基于“虚气留滞”理论探讨颈动脉斑块的病机  

Discussion on pathogenesis of carotid artery plaque based on theory of deficiency qi stagnation

作　　者：黎莉莉 刘冲冲 董笑克 李中浩 吴梦玮[3] 王凯悦 吴婧 王乐[1] 刘金民[1] LI Lili;LIU Chongchong;DONG Xiaoke;LI Zhonghao;WU Mengwei;WANG Kaiyue;WU Jing;WANG Le;LIU Jinmin(Department of Encephalopathy,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院脑病科,100078 [2]河南中医药大学第一附属医院脑病科 [3]北京中医药大学东方医院体检科

出　　处：《环球中医药》2021年第5期855-859,共5页Global Traditional Chinese Medicine

基　　金：中央高校基本科研业务费专项资金(2020-JYB-ZDGG-131)。

摘　　要：探讨颈动脉斑块的中医病机,可为指导临床治疗提供思路。根据现代医学对颈动脉斑块的认识,结合“虚气留滞”理论对其病机进行探讨,揭示了颈动脉斑块的病机在于元气虚衰,导致气滞、血瘀、痰凝等流动性物质郁滞而阻滞脉络。内皮损伤为颈动脉斑块的始动环节,此阶段以元气亏虚为主,内皮的屏障作用、内分泌作用及功能衰退与元气的功能与衰减规律一致;斑块形成阶段与因元气亏虚而致痰瘀留滞一致,斑块导致的血管狭窄与易损斑块脱落导致脑血管事件与痰瘀阻滞脉络导致中风相符。根据疾病的病机特点,其治则当以培补元气为主,佐以行气化痰、活血通络等,各阶段的病机重点不同,治则也应有所不同。To explore the pathogenesis of carotid artery plaque in traditional Chinese medicine,so as to provide ideas for guiding clinical treatment.According to the understanding of carotid artery plaques in modern medicine,the pathogenesis of carotid artery plaques is discussed in combination with the theory of‘deficiency qi stagnation’and it is revealed its pathogenesis lies in the deficiency of primordial qi,which leads to qi,blood,phlegm and other fluid substances to block the vessel collateral.Endothelial injury is the initial link of carotid artery plaques,and the deficiency of primordial qi is the main pathogenesis in this stage.The barrier function,endocrine function and function decline of endothelium are consistent with the function of primordial qi and their rule of recession.In addition,the stage of plaque formation is the same as the stagnation of phlegm and blood stasis due to deficiency of primordial qi.The stenosis caused by plaques is consistent with the loss of vulnerable plaques leading to cerebrovascular events such as phlegm and stasis blocking the vessel collateral leading to stroke.According to the characteristics of the disease pathogenesis,its rule of treatment should be based on nourishing primordial qi,with the addition of activating qi and eliminating phlegm,promoting blood circulation and dredging collateral,and others.The pathogenesis of each stage is different,so the rule of treatment should be different.

关 键 词：颈动脉斑块 虚气留滞 病机 卒中 分期论治 治则 

分 类 号：R228[医药卫生—中医基础理论]