中医药干预冠状动脉临界病变的研究现状与治疗实践  

Research Status and Treatment Practice of Traditional Chinese Medicine Intervention in Coronary Artery Critical Lesion

作　　者：陈寅萤[1] 王阶[1] CHEN Yinying;WANG Jie(Guang'anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing China 100053)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中医学报》2023年第10期2035-2042,共8页Acta Chinese Medicine

基　　金：国家重点研发计划“中医药现代化研究”重点专项项目(2018YFC1704701);中央级公益性科研院所基本科研业务费专项项目(ZZ13-YQ-029)。

摘　　要：中医药干预冠心病具有独特优势,临床上多从活血化瘀、清热化痰、益气活血、温阳活血、补肾活血等方面进行辨证论治。中西医结合治疗冠状动脉临界病变具有显著的临床疗效,可有效改善患者临床症状,稳定斑块,减轻炎症反应,改善心肌供血,防止心血管不良事件发生,但在诊治上仍存在如下局限性:缺乏相关的中医西医治疗指南;多数临床研究质量不高,亟需严格设计大样本、多中心的随机对照试验来评价中医药干预冠状动脉临界病变的有效性和安全性;中西医结合治疗机制尚未明确,相关疾病模型难以构建,基础研究薄弱。今后的研究或可借鉴药理学分析框架,促使药物模块与疾病模块的对接,系统阐释中药复方干预冠状动脉临界病变多组分、多靶点、多途径的药理作用机制。Traditional Chinese medicine intervention in coronary heart disease has unique advantages,and in clinical practice,it is more from promoting blood circulation to remove blood stasis,clearing Heat and resolving Phlegm,supplementing Qi and activating blood circulation,warming Yang and activating blood circulation,tonifying the Kidney and activating blood circulation,etc.Clinical studies have shown that the combination of traditional Chinese and Western medicine has significant clinical efficacy in treating critical coronary artery lesions,which can effectively improve clinical symptoms,stabilize plaques,reduce inflammatory reactions,improve myocardial blood supply,and prevent cardiovascular adverse events.However,there are still limitations in diagnosis and treatment:there is a lack of relevant guidelines for traditional Chinese and Western medicine treatment.The quality of most clinical studies is not high,and it is urgent to strictly design high-quality clinical trials with large samples and multiple centers to evaluate the effectiveness and safety of traditional Chinese medicine intervention in coronary artery critical lesions.The mechanism of integrative medicine treatment is not yet clear,and it is difficult to construct relevant disease models,resulting in weak basic research.Future research may draw inspiration from the pharmacological analysis framework,establish a docking between the drug module and the disease module,and systematically explain the pharmacological mechanisms of the intervention of traditional Chinese medicine prescriptions in coronary artery critical lesions with multiple components,targets and pathways.

关 键 词：冠状动脉临界病变 活血化瘀法 清热化痰活血法 益气活血法 温阳活血法 补肾活血法 

分 类 号：R256.2[医药卫生—中医内科学]