圆运动六经辨证论治心力衰竭*
作者：邓贤斌1，颜 芳1，廖 宇2，陈路军2，刘 星2，陈伟容2，张建松2，陈文静2，何姣娜2，何凡应2，谢 婧2
单位：1.广州中医药大学第二临床医学院/广东省中医院中医经典临床应用研究基地，广东 广州 510370； 2.郴州市中医医院，湖南 郴州 423000
引用：引用：邓贤斌，颜芳，廖宇，陈路军，刘星，陈伟容，张建松，陈文静，何姣娜，何凡应，谢婧.圆运动六经辨证论治心力衰竭[J].中医药导报,2025,31(5):229-236.
DOI：10.13862/j.cn43-1446/r.2025.05.043
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摘要：
从中医经典理论出发，结合名老中医经验，并根据多年来在中医经典病房治疗各类急、慢性心力衰竭的实践研究，构建了以圆运动六经辨证为主导的理论体系。该体系以几何圆为基础模型，立足整体，结合六经辨证以“明病因、定病位，识病性、断病势”，动态认识人身“一气”之运行，以恢复一气周流、阴平阳秘为目的，最终使疾病向愈。圆运动六经辨证体系认为心力衰竭乃心脏遭受外邪或者内因损伤，损伤其阳气，耗竭其精血，使气机的升降出入失常，痰浊、瘀血、水饮等浊阴之邪内生，其又反过来影响一气之周流，其病位在六经中往往不离太阳和少阴，而在脏腑病位中常心、肾互相影响，共同发病。治疗上，针对“阳气衰微”这一病机，治以破格救心汤。而针对阳气衰微后所产生的病理产物，如以水饮为主，合用温氏奔豚汤或木防己去石膏加茯苓芒硝汤、十枣汤等；如以痰饮为主，合用瓜蒌薤白类方；如以瘀血为主，合用桃仁承气汤、丹参饮或大黄?虫丸。若阳气虚衰表现不明显，而以病理产物壅盛结聚之象为主者，可单用承气类方泻其标实，以恢复其一气周流；若合并精气亏虚，合用炙甘草汤、肾四味、肾气丸或培元固本散；若合并外感，可合用变通小青龙汤、麻黄附子细辛汤等。立足圆运动六经辨证体系，纠正三阴三阳之气机失偏，往往能快速起效。
关键词：圆运动六经辨证；心力衰竭；辨证论治；太阳；少阴
Abstract：
Based on classical theories of traditional Chinese medicine (TCM), combined with the experience of renowned senior TCM physicians, and through years of practical research on treating various acute and chronic heart failures in TCM classic wards, a theoretical system guided by six meridian syndrome differentiation of circular motion has been constructed. This system utilizes the geometric circle as its fundamental model, considers the entire body while incorporating syndrome differentiation of six meridians to "identify etiology, determine disease location, ascertain disease nature, and disrupt disease progression." It dynamically recognizes the functioning of "one Qi" within the human body with an aim to restore Qi flow, maintain Yin-Yang balance, and ultimately facilitate healing. The six meridians syndrome differentiation system of circular motion posits that heart failure occurs when the heart is damaged by external pathogens or internal factors, which depletes Yang Qi and vital essence, disrupts the normal ascent-descent and entry-exit of Qi movement, and generates turbid Yin pathogens such as phlegm-turbidity, blood stasis, and water retention. These pathogens in turn affect the circulation of Qi. The disease location in the six meridians often involves the Taiyang and Shaoyin meridians, while in the zang-fu organs, the heart and kidney often influence each other and co-occur. In the aspect of treatment, in response to the pathogenesis of "decline of Yang Qi", the treatment is carried out with the Poge Jiuxin Decoction (破格救心汤). For the pathological products resulting from the decline of Yang Qi, such as when water retention is dominant, the combination of Wen's Bentun Decoction (温氏奔豚汤) or Mufangji Qu Shigao Jia Fuling Mangxiao Decoction (木防己去石膏加茯苓芒硝汤) and Shizao Decoction (十枣汤) can be applied. When phlegm retention is dominant, the combination of prescriptions like Gualou Xiebai class formulas can be used. When blood stasis is dominant, the combination of Taoren Chengqi Decoction (桃仁承气汤), Danshen Yin (丹参饮) or Dahuang Zhechong Wan (大黄?虫丸) can be utilized. If the manifestation of deficient Yang Qi is not obvious but the congestion and accumulation of pathological products are predominant, the defecation prescriptions alone can be used to purge the excess to restore the circulation of Qi. If there are deficiency of essence and Qi, the combination of Zhigancao Decoction (炙甘草汤), Shen Si Wei (肾四味), Shenqi Wan (肾气丸), or Peiyuan Guben San (培元固本散) can be adopted. If combined with external infection, the combination of modified Xiaoqinglong Decoction (小青龙汤) or Mahuang Fuzi Xixin Decoction (麻黄附子细辛汤) can be used. Based on the six meridian syndrome differentiation system of circular motion, correcting the deviation of the Qi mechanism of the three Yin and three Yang can often achieve rapid efficacy.
Key words：six meridians syndrome differentiation system of circular motion; heart failure; syndrome differentiation and treatment; Taiyang; Shaoyin
发布时间：2026-01-03
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