首页|活血化瘀法协同溶栓/取栓提高临床疗效的中医理论机制探索

活血化瘀法协同溶栓/取栓提高临床疗效的中医理论机制探索

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溶栓/取栓是针对急性缺血性脑卒中患者的一种紧急医疗干预措施,其核心目的是通过恢复脑部血流来减少脑组织损伤,并改善患者的预后.在及时恢复脑部血流、减少脑卒中后遗症方面具有显著优势.但有研究显示,即使成功进行溶栓/取栓治疗,部分患者仍会出现靶血管再次闭塞,引起二次损伤从而加重病情.该文通过回溯中西医有关溶栓/取栓的临床、实验和理论,结合课题组前期临床研究,分析活血化瘀法在溶栓/取栓不同环节的作用特点,不同种类的活血化瘀方药与溶栓/取栓治疗的协同机制,并进一步解释易损脉痹表现阳络亢戾、阴络滞瘀的"脉络亢变"特点,从理论层面揭示了活血中药通过多靶点、多途径降低溶栓/取栓治疗后血管再闭塞发生率的中医理论机制,探讨了活血化瘀方药通过促进损伤脑组织建立痰、液、瘀、毒等病理产物的排泄通道,提高损伤脑组织自我修复,以及机体气、血、精相互供给转化的能力,加快大脑重塑的作用机制,旨在深入阐释活血化瘀法在降低溶栓/取栓过程中"真溶栓、假复流"中医理论机制,具有重要的理论和实践意义.
Traditional Chinese medicine theoretical mechanism of blood-activating and stasis-resolving therapy combined with thrombolysis/thrombectomy in improving clinical efficacy
Thrombolysis/thrombectomy treatment is an emergency medical intervention for patients with acute ischemic stroke.Its core purpose is to reduce brain tissue damage and improve patient prognosis by restoring blood flow to the brain,which is significantly advantageous in timely restoring blood flow to the brain and reducing post-stroke sequelae.However,research shows that even with successful thrombolysis/thrombectomy treatment,some patients may still experience re-occlusion of the target vessel,leading to secondary damage and worsening of the condition.This study retrospectively examined clinical,experimental,and theoretical aspects of thrombolysis/thrombectomy in both traditional Chinese medicine(TCM)and western medicine,and analyzed the characteristics of blood-activating and stasis-resolving therapy in different stages of thrombolysis/thrombectomy and the synergistic mechanism of different types of blood-activating and stasis-resolving drugs with thrombolysis/thrombectomy in combination of previous clinical studies by the research team.Furthermore,the"vessel hyperactivity"characteristics embodied by Yang vessel irritability and Yin vessel stagnation was explained,revealing the TCM mechanism by which blood-activating TCM drugs reduce the incidence of vessel re-occlusion after thrombolysis/thrombectomy through multiple targets and pathways from a theoretical perspective.It also explored how blood-activating and stasis-resolving drugs promoted the excretion of pathological products such as phlegm,fluid,stasis,and toxins from damaged brain tissue,enhanced self-repair of damaged brain tissue,and accelerated the reconstruction of the brain by facilitating the transformation of Qi,blood,and essence within the body.This study aims to deeply elucidate the TCM theoretical mechanism of blood-activating and stasis-resolving therapy in reducing the occurrence of"cerebral infarction and vascular re-occlusion"during thrombolysis/thrombectomy,which holds significant theoretical and practical significance.

blood-activating and stasis-resolvingthrombolysis/thrombectomycerebral infarctionvascular re-occlusiontraditio-nal Chinese medicine theory

张金生、张宝霞、惠小珊、王阶

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河南中医药大学第三附属医院,河南郑州 450046

河南中医药大学第一附属医院,河南郑州 450046

中国中医科学院广安门医院,北京 100053

活血化瘀 溶栓/取栓 真溶栓 假复流 中医理论

河南省高等学校重点科研项目基础研究项目河南省中医药科学研究专项河南省中医药科学研究专项中原科技创新领军人才项目

24A3600162022ZY11102019JDZX2095214200510022

2024

10.19540/j.cnki.cjcmm.20240419.501

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子：1.718
ISSN：1001-5302
年,卷(期)：2024.49(17)
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