失明，相火失位是双心疾病的核心病机，情志过极则君火燥亢，血脉运行失畅；心肾不交则水火失济，心神浮越不宁；君相失位致阴阳两虚，气血亏耗，心体失养。周亚滨教授临床治疗以清火调血，调和阴阳为治疗原则，通过急则清心泻火，安神定志，缓则交通心肾，引火归元，重则温阳益气，调燮君相的治法，从而平稳病情，达到治疗效果。本文主要介绍周亚滨教授治疗双心疾病的经验，并附验案1则。

Abstract: Based on the theory of “The sovereign fire is for clarity, and the minister fire is for position” from “The Yellow Emperor’s Inner Classic: The Great Treatise on the Heavenly Origin”, this paper explores the etiology, pathogenesis, and treatment of dual heart disease in traditional Chinese medicine. According to clinical symptoms and the disease evolution process, dual heart disease can be classified under the categories of “chest obstruction” and “depression” in traditional Chinese medicine. Professor Zhou Yabin pointed out that the loss of clarity of the sovereign fire and the loss of position of the minister fire are the key pathogenic factors of dual heart disease. Excessive emotions lead to the hyperactivity of the sovereign fire and the obstruction of blood circulation; the non-interaction between the heart and the kidney results in the imbalance of water and fire, and the restlessness of the heart spirit. The loss of position of the sovereign and minister fires leads to the deficiency of both yin and yang, the depletion of qi and blood, and the lack of nourishment of the heart. Professor Zhou Yabin’s clinical treatment is based on the principles of clearing fire, regulating blood, and harmonizing yin and yang. The treatment methods include clearing heart fire and calming the spirit in acute cases, communicating heart and kidney and guiding fire back to its origin in mild cases, and warming yang and tonifying qi and regulating the sovereign and minister fires in severe cases, thereby stabilizing the condition and achieving therapeutic effects. This paper mainly introduces Professor Zhou Yabin’s experience in treating dual heart disease and includes one verified case.