浅析慢性心力衰竭与三焦湿浊的关系

A Brief Analysis of the Relationship between Chronic Heart Failure and Trifocal Dampness and Turbidness

摘要: 慢性心力衰竭的病理特点为本虚标实，核心病机在于心、脾、肾阳气亏虚，导致三焦气化功能失调，湿浊内蕴。三焦作为水液代谢与气机升降的关键枢纽，一旦受阻，湿浊便会弥散全身。湿浊上犯心肺可引发喘促心悸，中焦脾胃受困则表现为脘腹胀满、纳差食少，下焦泛滥则形成水肿及尿量减少，从而形成“心–三焦–湿浊”的恶性循环，病情迁延难愈。本文依托三焦湿浊理论，提出治疗应以整体观念为统领，以“通调三焦、分消湿浊”为基本法则，通过宣通上焦助心行水、运化中焦健脾化湿、渗利下焦温阳祛浊，恢复三焦正常的气化功能，为慢性心力衰竭的诊疗提供思路参考。

Abstract: The pathological characteristics of chronic heart failure are defined as deficiency in origin and excess in superficiality. Its core pathogenesis lies in yang qi deficiency of the heart, spleen and kidney, which leads to dysfunction of qi transformation in the triple energizer and internal accumulation of damp turbidity. As a critical hub for water metabolism and the ascending and descending of qi movement, once the triple energizer is obstructed, damp turbidity will diffuse throughout the whole body. When damp turbidity invades the heart and lung upward, it can cause dyspnea and palpitations; when the spleen and stomach in the middle energizer are trapped, it manifests as epigastric abdominal distension and anorexia; when it overflows in the lower energizer, it causes edema and reduced urine output, thereby forming a vicious cycle of “heart, triple energizer, damp turbidity”, resulting in prolonged and intractable condition. Based on the triple energizer damp turbidity theory, this paper proposes that treatment should be guided by the holistic concept, with “unblocking the triple energizer and dispersing damp turbidity” as the basic therapeutic principle. By diffusing and unblocking the upper energizer to assist the heart in promoting water circulation, activating the middle energizer to invigorate the spleen and resolve dampness, and dredging the lower energizer to warm yang and eliminate turbidity, the normal qi transformation function of the triple energizer can be restored, which provides reference for the diagnosis and treatment of chronic heart failure.