从“痰瘀-热毒”论冠脉临界病变斑块微环境中医药调控机制  

TCM Microenvironmental Regulation Mechanism of Coronary Artery Critical Lesion Plaques from Perspective of"Phlegm-Stasis and Heat-Toxin"

作　　者：连文静 王阶[1] 张振鹏[1] 刘兰椿 LIAN Wenjing;WANG Jie;ZHANG Zhenpeng;LIU Lanchun(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing China 100053)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中医学报》2025年第1期57-61,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(82230124)。

摘　　要：冠脉临界病变是冠状动脉粥样硬化性心脏病发展过程中的特殊阶段,此阶段中斑块微环境内的多种生物成分相互作用,形成一个复杂的生态系统。冠脉临界病变“痰瘀-热毒”的证候演变与炎症反应、内皮损伤、血管新生及脂质代谢等现代病理机制相应。故临证治疗应采用“消、清、通”法调控冠脉临界病变斑块微环境,即:消痰瘀——改善内皮损伤与脂质沉积;清热毒——抑制炎症反应;通脉络——抑制斑块内血管新生。如此则可发挥抗炎、改善内皮与血脂代谢、抑制斑块内血管新生的作用,共同构建冠脉临界病变“痰瘀-热毒”的病证结合全周期动态干预模式。Critical coronary lesions are a special stage in the development of coronary atherosclerotic heart disease,in which multiple biological components within the plaque microenvironment interact with each other to form a complex ecosystem.The evolution of"Phlegm-Stasis and Heat-toxin"in critical lesions of coronary artery corresponds to the modern pathological mechanisms of inflammatory reaction,endothelial damage,neovascularization and lipid metabolism.Therefore,the clinical treatment should adopt the method of"eliminating,clearing and dredging"to regulate the plaque microenvironment of critical lesions of coronary artery,i.e.:eliminating Phlegm and stasis to improve endothelial damage and lipid deposition;clearing Heat and toxin to suppress the inflammatory reaction;dredging meridians and collaterals to suppress the vascularization in the plaque.In this way,it can play the role of anti-inflammatory,improve the quality of blood vessels in plaque.In this way,anti-inflammation,improvement of endothelial and lipid metabolism,and inhibition of plaque neovascularization can be realized,and the whole-cycle dynamic intervention model of"Phlegm-stasis and Heat-Toxin"for critical coronary lesions can be constructed together.

关 键 词：冠脉临界病变 “痰瘀-热毒” 动脉粥样硬化 斑块微环境 血管新生 

分 类 号：R259.433[医药卫生—中西医结合]