【摘要】 本研究主要介绍毛以林教授从“宗气”论治慢性肺源性心脏病（简称肺心病）的临证经验。毛以林教授深究中医学著作，扎根临床数十年，提出慢性肺心病的根本病机在于宗气亏虚（心肺之气亏虚），痰饮、水湿、瘀血为重要的病理因素，病久以固护正气为要。故在治疗慢性肺心病时，毛教授主张以“大补宗气”为核心治疗原则，方选升陷汤，贯穿疾病治疗始终。同时配合化饮、利水、祛瘀等治法以治其标，结合脏腑辨证：对于痰饮停于肺见咳嗽咳痰者，合小青龙汤、苓甘五味姜辛汤温肺化饮，千金苇茎汤清肺化痰，柴胡、桔梗宣降肺气；痰停于胸胁见胸腔积液、气短者，合葶苈大枣泻肺汤泻肺逐饮、生脉散益气固脱；痰停于脾见腹胀、纳呆者，合苓桂术甘汤、参苓白术散健脾祛湿；水饮泛溢肌肤见肿胀者，合真武汤、五苓散化气利水；四肢肿甚者，加姜皮、大腹皮；饮停胸胁见咳嗽、胸痛者，合椒目瓜蒌汤泻肺逐饮；心脉瘀阻见胸闷、胸痛者，合瓜蒌薤白半夏汤通阳宣痹；心阳亏虚见心悸者，合桂枝加龙骨牡蛎汤温通心阳。病久、病重者从三焦论治固护正气：上焦宗气、中焦脾胃之气、下焦肾气。三大治法灵活运用以达显著疗效。在临床实践中，毛教授注重辨证论治，灵活选用经方，随证加减，疗效卓著。文章从理论来源、病因病机以及诊疗特色三大方面阐述其治疗经验，并附验案1则，以资佐证。更多还原

【Abstract】 In this study, Professor MAO Yilin’s clinical experience in treating chronic pulmonale heart disease(CPHD) based on the theory of “Zongqi(宗气)” is mainly introduced. Having been deeply rooted in traditional Chinese medicine classics, with decades of clinical practice, Professor MAO Yilin proposes that the fundamental pathogenesis of CPHD lies in the deficiency of Zongqi, that is, deficiency of heart and lungs Qi(气). Important pathological factors include phlegm retention, water-dampness, and blood stasis, and it is crucial to protect the vital energy of the body for patients with a long-term illness. Therefore, in the treatment of CHPD, Professor MAO advocates taking the great supplementation of Zongqi as the core treatment principle. Shengxian Decoction(升陷汤) is selected and applied throughout the whole process of the treatment. At the same time, the treatment methods such as resolving retained fluid, promoting diuresis, and removing blood stasis are used to relieve the symptoms, combined with Zangfu organs(脏腑) syndrome differentiation. Specifically, for patients with cough and expectoration due to phlegm-fluid retention in the lungs, Xiaoqinglong Decoction(小青龙汤) and Linggan Wuwei Jiangxin Decoction(苓甘五味姜辛汤) are used additionally to warm the lungs and resolve retained fluid, or Qianjin Weijing Decoction(千金苇茎汤) is used additionally to clear the lungs and resolve phlegm, or Chaihu(Radix Bupleuri) and Jiegeng(Radix Platycodonis) are used to regulate the ascending and descending of lung Qi. For patients with pleural effusion and shortness of breath due to phlegm retention in the chest and hypochondrium, Tingli Dazao Xiefei Decoction(葶苈大枣泻肺汤) is additionally used to purge the lungs and expel retained fluid, and Shengmai San(生脉散) is additionally used to replenish Qi and prevent collapse. For patients with abdominal distension and poor appetite due to phlegm retention in the spleen, Linggui Zhugan Decoction(苓桂术甘汤) and Shenling Baizhu San(参苓白术散) are additionally used to invigorate the spleen and dispel dampness. For those with swelling due to water-fluid overflowing on the skin, Zhenwu Decoction(真武汤) and Wuling San(五苓散) additionally are used to transform Qi and promote diuresis. For those with severe swelling of the limbs, Jiangpi(Ginger Peel) and Dafupi(Pericarpium Arecae) are added. For those with cough and chest pain due to retained fluid in the chest and hypochondrium, Jiaomu Gualou Decoction(椒目瓜蒌汤) is additionally used to purge the lungs and expel retained fluid. For those with stuffy chest and chest pain due to obstruction of the heart meridian, Gualou Xiebai Banxia Decoction(瓜蒌薤白半夏汤) is additionally used to activate Yang(阳) and relieve obstruction. For those with palpitations due to deficiency of heart Yang, Guizhi Jia Longgu Muli Decoction(桂枝加龙骨牡蛎汤) is additionally used to warm and activate heart Yang. For those with a long course of disease and severe condition, the treatment is carried out from the perspective of triple energizer to protect the vital Qi, which includes Zongqi in the upper energizer, spleen and stomach Qi in the middle energizer, and kidney Qi in the lower energizer. Remarkable curative effects can be achieved by flexibly applying the three methods. In clinical practice, Professor MAO attaches great importance to syndrome differentiation and treatment, flexibly selects classical prescriptions, and makes modifications according to the symptoms, with excellent curative effects. In this article, clinical experience of Professor MAO is elaborated from the three aspects of theoretical source, etiology and pathogenesis, and the characteristics of diagnosis and treatment, and one empirical case is attached as evidence.更多还原