目的:探讨大量心包积液的病因、中医证候和中西医结合治疗方法。方法:对39例住院患者的临床资料进行分析。结果:病因构成依次为肿瘤性(41.0%)、结核性(20.5%)、甲减性(7.7%)、心功能不全(5.1%),心包切开综合征(5.1%),其它原因(10.3%),不明原因(10.3%)。中医证候分布以脾肾阳虚证(41.3%)多见,而结核性患者则以邪犯胸肺证(62.5%)、热传心包证(37.5%)为主。结论:临床辨治大量心包积液应辨病为先,明确病因,在心包穿刺引流及腔内药物注射治疗基础上辨证加服中药,有利于缓解心包积液症状,改善临床治疗结局。 Objective: To investigate the etiology of a large number of pericardial effusion, traditional Chinese medicine syndrome and Integrative Medicine treatment. Methods: The clinical data of 39 inpatients were analyzed. Results: The causes of etiology were neoplastic (41.0%), tuberculous (20.5%), hypothyroidism (7.7%), cardiac insufficiency (5.1%), pericardial entrapment syndrome (5.1%) and other causes %), Unknown reason (10.3%). TCM syndromes were more common in spleen and kidney yang deficiency syndrome (41.3%), whereas tuberculous patients were mainly infectious chest and lung syndrome (62.5%) and heat syndrome (37.5%). Conclusion: A large number of pericardial effusion fluid should be identified first, clear the cause, pericardial puncture drainage and intracavitary drug injection therapy based on syndrome differentiation plus traditional Chinese medicine, help to alleviate the symptoms of pericardial effusion and improve the outcome of clinical treatment.