血运重建时代急性冠脉综合征的中西医结合防治  

The prevention and treatment of acute coronary syndrome with integration of Chinese and Western medicine in revascularization

作　　者：史大卓[1] 郭艳[1] 

机构地区：[1]中国中医科学院西苑医院心血管中心,北京100091

出　　处：《环球中医药》2009年第2期81-84,共4页Global Traditional Chinese Medicine

摘　　要：急性冠状动脉综合征(ACS)是以冠状动脉粥样硬化(AS)斑块破裂,继发完全或不完全闭塞性血栓形成为共同病理基础的一组临床综合征,为心血管病致残和死亡的主要原因。随着冠心病介入治疗(PCI)技术的迅速发展、强化降脂理念的普遍认同及新型抗血小板制剂的临床应用,显著改善了ACS的预后。ACS是一种代谢性疾病,冠状动脉粥样硬化及其基础上的血栓形成是机体病理生理变化的局部反应,治疗靶向仅集中于冠状动脉或者缺血的心肌组织,显然难以获得真正理想的效果。如何改善ACS患者的长期预后,中医药复杂的药理作用初步显示有较好的综合效果,但仍有许多问题需要深入系统研究。按照循证医学要求,进行多中心、大样本、随机对照的中医药综合治疗ACS的临床研究,采用临床流行病学、现代生物信息技术,综合现代ACS中西医研究进展,建立包括中医证候在内的ACS高危人群的辨识体系。在此基础上,结合专家临床经验,构建ACS中医药干预规范,对提高我国ACS患者高危人群的综合识别能力和ACS中医药二级预防水平,具有十分重要的意义。Acute coronary syndrome（ACS） is a set of clinical syndrome, which is one of the main causes of disability and even mortality in coronary heart disease patients. The pathology is rupture of coronary atherosclerotic plaque leading to complete or incomplete occlusive thrombosis. Along with the rapid development of percutaneous coronary intervention （PCI） technique, prevalence of Intensive lipid lowering and clinical application of new anti - platelet agents, prognosis of ACS has been increasing greatly. ACS is also regarded as a metabolic disorder, atherosclerosis and thrombosisis just local reactions of the whole body pathophysiologic changes, therefore, treatment targeting at coronary artery or ischemic myocardium could not obtain ideal effect. Pharmacological studies showed traditional Chinese medicine has favorable efficiency on the long-term prognosis of ACS patients. However, there are problems needing deep and systematic study. Multi-center large-sample randomized controlled clinical trials for ACS treatment with TCM should be conducted according to evidence-based medicine. Clinical epidemiology and modern biological information technique should be utilized, and research progress on ACS of Western medicine and traditional Chinese medicine be combined to establish the identification system for ACS high risk population. On this base of the identification system, TCM intervention standard for ACS could be built up combining clinical experiences of the experts, which is of great importance for improving identification of ACS high risk population in China and raising the secondary prevention level with TCM.

关 键 词：急性冠脉综合征 血运重建 中西医结合 

分 类 号：R256.2[医药卫生—中医内科学]