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从痰瘀论治冠状动脉粥样硬化性心脏病概述

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冠状动脉粥样硬化性心脏病(简称冠心病),属于中医"胸痹""心痛"范畴,多具有病势缠绵难愈、病情反复多变等特点,中医药在治疗胸痹心痛方面历史悠久且疗效显著,具有从多途径、多层次、多环节、多靶点整体调理的优势,可改善冠心病患者冠状动脉病理状态,在改善临床症状、提高生活质量方面凸显优势.现代大量的临床实践及研究也验证了中医治法在冠心病治疗中的临床疗效.近年来,随着人们生活条件改善,饮食失节,劳逸失度,气、血、水液运行失常,内生痰浊、瘀血等病理产物,早期可表现为西医学的高脂血症、动脉硬化等,痰浊、瘀血痹阻心脉,痰、瘀相互影响、相互作用,加快疾病的进程,导致胸闷、胸痛、气短等症状的发生,中医辨证为痰瘀互结证,冠心病中医证候特征研究文献表明,痰瘀互结证是冠心病的主要证候要素之一,并且所占比例逐年上升.传统中医经典著作对痰、瘀的形成及痰、瘀与胸痹的关系进行了大量描述,为从痰瘀论治冠心病提供了理论依据,文章旨在从传统中医经典、现代中医学机制研究及临床研究等方面综述对痰、瘀的认识,以期为从痰瘀论治冠心病提供更多理论依据.
A review on treating coronary heart disease from the aspect of phlegm and stasis
Coronary atherosclerotic heart disease,referred to as coronary heart disease,belongs to the category of chest impediment and heartache of traditional Chinese medicine,mainly has the characteristics of lingering and difficult to cure,repeated and changeable disease,etc.Traditional Chinese medicine has a long history and significant curative effects in the treatment of chest impediment and heartache.Traditional Chinese medicine has the advantage of overall comprehensive conditioning from multi-pathway,multi-level,multi-link and multi-target.In addition to ameliorating the pathological state of coronary artery in patients with coronary heart disease,it has prominent advan-tages in relieving clinical symptoms and improving quality of life.A large number of modem clinical practice and research have also verified the clinical effect of traditional Chinese medicine in the treatment of coronary heart disease.In recent years,with the improvement of people's living conditions,it is caused by improper diet,imbalanced work and rest,abnormal operation of Qi(气),blood,and water,internal phlegm turbidity,blood stasis and other pathological products,it manifests as hyperlipidemia and arteriosclerosis in western medicine in the early stage,leads to phlegm turbidity and blood stasis obstruction of heart meridian,resulting in phlegm and blood stasis mutual influence and interaction,which ac-celerates the process of disease and leads to chest tightness,chest pain,shortness of breath and other symptoms.TCM differentiation of the disease is intermingled phlegm and blood stasis syndrome.Research literature shows that the syndrome of intermingled phlegm and blood stasis is one of the main syndromic elements of coronary heart disease,and the proportion is increasing year by year.The traditional Chinese medicine classics describe the formation of phlegm and blood stasis,and the relationship between phlegm and blood stasis,and chest arthralgia,which provides a theoretical basis for treating coronary heart disease from phlegm and blood stasis.This paper aims to summarize the understanding of phlegm and blood stasis from traditional Chinese medicine classics,modem Chinese medicine mechanism research and clinical research,in order to provide more theoretical basis for treating coronary heart disease from the aspect of phlegm and blood stasis.

Coronary heart diseaseChest arthralgiaIntermingled phlegm and blood stasisReview

张丽慧、侍星宇、于清华

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长春中医药大学,吉林 长春,130021

吉林省中医药科学院第一临床医院,吉林 长春,130021

冠心病 胸痹 痰瘀互结 综述

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(24)