郭晟 周承志

[摘要] 心脑血管疾病是中老年人的常见病，具有发病率高、致残率高、死亡率高、复发率高、并发症多的特点，严重威胁人类的生命健康。血瘀证是各类心脑血管疾病的常见证型，贯穿临床各种疾病的病程始终。活血化瘀法是治疗中医血瘀证的基本治法，由于临床上各类心脑血管疾病的病程长短、病因病机存在差异，血瘀证又有急性血瘀证与慢性血瘀证之分。中医认为急性血瘀证的致病因素主要包括风邪、寒邪、气逆，而慢性血瘀证的致病因素则主要包括痰浊、本虚、络阻。在治疗时，应当辨证论治，在以活血化瘀为根本治法的前提下，结合其具体的致病因素，灵活地根据病情结合其他治法，以发挥更好的疗效。本文通过总结古今历代医家对血瘀证的认识及治疗方法，探究活血化瘀法在治疗血瘀型急慢性心脑血管疾病中的异与同。

[关键词] 活血化瘀法;血瘀证;心脑血管疾病;辨证论治

[中图分类号] R256.2、R277.7          [文献标识码] A          [文章编号] 1673-7210（2020）07（a）-0140-04

[Abstract] Cardio-cerebrovascular diseases is a common disease of middle-aged and elderly people. It has the characteristics of high morbidity， high disability， high mortality， high recurrence rate and many complications， which seriously threatens human life and health. Blood stasis syndrome is a common type of various cardio-cerebrovascular diseases， which runs through the course of various clinical diseases. The method of promoting blood circulation and removing blood stasis is a basic treatment method for treating blood stasis syndrome of traditional Chinese medicine. Due to the clinical course of various cardio-cerebrovascular diseases， the etiology and pathogenesis are different. Traditional Chinese medicine believes that the pathogenic factors of acute blood stasis syndrome mainly include wind pathogen， cold pathogen， and qi reversal， while the chronic pathogenic factors of chronic blood stasis syndrome mainly include phlegm turbidity， virtual， and obstruction. In the treatment， we should dialectically treat the disease， based on the premise of promoting blood circulation and removing blood stasis， combining its specific pathogenic factors， and flexibly combining with other treatments according to the condition to exert better curative effect. This article summarizes the ancient and modern doctors′ understanding of blood stasis syndromes and their treatment methods， and explores the similarities and differences between the method of promoting blood circulation and removing blood stasis in the treatment of blood stasis type acute and chronic cardio-cerebrovascular diseases.

[Key words] Promoting blood circulation and removing blood stasis; Blood stasis syndrome; Cardio-cerebrovascular diseases; Treatment based on Syndrome differentiation

心脑血管疾病是心脏血管和脑血管疾病的统称，西医泛指由于血液黏稠、高脂血症、动脉粥样硬化所导致的心脏、大脑及全身组织发生的缺血性或出血性疾病。随着我国人口老龄化日趋严重，心脑血管疾病的发病率呈显著升高趋势，即使现代医疗技术日益先进，其死亡率仍居高不下[1-2]。2017年中国心血管报告显示了目前我国心脑血管疾病患者数量高达2.9亿[3]。心脑血管同时发病，可以认为是中医学中的“并病”，“脑心同治”理论是中医整体观和辨证论治的体现[4]。……