从风论治血管痉挛性心绞痛

血管痉挛性心绞痛(vasospastic angina,VSA)发作时疼痛部位不固定,或者表现为牙痛、头痛、腹痛等,疼痛时发时止,病位不固定,与风邪"善行"特点相符;VSA发病急骤,轻重不一,变化无常,与风邪"数变"特点相符。善行数变是风邪致病的特点,风邪外侵是VSA重要的病因。风邪包括外风、内风,VSA的发病病机为正虚邪中,由脏腑虚弱,风邪内侵而致,常因感受风寒邪气或在季节更替时诱发或加重,可见,外风是VSA的重要致病因素。内风与VSA也密切相关,肝为风木之脏,肝病则风从内生,肝风内动,风邪乘于心,心脉痉挛,卒发VSA。基于治病必求于本,中医治疗本病应重视运用风药,风药是指具有发散风邪、祛风、解痉功能的一类药物。现代药理研究表明,绝大多数祛风药均具有解除血管痉挛、扩张血管、改善血液循环、抗血小板聚集、抗凝、改善末梢循环、止痛等多方面的作用,是治疗VSA的有效中药。

An Analysis of Treating Vasospasm Angina from Wind in TCM

When the onset of vasospasmic angina(VSA)appears,the pain is not fixed,manifested as toothache,or headache,or abdominal pain,etc.when the pain occurs,the disease location is not fixed,which is consistent with the characteristic of"being susceptible to movement"of wind pathogen.The onset of VSA is urgent,varying in severity and variability,which is consistent with the characteristic of"being susceptible to change"of wind pathogen in TCM."Being susceptible to movement and change"is the characteristic of pathogenic wind,and external invasion of pathogenic wind is an important cause of VSA.Wind pathogen includes external wind and internal wind.The pathogenesis of VSA is deficiency of healthy qi,which is caused by the weakness of viscera and the invasion of wind pathogen.It is often induced or aggravated by the attack of wind cold or the change of seasons.It can be seen that external wind is an important pathogenic factor of VSA.The internal wind is also closely related to VSA.The liver is the organ of wind wood.The liver disease is caused by the internal wind.The wind moves in the liver and attacks the heart.The heart vessels are spasmodic causing chest arthralgia and heartache.Based on the principle of treating diseases from root cause,TCM should pay attention to the use of wind medicinals,which is a kind of medicinal with the functions of dispersing wind,dispelling wind and spasmolysis.Modern pharmacological research shows that most of the wind-expelling medicinals have the functions of relieving vasospasm,dilating blood vessels,improving blood circulation,anti platelet aggregation,anticoagulation,improving peripheral circulation,and relieving pain.They are effective Chinese medicinals for VSA.