“丁氏脑科”颈动脉粥样硬化创新性研究概述  

Review on the Innovative Research on Carotid Atherosclerosis by “Ding’s Encephalopathy”

作　　者：赵哲 丁玉洁[1] 陈哲 温雅[2] 赵丽丽[1] 黄鑫磊 丁元庆[3] ZHAO Zhe;DING Yujie;CHEN Zhe;WEN Ya;ZHAO Lili;HUANG Xinlei;DING Yuanqing(Rizhao Hospital of Traditional Chinese Medicine,Rizhao 276800,China;Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China)

机构地区：[1]日照市中医医院,山东日照276800 [2]山东中医药大学,山东济南250355 [3]山东中医药大学附属医院,山东济南250011

出　　处：《山东中医杂志》2023年第4期405-411,共7页Shandong Journal of Traditional Chinese Medicine

基　　金：全国中医学术流派传承工作室第二轮建设项目(批文号:国中医药人教函〔2019〕62号);山东省名老中医药专家传承工作室建设项目(批文号:鲁卫中发展字〔2018〕1号);日照市中医药科技项目(编号:RZ2022C11)。

摘　　要：丁氏脑科团队近20年来就中风独立危险因素颈动脉粥样硬化(CAS)及斑块形成做了大量基础及临床研究,包括:①提出了CAS中医病名应为“人迎脉积”。②系统整理并丰富CAS病因病机,在传统病因基础上补充了吸烟、贪嗜咸辣、生活压力、气候变化、肥胖、阻塞性睡眠呼吸暂停低通气综合征等内容;病机方面,发现火热是CAS的始动因素并贯穿疾病始终,亦是CAS进展为中风的首要推动因素:火热灼伤脉道,痰瘀胶着不化,结于人迎脉,形成人迎脉积,这是“火热致中风”的病机核心,由此提出了“火热灼脉”CAS病机学说。③对高血压、2型糖尿病、代谢综合征、吸烟患者及绝经女性等特定人群CAS进行了针对性病机探讨。④研制了高血压CAS证素诊断量表。⑤制定了清热泻火治法。⑥临床以清热泻火法干预CAS火热证,应用葛根芩连汤加减,疗效确切,开展多项临床疗效观察并提出了针药联合治疗方案。参考文献44篇。In the last 20 years,Ding’s Encephalopathy Group has conducted numerous fundamental and clinical studies on formation of carotid atherosclerosis(CAS)and plaque,an independent risk factors of apoplexia.The research work includes the follows:①It was proposed that the corresponding name of CAS in traditional Chinese medicine(TCM)should be“Ren Ying pulse accumulation”;②The disease cause and mechanism of CAS was systemically reviewed and further studied,and in addition to traditional disease causes,other factors such as smoking,indulging in salty and spicy food,life pressure,climate changes,obesity and obstructive sleep apnea hypopnea syndrome were also included;in the disease mechanism research,fire-heat is regarded as the initiating factor of CAS,is involved in the entire process of the disease,and is the primary driving factor for CAS to develop into apoplexia,that is,fire-heat burns the channels of pulse,with the formation of phlegm and stasis,finally accumulating in the Ren Ying pulse to cause Ren Ying pulse accumulation,which is the core of disease mechanism,“fire-heat causing apoplexia”.Based on this understanding,the disease mechanism of CAS,“fire-heat burning pulse”has been proposed;③The disease mechanism of CAS was explored focusing on specific populations such as patients with hypertension,type 2 diabetes,metabolic syndrome,smoking,or menopausal women;④The syndrome factor diagnostic scale for hypertension CAS was established;⑤The treatment method of clearing heat and purging fire was established;⑥In clinical practice,the method of clearing heat and purging fire was applied to treat CAS fire heat syndrome.Usually,modified Gegen Qinlian Decoction was applied,and the therapeutic effect was good.Besides,multiple-observations on the clinical effect were conducted,and the treatment protocol of combining acupuncture and medicinals was proposed.There are 45 research papers in the references.

关 键 词：丁氏脑科 颈动脉粥样硬化及斑块 人迎脉积 中风 火热灼脉学说 火热致中 清热泻火法 

分 类 号：R543.4[医药卫生—心血管疾病]