摘要
冠状动脉粥样硬化性心脏病(简称冠心病)是全球导致人类死亡的主要病因,具有较高的致残率与病死率,其病理机制包括冠状动脉脂质紊乱、血栓形成、炎症、血管平滑细胞活化/重塑、血小板活化、内皮功能障碍、氧化应激、基质代谢改变和遗传因素等,目前冠心病的病理机制虽然相对明确,二级预防用药也有效延缓了疾病进展、减少病死率,但冠心病患病人数仍不断攀升,现有药物治疗靶点单一,缺乏作用于多靶点、多途径的药物.近年来中医药在治疗冠心病的认知与作用机制上取得丰硕成果.冠心病属中医学"胸痹""心痛"范畴,临床以气虚血瘀证最为常见,益气活血为主要治则.文章通过查阅大量的相关信息,整理了近五年益气活血类方治疗冠心病气虚血瘀证临床疗效的相关文献,发现其作用机制丰富,主要包括改善血液流变学、保护血管内皮、抑制炎症反应、抗氧化应激反应、改善心室结构及心功能、调脂、稳定斑块、改善冠状动脉血流量/慢血流、改善心肌损伤等,大量的研究结果表明在二级预防用药基础上加用益气活血类方治疗冠心病气虚血瘀证可以拓展该病的治疗靶点与途径,相较于现代医学具有独特优势,对后期临床实践与研究具有一定的理论参考价值.
Abstract
Coronary heart disease is the main causes of human death worldwide,with high disability rate and mortality,the pathological mechanism include coronary lipid disorders,thrombosis,inflammation,vascular smooth cell activation or remodeling,platelet activation,endothelial dysfunction,oxidative stress,matrix metabolic changes and genetic factors.Although the pathological mechanism of coronary heart disease is relatively clear,secondary prevention drugs also effectively delay the disease progression,and reduce mortality,the number of coronary heart disease is still rising.Existing drug treatment target is single,and lack of drugs acting on a multitarget and multipathway site.In recent years,traditional Chinese medicine has achieved fruitful results in the cognition and action mechanism of treatment of coronary heart disease.Coronary heart disease belongs to the category of chest obstruction and heartache in traditional Chinese medicine.Qi(气)deficiency and blood stasis syndrome are the most common clinically,and supplementing Qi and promoting blood circulation is the main treatment rule.By consulting a large amount of relevant information,this paper sorted out the treatment of coronary heart disease of the Qi deficiency and blood stasis syndrome by supplementing Qi and promoting blood circulation in the past five years,the mechanism of action is abundant,mainly includes improving hemorheology,protecting vascular endothelium,inhibiting inflammatory response,fighting oxidative stress response,improving ventricular structure and cardiac function,regulating lipid to stabilize plaque,improving coronary blood flow/slow blood flow,ameliorating myocardial injury,etc..These large number of research results show that on the basis of secondary preventive drugs,the addition of supplementing Qi and promoting blood circulation prescription in the treatment of coronary heart disease of the Qi deficiency and blood stasis syndrome can expand the therapeutic targets and pathways of the disease.Compared with modern medicine,this therapy has a certain theoretical reference for the later clinical practice and research.
基金项目
省部共建中亚高发病成因与防治国家重点实验室开放基金(SKL-HIDCA-2021-42)
国家科技期刊平台
NSTL
维普
万方数据