基于“五脏相关”理论并结合现代临床实践，从心之体阴而用阳的生理特点出发，提出“心体久病，发为喘证”为 心源性哮喘发病的病理机制。并从脏腑相关角度分述五脏与心源性哮喘的关系：“心衰之喘，累及肺脏”“心衰之喘，不离 中焦”“心衰之喘，心肝同病”“心衰之喘，其用在肾”。认为心源性哮喘伤及心体，瘀血内阻，故其本在心。心血不畅，饮 停胸肺，多累及肺脏。若中焦脾胃生化乏源，气血不畅，或肝气郁滞，肝血失养，或肾之阴火妄行，上扰心阳，均易导致 心衰之喘的加重。心源性哮喘的中医论治可立足于心，将“益气、活血、利水”作为治疗的主线，根据病情所累及的脏腑， 通调五脏，平衡阴阳，精准施治，以提高疗效。

Under the guidance of five-viscus correlation theory，and with reference to the clinical practice，this paper discusses the pathogenesis of cardiogenic asthma，i.e. long illness of the heart resulting in asthma，from the perspective of physiological characteristics of heart，which belongs to yin in essence and yang in function. And this paper also introduces the correlation between five zang-organs and cardiogenic asthma：asthma induced by heart failure involves the lung， has close relation with middle energizer（spleen and stomach）， results from the comorbidity of heart and liver，and contributes to the disorders of kidney. It is believed that cardiogenic asthma injures the heart，results in internal blockage of blood stasis，so the original pathogenesis of cardiogenic asthma is due to the heart；unsmoothed blood circulation causes fluid retention in the chest and lung，and then the lung is involved. The failure of spleen and stomach in generation and transportation will cause the unsmoothed circulation of qi and blood，liver qi stagnation will result in the failure of liver blood in nourishment，and the intense kidney yin-fire will stir upward and attack heart yang. The factors mentioned above all are prone to result in the aggravation of cardiogenic asthma. Therefore，the treatment of cardiogenic asthma with traditional Chinese medicine should be focused on heart，and methods of replenishing qi，activating blood circulation，and inducing diuresis are used as the primary therapeutic approaches. Moreover，according to the organs involved in cardiogenic asthma，therapies of regulating the five viscera and restoring the balance of yin and yang are used for precise treatment，and the therapeutic effect will be enhanced.

R256.12

国家重点研发计划项目（编号：2022YFC3500100）；国家自然科学基金项目（编号：81774260）