基于脉络学说探析慢性冠脉综合征的病机及治疗  

Analysis of Pathogenesis and Treatment of Chronic Coronary Syndrome Based on Vessel-collateral Theory

作　　者：李雅文 常丽萍 秘红英 王康 尹玉洁 贾振华 LI Ya-wen;CHANG Li-ping;MI Hong-ying;WANG Kang;YIN Yu-jie;JIA Zhen-hua(School of Graduate,Hebei University of Chinese Medicine,Shijiazhuang 050092,China;Hebei Yiling Pharmaceutical Research Institute.Shijiazhuang 050035,China;Yiling Hospital Affiliated to Hebei Medical University,Shijiazhuang 050091,China)

机构地区：[1]河北中医学院研究生学院,石家庄050092 [2]河北以岭医药研究院,石家庄050035 [3]河北医科大学附属以岭医院,石家庄050091

出　　处：《中国实验方剂学杂志》2021年第1期196-202,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划“中医药现代化研究”重点专项(2017YFC1700501);河北省中医药管理局科研计划项目(2020242);石家庄市科学技术研究与发展计划项目(191200913)。

摘　　要：基于络病证治体系,继承发展中医血脉理论,吴以岭院士系统构建中医脉络学说,提出其核心理论为营卫理论,即"营在脉中,卫在脉外"(《黄帝内经·灵枢·营卫生会》),"营卫不通,血凝不流"(《伤寒论·辨脉法》),"血脉相传,壅塞不通"(《金匮要略·脏腑经络先后病脉证第一》),"损其心者,调其营卫"。基于中医脉络作为血液运行的通道与西医学血管具有一致性,以脉络学说营卫理论为指导,建立以冠心病、心律失常、心力衰竭等为代表的脉络-血管系统病辨证诊断标准,以指导血管病变防治。基于此,笔者以脉络学说营卫理论为指导,基于脉络-血管系统相关研究,探讨冠心病慢性冠脉综合征中医病因、病机,"不通"精辟概括该病的病理机制,故以"络以通为用"为其治疗原则,构建通络代表方"通心络"组方,并从动物实验研究、药理研究及临床循证研究等多方面总结通心络研究进展,形成慢性冠脉综合征从病因、病机、辨证到治疗的综合体系,以期为慢性冠脉综合征的临床治疗提供新思路。Based on the syndrome and treatment system of collateral disease,and inheriting the development of the bloodline theory of traditional Chinese medicine(TCM), academician WU Yi-ling systematically constructed the vessel-collateral theory of TCM and proposed that its core theory was the theory of Yingwei,that is, "Ying in the vein,and Wei outside the vein"(Huangdi Neijing·Lingshu·Yingwei Shenghui), "obstructing of Yingwei,congelation of blood"(Treatise on Febrile Diseases·Pulse Differentiation Method), "pathogen transferring through blood vessels,obstructed by blocking"(Jinkui Yaolue·Zangfu Jingluo Xianhou Bingmaizheng First),and "damage of the heart,adjust its Yingwei". Based on the consistency of vesselcollateral as the channel of blood circulation in TCM with the blood vessels in western medicine,and guided by the Yingwei theory of vessel-collateral theory,the diagnostic criteria of syndrome differentiation of disease of vessel-collateral and vascular system represented by coronary heart disease,arrhythmia,heart failure and others was established to guide the prevention and treatment of vascular diseases. Based on the above analysis,guided by the Yingwei theory of vessel-collateral theory,and on the basis of related researches of vessel-collateral and vascular system,this paper discussed the etiology and pathogenesis of chronic coronary syndrome(CCS)in TCM. Taking useful collateral with unblocking as the treatment principle,the representative Tongluo prescription(Tongxinluo)was constructed,the research progress of Tongxinluo from various aspects such as animal experiment research, pharmacological research and clinical evidence-based research was summarized, a comprehensive system from etiology,pathogenesis,syndrome differentiation to treatment was formed,in order to provide new ideas for the clinical treatment of CCS.

关 键 词：脉络学说 营卫理论 脉络-血管系统病 慢性冠脉综合征 通心络 

分 类 号：R22[医药卫生—中医基础理论] R24[医药卫生—中医学]