泛血管疾病的中医内涵及防治策略  

Connotation and Prevention Strategies of Traditional Chinese Medicine for Panvascular Diseases

作　　者：王阶[1] 李军[1] 董艳[1] 陈聪 刘咏梅[1] 刘超[1] 刘兰椿 孙璇 WANG Jie;LI Jun;DONG Yan;CHEN Cong;LIU Yongmei;LIU Chao;LIU Lanchun;SUN Xuan(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中国实验方剂学杂志》2025年第7期1-14,共14页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金重点项目(82230124);中央高水平中医医院临床科研业务项目(HLCMHPP2023083);国家中医药管理局第二届全国名中医传承工作室建设项目(国中医药办人教函〔2022〕245号);国家自然科学基金青年科学基金项目(82305213)。

摘　　要：泛血管疾病以血管病变为共同病理特征,主要表现为动脉粥样硬化,危害心、脑、肾及四肢等重要器官,是当前中国居民的首要死因之一。既往由于学科分支较细,各个学科过度关注局部的病变,导致泛血管疾病作为一个全身系统性疾病的重要性被临床忽视。泛血管疾病在病理上的整体性、防治上的综合性和个体性使得其十分契合中医整体观和辨证论治。中医认为血瘀是动脉粥样硬化的核心病机,且贯穿动脉粥样硬化全过程。通过中医“血脉”“经络”“藏象”和“脏腑-经络”理论,有助于全面理解泛血管疾病的复杂性,提供更加系统的治疗方案。泛血管疾病中医证候存在“痰瘀滞虚”演变,泛血管动脉粥样硬化与“瘀、痰”证候相关,治法以活血化痰为主,针对冠状动脉粥样硬化、脑动脉粥样硬化、肾动脉粥样硬化性狭窄分别有不同的具体药物和作用机制。泛血管静脉病变与中医“虚、瘀”证候相关,中医治法以益气活血为主,可以达到抑制静脉血栓形成、改善静脉性溃疡、抗静脉内皮损伤的作用。泛血管微循环病变与中医“滞、瘀”密不可分,治法以行气通络为主,对冠脉微血管病变、糖尿病微血管病变、肺微血管病变、胰腺微血管病变均有良好疗效。泛血管淋巴管病变与中医“水、瘀”证候相关,治法以活血利水为主,可以达到促进淋巴管生成、增强淋巴液回流的作用。此外,中医药结合现代科技,特别是人工智能的应用,可以提升早期识别和个性化治疗的效率,实现泛血管疾病的早期筛查和综合管理。由此可见,中医药防治泛血管疾病将大有可为。Panvascular disease,with vascular diseases as the common pathological feature,is mainly manifested as atherosclerosis.Panvascular disease mainly affects the important organs of the heart,brain,kidney,and limbs.It is one of the leading causes of death for Chinese residents at present.Previously,due to the narrow branches of disciplines,too much attention was paid to local lesions,resulting in the neglect of panvascular disease as a systemic one.The fact that panvascular disease has overall pathology and comprehensive and individualized treatment strategies,makes the disease highly compatible with the principles of holism concept and syndrome differentiation and treatment in traditional Chinese medicine(TCM).It is believed that blood stasis is the core pathogenesis of atherosclerosis and is involved in the whole process of atherosclerosis.The theories of“blood vessel”,“meridians”,“visceral manifestation”,and“organs-meridians”in TCM are helpful to comprehensively understand the complexity of panvascular diseases.Moreover,those theories can provide systematic treatment strategies.The TCM syndromes of panvascular diseases evolve from“phlegm,stasis,stagnation,and deficiency”.Panvascular arteriosclerosis is related to the syndrome of“stasis and phlegm”,and the treatment mainly promotes blood circulation and removes phlegm.There are different specific drugs and mechanisms of action for coronary atherosclerosis,cerebral atherosclerosis,and renal artery atherosclerotic stenosis.Panvascular venous lesions are related to the syndrome of"deficiency and stasis"in TCM,and the TCM treatment mainly invigorates Qi and promotes blood circulation,which can inhibit venous thrombosis,improve venous ulcers,and resist venous endothelial damage.Panvascular microcirculatory lesions are inseparable from the“stagnation and stasis”in TCM,and the treatment mainly promotes Qi and dredges collaterals,which has a good effect on coronary microvascular lesions,diabetic microvascular lesions,pulmonary microvascular lesio

关 键 词：泛血管疾病 血瘀 整体观念 辨证论治 人工智能 

分 类 号：R256[医药卫生—中医内科学] R287[医药卫生—中医学] R543