李军教授治疗缺血伴非阻塞性冠状动脉疾病临证经验  

Professor Li Jun’s clinical experience in the treatment of ischemia combined with non-obstructive coronary artery disease

作　　者：张乐松 李军[1] 张文杰 ZHANG Lesong;LI Jun;ZHANG Wenjie(Department of Cardiovascular,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing100053,China)

机构地区：[1]中国中医科学院广安门医院心血管科,北京100053

出　　处：《中国医药导报》2025年第5期149-153,157,共6页China Medical Herald

基　　金：国家重点研发计划项目(2022YFC3500102);国家自然科学基金面上项目(82474494)。

摘　　要：缺血伴非阻塞性冠状动脉疾病逐渐成为临床研究热点,其发病率高,是导致患者反复住院、发生不良心血管事件的主要原因之一,现代医学对其诊断和治疗手段尚有局限,动脉粥样硬化、冠状动脉微循环障碍、冠状动脉痉挛是主要发病机制。李军教授结合现代病理研究及中医理论,认为痰湿瘀浊、痹结隧络、毒热蕴结易导致动脉粥样硬化,内外合邪、情志不遂、络脉郁滞是冠状动脉微循环障碍的主要病机,风邪乘络、阴阳虚损、脉络绌急是冠状动脉痉挛的重要机制,治疗以蠲痰散瘀,透发毒热、发汗通络,行气解郁、祛风补虚,调节枢机为主要治法,重视运用风药、虫类药,善于调和升降、通阳解郁。Ischemia combined with non-obstructive coronary artery disease has gradually become a hot spot in clinical research,its incidence rate is high,is one of the main causes of repeated hospitalizations and adverse cardiovascular events in patients.Modern medicine still has limitations in its diagnosis and treatment methods,atherosclerosis,coronary artery microcirculation disorder,and coronary artery spasm are main pathogenesis.Professor Li Jun,combining modern pathological research and traditional Chinese medicine theory,believes that phlegm,dampness and blood stasis,arthralgia and collateral tunnel,accumulation of toxin and heat can easily lead to atherosclerosis,internal and external pathogenic factors,emotional disorders,and stagnation of collaterals are main pathogenesis of coronary artery microcirculation disorders,wind evil invading meridians,yin and yang deficiency and damage,and urgent constriction of meridians are important mechanisms of coronary artery spasm.The main treatment methods include relieving phlegm and blood stasis,promoting circulation of toxins and heat,sweating and unblocking meridians,promoting qi circulation to relieve depression,dispelling wind and tonifying deficiency,and regulating qi circulation.Emphasis is placed on the use of wind-medicine and insect medicine,it is good at regulating rise and fall,promoting yang to relieve depression.

关 键 词：缺血伴非阻塞性冠状动脉疾病 动脉粥样硬化 冠状动脉微循环障碍 冠状动脉痉挛 临证经验 

分 类 号：R259[医药卫生—中西医结合]