缺血性心肌病中医病名证治探赜*
作者：张卓珺，陶国水，沈丽娟，谈晓东，夏成霞，朱红俊，高 枫，陆 曙
单位：南京中医药大学附属无锡医院，江苏 无锡 214071
引用：引用：张卓珺，陶国水，沈丽娟，谈晓东，夏成霞，朱红俊，高枫，陆曙.缺血性心肌病中医病名证治探赜[J].中医药导报,2026,32(1):256-259.
DOI：10.13862/j.cn43-1446/r.2026.01.043
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摘要：
中医学对缺血性心肌病的中医病名尚未形成统一的认识，本文将逻辑学“属加种差法”作为疾病命名原则，从病因、病机、症状3个方面，在复习历代中医医籍、文献的基础上，结合本病的特征及现代医学的认识，阐明缺血性心肌病的中医病名为“胸痹心胀病”的合理性。病因方面，“胸痹”取自“胸痹心痛”，是引起缺血性心肌病的根本原因，以区别于其他原因引起的心力衰竭。病机方面，“心胀”体现心体因“胸痹”受损后，气血阴阳虚衰，加之实邪阻络，心气无以固摄引起的心体胀大，心功能下降。症状方面，“胸痹”和“心胀”可以体现缺血性心肌病胸痛、胸闷、气喘、乏力等表现，同时又可以与“心水”“心衰”“心悸”“水肿”“喘证”此类涵盖部分缺血性心肌病症状的病名区别。
关键词：缺血性心肌病；中医病名；胸痹心胀病
Abstract：
A unified understanding of the traditional Chinese medicine (TCM) nomenclature for ischemic cardiomyopathy has not yet been established in TCM academia. Based on reviewing TCM classics and literature from successive dynasties, combined with the characteristics of this disease and modern medical understanding, this paper adopts the logical method of "genus plus specific difference" as the principle for disease nomenclature, and clarifies the rationality of defining the TCM name of ischemic cardiomyopathy as "Xiong Bi Xin Zhang Bing" from three aspects: etiology, pathogenesis and symptoms. In terms of etiology, "Xiong Bi" is derived from "Xiong Bi Xin Tong", which is the fundamental cause of ischemic cardiomyopathy, serving to distinguish it from heart failure caused by other etiologies. In terms of pathogenesis, "Xin Zhang" reflects the pathological state where the heart structure becomes enlarged and cardiac function declines after the heart is damaged by "Xiong Bi". This condition arises from the deficiency of Qi, blood, Yin and Yang, together with pathogenic obstruction of collaterals, leading to the failure of heart Qi to consolidate and contain the heart structure. In terms of symptoms, "Xiong Bi" and "Xin Zhang" can cover the clinical manifestations of ischemic cardiomyopathy such as chest pain, chest tightness, dyspnea and fatigue. Meanwhile, this nomenclature can also differentiate ischemic cardiomyopathy from other TCM disease names that only cover partial symptoms of the disease, such as "Xin Shui", "Xin Shuai", "Xin Ji", "Shui Zhong" and "Chuan Zheng".
Key words：ischemic cardiomyopathy; traditional Chinese medicine disease name; Xiong Bi Xin Zhang Bing
发布时间：2026-01-30
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