国医大师朱良春从痰瘀论治颈动脉不稳定斑块的学术经验  

Professor ZHU Liang-Chun’s Academic Experience in Treating Unstable Carotid Plaques Based on Theory of Phlegm and Blood Stasis

作　　者：李英 龚宝莹 朱建华 朱婉华 郭建文[5] LIYing;GONG Bao-ying;ZHU Jian-hua;ZHUWan-hua;GUO Jian-wen(Shenyang Second Hospital of Traditional Chinese Medicine(TCM),Shenyang 110101,China;Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Nantong Liangchun TCM Hall,Nantong 226001,China;Nantong Liangchun TCM Hospital,Nantong 226001,China;Guangdong Provincial Hospital of TCM,Guangzhou 510120,China)

机构地区：[1]沈阳市第二中医院,沈阳110101 [2]广州中医药大学,广州510006 [3]南通市良春国医堂,江苏南通226001 [4]南通良春中医医院,江苏南通226001 [5]广东省中医院,广州510120

出　　处：《中国实验方剂学杂志》2021年第23期195-200,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中医湿证国家重点实验室项目(SZ2020ZZ14,SZ2021ZZ3205);国家重点研发计划项目(2018YFC1704102);广东省自然科学基金项目(2020A1515010992);广东省中医院朱良春学术传承名医工作室项目(YN2014LN08)。

摘　　要：颈动脉不稳定斑块是导致脑卒中在内的严重脑血管事件的独立危险因素,是脑血管疾病的一级、二级预防的重要干预靶点。朱良春教授是著名的国医大师,以善治疑难杂症,善用虫类药物而闻名。朱老认为根据病位及致病特点,颈动脉不稳定斑块应归属于中医"脉痹"范畴,本虚标实为其基本病性,其中本虚以脾肾不足为主,痰瘀互结为标实,是疾病核心病机。指出治疗上应注重痰瘀同治,在常用的健脾祛瘀化痰的草木类药味以外,可适当加入搜风通络之力较强的虫类药物,加强祛瘀通络的功力。根据本病病机自拟"祛痰通络稳斑方",现代药理研究结果提示该方具有抗炎、调节内皮细胞功能,降脂调节代谢,改善血液循环等方面的作用,从而调节动脉粥样硬化形成的相关生物过程,达到抗动脉粥样硬化及稳斑的效果。临床实践中也提示其可协助降低血脂,减少颈动脉不稳定斑块面积,可在临床推广使用。Unstable carotid plaque is an independent risk factor for serious cerebrovascular events including stroke,making it considered as an intervention target for the primary and secondary prevention of cardiovascular diseases.Professor ZHU Liang-chun is a national distinguished master of traditional Chinese medicine(TCM)who is adept at treating difficult miscellaneous diseases with insects.He believes that the unstable carotid plaque falls into the category of"vessel impediment"in TCM according to the disease location and characteristics.The core pathogenesis of unstable carotid plaque lies in asthenia in origin and sthenia in superficiality,with spleen-kidney deficiency as the root cause and combined phlegm and blood stasis as the manifestations.He has pointed out that both phlegm and blood stasis should be emphasized in the treatment.In addition to the commonly used herbs for strengthening spleen,removing stasis,and resolving phlegm,the insects with strong effects of searching wind and dredging collateral can be added as appropriate to strengthen the power of removing stasis and dredging collateral.According to the pathogenesis of this disease,he develops the Qutan Tongluo Wenbanfang,which has been confirmed by modern pharmacological research to be efficient in resisting inflammation,regulating endothelial cell functions,lowering lipids,adjusting metabolism,and improving blood circulation,thereby ameliorating the related biological processes of atherosclerosis,suppressing atherosclerosis,and stabilizing plaques.As proved by clinical practice,Qutan Tongluo Wenbanfang helps to reduce blood lipids and reduce the area of unstable carotid plaque,indicating that it deserves clinical promotion.

关 键 词：颈动脉不稳定斑块 痰瘀同治 朱良春 学术经验 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]