基于脉络学说营卫理论探讨桂枝汤类方防治冠状动脉微血管病应用  

Discussion on Prevention and Treatment of Coronary Microvascular Dysfunction with Guizhi Decoction from Perspective of Pulse-collateral Theory and Ying-wei Theory

作　　者：黄嬿燕 王海燕[2] HUANG Yanyan;WANG Haiyan(The Seventh Clinical College,Guangzhou University of Chinese Medicine,Shenzhen 518100,China;Shenzhen Baoan District Hospital of Traditional Chinese Medicine,Shenzhen 518100,China)

机构地区：[1]广州中医药大学第七临床医学院,广东深圳518000 [2]深圳市宝安区中医院,广东深圳518000

出　　处：《中国中医药图书情报杂志》2024年第6期18-22,共5页Chinese Journal of Library and Information Science for Traditional Chinese Medicine

基　　金：深圳市宝安区中医院资助项目(BAZYY2020066)。

摘　　要：冠状动脉微血管病(CMVD)可显著增加心血管不良事件发生率,西医治疗仍以传统预防性药物为主。吴以岭院士提出的脉络学说营卫理论认为,CMVD属于“孙络-微血管”病变,与孙络、营卫生理病理密切相关,“营卫不通、血凝不流”是其主要发病机制,应以“损其心者,调其营卫”为治疗原则。桂枝汤为调和营卫代表方,桂枝汤类方可通过抗炎、减少斑块形成及稳定斑块、缓解内皮功能障碍、抑制氧化应激、调节自主神经重构防治CMVD,但目前临床中仍以活血通络药物为主。本研究在脉络学说营卫理论指导下,从CMVD与孙络、营卫的生理病理关系,探讨中医利用桂枝汤类方防治CMVD,为临床用药提供思路。Microcirculation dysfunction(CMVD)can significantly increase the incidence of adverse cardiovascular events.However,the current western medical treatment is still based on traditional prophylactic drugs.Academician Wu Yiling proposes the pulse-collateral theory and Ying-wei theory,which hold that CMVD belongs to the“Sun collateral-microvascular”lesion and is closely related to the physiology and pathology of Sun collateral and nutritive and defensive levels.“Disharmony between nutritive and defensive levels,blood clotting obstruction”is the main pathogenesis and the principle of treatment should be“for those who damage their hearts,nutritive and defensive levels should be adjusted”.Guizhi Decoction is a representative prescription for harmonizing nutritive and defensive levels.Guizhi Decoction can prevent and treat CMVD from anti-inflammation,reducing plaque formation and making plaque stable,alleviation of endothelial dysfunction,inhibition of oxidative stress,and remolding of the autonomic nervous.However,the current clinical practice is still dominated by the use of drugs that invigorate promote blood circulation and dredging collaterals.Under the guidance of pulse-collateral theory and Ying-wei theory,this study explored the physiological and pathological relationship between CMVD and Sun collateral and nutritive and defensive levels,and discussed the use of Guizhi Decoction in preventing and treating CMVD,providing ideas for clinical medication.

关 键 词：冠状动脉微血管病 脉络学说 营卫理论 孙络-微血管 桂枝汤 治未病理论 

分 类 号：R224.1[医药卫生—中医基础理论] R222.16[医药卫生—中医学]