从2013年欧洲心脏病协会稳定性冠状动脉疾病管理指南谈冠心病络风内动-心脉瘀阻理论  

Comprehensive Understanding of Internal Stirring of Collateral Wind and Blockade of Heart Vessel Theory of Coronary Heart Disease: Based on 2013 ESC Guideline on Management of Stable Coronary Artery Disease

作　　者：李红梅[1,2] 孔维颖[1,2] 孙孟琼 王显[1,2] LI Hongmei KONG Weiying SUN Mengqiong WANG Xian(Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700 Angiocardiopathy Institute, Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学东直门医院,北京市东直门内海运仓5号100700 [2]北京中医药大学心血管病研究所

出　　处：《中医杂志》2016年第22期1917-1920,1924,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81273913);北京中医药大学重点学科开放课题(2013-ZDXKKF-27)

摘　　要：2013年欧洲心脏病学会(ESC)稳定性冠状动脉疾病(SCAD)管理指南重新定义了SCAD的发病机制,指出冠状动脉微循环障碍或痉挛是SCAD发病的重要原因,需密切关注冠状动脉微循环及心肌细胞水平的再灌注。由于目前微血管功能障碍机制尚未明确,仍需探索包括中医药在内的多种治疗方法。冠状动脉微循环障碍或痉挛与中医"络脉为病"相似,具备多虚、多瘀、多变特点,加之其病理变化极具风证表现,提出络风内动病机理论,认为心脉瘀阻是SCAD的基本病机,而络风内动是其重要补充,络风内动-心脉瘀阻互为因果、合而为害,最终可导致急性冠脉综合征等心血管急危重症的发生。2013 ESC Guideline on Management of Stable Coronary Artery Disease redefined the pathogenesis of stable coronary artery disease（ SCAD）. The guidelines pointed out that coronary artery microcirculatory disturbance or arteriospasm was an important cause of SCAD. Coronary microcirculation and reperfusion of myocardial cells should be paid close attention. As the mechanism of microvascular dysfunction is not clear so far,many therapies should still be explored,including Chinese medicine. Coronary artery microcirculatory disturbance or arteriospasm is similar to＂collaterals dysfunction＂in Chinese medicine,with the characteristics of most deficiency,most blood stasis and mostly changeable. Besides,the pathological changes of SCAD is quite like wind syndrome. The authors put forward the internal stirring of collateral wind theory. The authors hold that the blockade of heart vessel is the basic pathogenesis of SCAD and that internal stirring of collateral wind is an important supplement. Blockade of heart vessel and internal stirring of collateral wind interact both as cause and effect and harm the body together. Then acute coronary syndrome and other cardiovascular emergency and severe diseases might be occurred eventually.

关 键 词：稳定性冠心病 络风内动 心脉瘀阻 冠状动脉微循环 急性冠脉综合征 

分 类 号：R259[医药卫生—中西医结合]