基于肺络构效理论探讨通络药治疗慢性阻塞性肺疾病合并肺动脉高压  

Study on the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Hypertension with Tongluo Medicine Based on Lung Collateral-structure-activity Theory

作　　者：张成 庞立健[2] 王琳琳[2] 王天娇 臧凝子[2] 于睿智 姜鑫 陈芷怡 王潇晗 杨小漩 王佳琪 ZHANG Cheng;PANG Lijian;WANG Linlin;WANG Tianjiao;ZANG Ningzi;YURuizhi;JIANG Xin;CHEN Zhiyi;WANG Xiaohan;YANG Xiaoxuan;WANG Jiaqi(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《辽宁中医药大学学报》2024年第9期114-118,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(82104804);辽宁省教育厅项目(LJKZ0880);沈阳市科技计划项目(20-205-4-056)。

摘　　要：慢性阻塞性肺疾病(chronic obstructive pulmonary diseases,COPD)合并肺动脉高压(pulmonary arterial hypertension,PAH)在呼吸系统疾病中为较难治的一种疾病,其日久而成,胶着难解。文章从肺络构效理论出发,通过分析基于肺络构效理论的COPD-PAH现代临床研究与实验研究,探讨肺络构效及其异常在COPD-PAH发生中的关键作用,将COPD-PAH的病理机制概括为肺之络脉损伤,从而引起肺络虚损(血管内皮功能障碍)、肺络热盛(炎症反应)、肺络瘀阻(血液黏稠度增加)、痰阻肺络(细胞外基质沉积),最终导致肺血管重构。故而应以通络法为治疗大法,临床上遣方用药应从补虚药、辛味药、虫类药和藤类药四大类通络药入手,用以疏通肺络、扶正祛邪,使其发挥正常生理功能,改善COPD-PAH患者症状,提高患者生活质量提供新方法,为COPD-PAH的治疗及其机制研究提供新的研究思路及科学依据。Chronic obstructive pulmonary disease(COPD)combined with pulmonary arterial hypertension(PAH)is a relatively difficult disease to treat among respiratory diseases.Based on the theory of pulmonary complex structure,this paper analyzes the modern clinical research and experimental research of COPD-PAH based on the theory of pulmonary complex structure,discusses the key role of pulmonary complex structure-efficiency and its abnormalities in the occurrence of COPD-PAH,and summarizes the pathological mechanism of COPD-PAH as pulmonary choroid injury,which causes pulmonary network deficiency(vascular endothelial dysfunction),pulmonary complex heat(inflammatory response),pulmonary network stasis obstruction(increased blood viscosity),phlegm obstruction(extracellular matrix deposition),and finally leads to pulmonary vascular remodeling.Therefore,the Tongluo method should be used as the treatment method,and the clinical prescription should start from the four categories of Tongluo medicine,such as deficiency tonic medicine,pungent medicine,insect medicine and rattan medicine,so as to dredge the lungs,strengthen the right and dispel evil,make them exert normal physiological functions,improve the symptoms of COPD-PAH patients,improve the quality of life of patients,and provide new research ideas and scientific basis for the treatment of COPD-PAH and its mechanism.

关 键 词：肺络构效 慢性阻塞性肺疾病 肺动脉高压 通络药 

分 类 号：R256.1[医药卫生—中医内科学] R563[医药卫生—中医学]