基于络病理论探讨微血管性心绞痛的病机及治法  

Exploration of the Pathogenesis and Treatment of Microvascular Angina Based on the Theory of Collateral Disease

作　　者：熊美玉 康达 陈必勤 XIONG Meiyu;KANG Da;CHEN Biqin(Yunnan University of Chinese Medicine,Kunming 650000,China;Harbin Traditional Chinese Medicine Hospital,Harbin 150000,China;Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650000,China)

机构地区：[1]云南中医药大学,云南昆明650000 [2]哈尔滨市中医医院,黑龙江哈尔滨150000 [3]云南省中医医院,云南昆明650000

出　　处：《中医药信息》2024年第12期27-31,共5页Information on Traditional Chinese Medicine

基　　金：黑龙江省自然科学基金项目(LH2023H076)。

摘　　要：微血管性心绞痛(MVA)是临床常见疾病之一,属“心络病”范畴。其发病机制复杂,且硝酸盐、雷诺嗪、尼可地尔等抗心绞痛药物治疗效果不佳,严重影响患者预后和生活质量。本文基于络病理论,结合络脉与微血管结构功能、生理病理上的相关性,分析微血管性心绞痛的病因病机并探讨治法。MVA发病的核心病机为络脉不通,从络脉视角总结“虚”“滞”“瘀”为其主要病理因素。针对心络亏虚、络气郁滞、痰瘀互结导致的络脉瘀阻,治疗上采用补虚通络、化瘀止痛;理气行滞、活血通络;益气化痰、化瘀通络的治法。Microvascular angina(MVA)is one of the common clinical conditions and falls under the category of"heart collateral disease."Its pathogenesis is complex,and the therapeutic effects of anti-anginal drugs such as nitrates,ranolazine,and nicorandil are often unsatisfactory,significantly affecting patients′prognosis and quality of life.Conbined with the correlation between the structure and function of collaterals and microvessels,as well as physiological and pathological factors,and based on the theory of collaterals,this article analyzes the etiology and pathogenesis of microvascular angina and explores treatment methods.The core pathogenesis of MVA is the obstruction of the collateral vessels.From the perspective of collaterals,"deficiency""stagnation"and"stasis"are identified as the primary pathological factors.For collateral obstruction caused by heart collateral deficiency,the treatment methods of tonifying deficiency and unblocking the collaterals,and resolving stasis to relieve pain should be applied;for stagnation of collateral qi,regulating qi to relieve stagnation,activating blood circulation,and promoting the collaterals should be employed;and the combination of phlegm and blood stasis,replenish qi,resolving phlegm,and resolving stasis to unblock the collaterals should be used.

关 键 词：络病理论 微血管性心绞痛 病因病机 

分 类 号：R259[医药卫生—中西医结合]