中医药防治PCI术后冠脉无复流研究进展  

Research Progress on Prevention and Treatment of Coronary Noreflow after PCI by Traditional Chinese Medicine

作　　者：罗文宽 卢健棋[2] 周家谭 杨敏 LUO Wenkuan;LU Jianqi;ZHOU Jiatan;YANG Min(Guangxi University of Traditional Chinese Medicine,Nanning 530000,Guangxi,China;First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Sub-center of National Center for Clinical Research of TCM Cardiovascular Diseases,Nanning 530000,Guangxi,China)

机构地区：[1]广西中医药大学,广西南宁530000 [2]广西中医药大学第一附属医院,国家中医心血管病临床医学研究中心分中心,广西南宁530000

出　　处：《辽宁中医药大学学报》2023年第2期102-109,共8页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82160887);国家中医药管理局国家中医临床研究基地业务建设科研专攻课题项目(JDZX2015146);广西自然科学基金项目(2021GXNSFBA196018);广西自然科学基金面上项目(2021GXNSFAA220111)。

摘　　要：经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)已经成为冠心病患者血运重建的重要治疗方法,但PCI术后冠脉无复流(coronary no-reflow,CNR)严重影响患者的预后,与恶性心律失常、心力衰竭、远期心源性猝死独立相关。现代医学在防治PCI术后冠脉无复流现象的发生取得了一些进展,临床常用替罗非班、尼可地尔、腺苷等药物,或应用血栓抽吸、远端保护装置防治CNR,但仍面临着心绞痛反复发作、患者生活质量差、远期预后不良等问题。中医药在治疗PCI术后冠脉无复流中有着独特的思路和体系,通过中药单体、中药复方、中成药、针灸等治疗手段,发挥抗炎、抗氧化、抗血小板聚集、改善血管内皮功能、保护心肌细胞的作用,防治冠脉无复流。现就中医药治疗PCI术后冠脉无复流的研究进行综述,以期为中西医结合治疗CNR提供新思路。Percutaneous coronary intervention(PCI)has become an important treatment for blood supply reconstruction in patients with coronary heart disease.However,coronary no-reflow(CNR)after PCI seriously affects the prognosis of patients,which is independent of malignant arrhythmia,heart failure and long-term sudden cardiac death.Modern medicine has made some progress in the prevention and treatment of coronary no-reflow phenomenon after PCI.Tirofiban,nicorandil,adenosine and other drugs are commonly used in clinic,or thrombus aspiration and distal protection device are used to prevent and treat CNR.However,there are still problems such as recurrent angina pectoris,poor quality of life of patients and poor long-term prognosis.Traditional Chinese medicine has a unique idea and system in the treatment of coronary no-reflow after PCI.Through traditional Chinese medicine monomer,traditional Chinese medicine compound,Chinese patent medicine,acupuncture and other treatment methods,it plays an anti-inflammatory,antioxidant,antiplatelet aggregation,improves vascular endothelial function,protects myocardial cells,and prevents coronary no-reflow.This paper reviews the research of traditional Chinese medicine in the treatment of coronary no-reflow after PCI,in order toprovide new ideas for the treatment of CNR with integrated traditional Chinese and Western medicine.

关 键 词：经皮冠状动脉介入治疗 冠心病 痹心痛 冠脉无复流 研究进展 

分 类 号：R541.4[医药卫生—心血管疾病]