中医杂志

基于“风者善行而数变”理论，提出心血管疾病复发的“风邪致复”病机认识。认为心血管疾病复发的核心病机在于风邪引动痰、瘀、火、水等伏邪，触发风痰阻络、风引水乘、风火相煽、瘀风流注等动态演变过程，导致气血逆乱、脏腑功能骤损，形成复发窗口期的病理枢纽。内风生于虚、热、瘀三大病理基础（因虚生风、因热生风、因瘀生风），外风夹邪侵袭为常见诱因。针对上述病因病机，构建固本熄风防复策略，即固本培元，治本防复，通过益气养阴、滋补肝肾、健脾化痰、活血通络消除生风内因；熄风防复，治标截变，按风动类型以潜阳、凉肝、化痰、通络等法阻断复发；分期施策，动态应变，稳定期重固本调质，先兆期强化熄风预警，复发期以防变为先、熄风为要。

Based on the theory that "wind is characterized by mobility and rapid change", this paper proposes the pathomechanistic concept of "wind pathogen-induced relapse" to explain recurrence in cardiovascular diseases. It posits that the core mechanism of recurrence lies in wind pathogens activating latent phlegm, stasis, fire, and water, thereby triggering dynamic pathological processes such as wind-phlegm obstructing the collaterals, wind driving water retention, mutual exacerbation of wind and fire, and migratory stasis with wind. These changes result in disordered qi and blood, abrupt impairment of zang-fu functions, and the formation of a pathological hub corresponding to a recurrence window period. Endogenous wind （内风） arises from three fundamental pathological bases, which are deficiency, heat, and stasis(wind generated from deficiency, heat, and stasis, respectively), while invasion of exogenous wind （外风） combined with other pathogens is a common precipitating factor. In response to these etiologies and mechanisms, a recurrence-prevention strategy centered on "strengthening the root and extinguishing wind" is proposed. This includes strengthening the root and cultivating vital qi to prevent recurrence at its source by tonifying qi and nourishing yin, enriching the liver and kidneys, strengthening the spleen and resolving phlegm, and activating blood and unblocking the collaterals to eliminate internal factors generating wind; extinguishing wind to prevent relapse by addressing manifestations and intercepting pathological change, with methods such as suppressing hyperactive yang, cooling the liver, resolving phlegm, and unblocking the collaterals according to the type of wind movement; and stage-based, dynamic intervention, emphasizing root-strengthening and constitutional regulation during the stable phase, enhancing wind-extinguishing vigilance during the prodromal phase, and prioritizing prevention of deterioration with windextinguishing as the key measure during the recurrence phase. This framework holds significant clinical value for improving secondary prevention systems for cardiovascular diseases and enhancing long-term prognosis.