基于瘀毒理论与血管平滑肌细胞表型转换的关系探讨动脉粥样硬化易损斑块的病机  

Pathogenesis of Atherosclerotic Vulnerable Plaques Based on Relationship Between Stasis Theory and Phenotypic Transformation of Vascular Smooth Muscle Cell

作　　者：胥怡帆 唐爱华[2] 冯晓桃[1] XU Yifan;TANG Aihua;FENG Xiaotao(Guangxi University of Traditional Chinese Medicine,Nanning Guangxi China 530000;The First Affiliated Hospital to Guangxi University of Traditional Chinese Medicine,Nanning Guangxi China 530000)

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,广西南宁530000

出　　处：《中医学报》2024年第11期2294-2298,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(82260902)。

摘　　要：动脉粥样硬化是一种以动脉闭塞为特征的血管疾病,动脉粥样硬化易损斑块会使动脉壁增厚、变硬,导致动脉管腔狭窄、弹性下降,是诱发严重血栓性心脑血管疾病的病理基础。血管平滑肌细胞在病理状态下从正常的收缩型表型转变为增殖型和合成型表型,刺激机体导致炎症反应加剧、血管内膜厚度增加及斑块形成、失稳,最终导致破裂等病理过程的发生,与动脉粥样硬化易损斑块的发展关系密切。动脉粥样硬化易损斑块发病急骤、预后凶险的特点与中医学“瘀毒”病机的临床表征存在相似之处。“瘀毒”为动脉粥样硬化易损斑块形成发展的关键病机,治疗上干预血管平滑肌细胞表型转换是延缓易损斑块病情进展的关键,应以活血解毒法为基本治则。Atherosclerosis is a vascular disease characterized by arterial occlusion,and atherosclerotic vulnerable plaques will thicken and harden the arterial wall,resulting in narrowing and decreased elasticity of the arterial lumen,which is the pathological basis for inducing severe thrombotic cardiovascular and cerebrovascular diseases.Vascular smooth muscle cells change from a normal contractile phenotype to a proliferative and synthetic phenotype in the pathological state,which stimulates the body and leads to the occurrence of pathological processes such as intensified inflammatory response,increased thickness of vascular intima,plaque formation,instability,and finally rupture,which is closely related to the development of atherosclerotic vulnerable plaques.There are similarities between the rapid onset and dangerous prognosis of atherosclerotic vulnerable plaques and the clinical characterization of the pathogenesis of"stasis toxin"in traditional Chinese medicine."Stasis toxin"is the key pathogenesis of the formation and development of atherosclerotic fragile plaques,and the key to delay the progression of vulnerable plaques is to intervene in the phenotypic transformation of vascular smooth muscle cells in treatment.

关 键 词：动脉粥样硬化易损斑块 瘀毒 血管平滑肌细胞表型转换 活血解毒法 

分 类 号：R256.22[医药卫生—中医内科学]