基于心系疾病热毒学说探讨动脉粥样硬化易损斑块形成的病理机制  

Discussion on the pathological mechanism of atherosclerotic vulnerable plaque formation based on the theory of heart toxicity of heat diseases

作　　者：秦乐乐 苏文革[2] 滑振 Qin Lele;Su Wenge;Hua Zhen(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Three Departments of Heart Disease,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学中医学院,济南250014 [2]山东中医药大学附属医院心病三科,济南250014

出　　处：《国际中医中药杂志》2024年第11期1401-1405,共5页International Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82104796);山东省自然科学基金青年项目(ZR2021QH219);辽宁中医药大学中医脏象理论及应用国家教育部重点实验室开放基金(zyzx110);山东省高等学校青创团队计划创新团队(2022KJ257)。

摘　　要：动脉粥样硬化易损斑块是诱发不稳定型心绞痛的重要原因,对其病因病机探讨一直是心血管领域的热点问题。心系疾病热毒学说以病理因素“热毒”为基础,是现代中医理论体系对冠状动脉粥样硬化性心脏病(CHD)中医病机的完善,为临床冠心病中医诊疗提供了新的理论基础,“热毒”作为冠心病的中医病因及病理产物贯穿整个冠心病的诊疗过程。在西医病理生理中,动脉粥样硬化易损斑块是不稳定型心绞痛及急性冠脉综合征的关键病因,疾病的发生涉及炎症反应、细胞焦亡、细胞凋亡及细胞胞葬等,而中医对应的急性心血管事件的理论探讨却仅局限于正阳虚脱、心阳暴脱等。故本文以心系疾病热毒学说为切入点,意在探讨西医病理生理中动脉粥样硬化易损斑块形成进程与中医病因病机中“热毒”长久熏蒸血脉之间的联系,并以此为基础提出用清热解毒法治疗临床不稳定性心绞痛的诊疗思路,即以清热解毒法稳定斑块,以期为临床诊疗提供新思路及新方法。Atherosclerotic plaque is an important cause of unstable angina pectoris,and its etiology and pathogenesis have always been a hot topic in cardiovascular field.The theory of heat toxicity of heart diseases is based on pathological factors"heat toxicity",which is the improvement of TCM pathogenesis of coronary atherosclerotic heart disease by modern TCM theory system,and provides a new theoretical basis for the TCM diagnosis and treatment of clinical coronary heart disease.As the TCM cause and pathological product of coronary heart disease,"heat toxicity"runs through the diagnosis and treatment process of coronary heart disease.In the pathophysiology of Western medicine,atherosclerotic plaque is the key cause of unstable angina pectoris and acute coronary syndrome,which involves inflammation,pyroptosis,apoptosis and cell burial.However,the theoretical discussion of acute cardiovascular events corresponding to TCM is limited to normal yang collapse,heart-yang outburst and so on.Therefore,starting from the theory of heat toxicity of heart diseases,this article aimed to explore the connection between the formation process of atherosclerotic vulnerable plaque in Western pathophysiology and the long-term fumigation of blood vessels by"heat toxicity"in the etiology and pathogenesis of TCM.On this basis,it proposed the diagnosis and treatment idea of treating clinically unstable angina pectoris with the method of clearing heat and detoxification,that is,stabilizing plaque by clearing heat and detoxification,in order to provide new methods and new ideas for clinical diagnosis and treatment.

关 键 词：斑块 动脉粥样硬化 心系疾病 热毒学说 理论探讨 

分 类 号：R259[医药卫生—中西医结合]