目的:探讨冠心病合并心力衰竭的中医基础治法。方法:编撰冠心病合并心衰治则治法临床专家调查问卷,开展多中心、大样本调查研究,应用汇总、组合、排序分析等方法进行统计分析。结果:冠心病合并心力衰竭诊疗中应优先判断病势轻重缓急,主要治法优选益气、温阳、活血化瘀、利水。急性发作期方选参附汤、四逆汤、真武汤加减,慢性缓解期方选生脉散、补阳还五汤合五苓散、人参汤、炙甘草汤加减。各期用药均优选辛甘药以化阳、甘淡以利水除湿、甘温以建中。结论:基于多中心大样本流调得出的冠心病合并心衰基础治则治法符合临床诊疗规律,可反映临床专家对该病的诊疗共识,为中医规范化治疗提供参考。
Objective: To explore the basic treatment of coronary heart disease with heart failure. Methods: The clinical experts questionnaire of coronary heart disease combined with heart failure was compiled. A muhieentre and large sample survey was carried out, and the data were analyzed by means of summary, combination and sequencing. Results: The diagnosis and treatment of coronary heart disease with heart failure should be prioritized. The main method of choice Yiqi, warm yang, promoting blood circulation, diuresis. Choosing Senate decoction, Sini Decoction, Zhenwu Decoction in acute period. And election of Shengmaisan, Buyang Huanwu Decoction, Wuling San, Ginseng soup, Zhigancao Decoction. All drugs are preferred pungent and swect drugs to producye Yang, sweet drugs facilitate water dehumidification, Sweet drugs for warm to repleaishting the Middle. Conclusion: Based on the multi-center large sample flow, the basic rule of CHD combined with heart failure is in accordance with clinical diagnosis and treatment, which can reflect the clinical consensus of clinicians and provide reference for standardized treatment of TCM.