瓜蒌薤白半夏汤治疗冠心病心绞痛研究进展  

Research Progress on Trichosanthes and Chinese Chive and Pinellia Decoction in Treating Angina Pectoris due to Coronary Atherosclerotic Heart Disease

作　　者：汪满意 WANG Manyi(Changzhou Hospital of Traditional Chinese Medicine,Changzhou,Jiangsu,China,213000)

机构地区：[1]常州市中医医院,江苏常州213000

出　　处：《河南中医》2025年第5期796-802,共7页Henan Traditional Chinese Medicine

基　　金：江苏省中医药管理局专题研究项目(ZT202116)。

摘　　要：瓜蒌薤白半夏汤出自《金匮要略》,具有通阳宣痹、宽胸散结之功效,是治疗上焦阳虚、痰浊痹阻型胸痹的经典方剂,临床广泛应用于治疗心血管疾病,尤其对冠状动脉粥样硬化性心脏病心绞痛,具有显著疗效。本研究在深入研究瓜蒌薤白半夏汤的药理作用及临床应用方面取得了一定的成绩,但仍存在诸多不足:(1)临床试验方面:许多临床研究存在样本量小、量化性差、科学说服力低等不足,且临床对药物疗效的判定尚无统一标准,因此,在未来的临床研究中,临床工作者需要引进循证医学手段并进行远期疗效观察,可结合人工智能,建立大型数据库,开展大数据筛查及靶点预测,开展大规模、多中心、高质量的随机对照试验,使研究结果更具说服力。(2)实验研究方面:心肌缺血动物实验模型与中医辨证理论下的“病-证”模型并不相符,未来在中医“证型造模”方面需进一步研究,以及在药物各成分剂量、毒理学等方面应进一步深入精准研究,以规范本方适应证提供科学依据;在药理学方面,可进一步在细胞、分子、基因层面开展深入研究。Trichosanthes and Chinese Chive and Pinellia Decoction derived from Synopsis of the Golden Chamber,is a classic formula for treating chest obstruction caused by upper-energizer yang deficiency and phlegm-turbidity blockage.It functions by unblocking yang,dispelling stagnation,and relieving chest stuffiness,and has been widely used in clinical practice to treat cardiovascular diseases,particularly angina pectoris due to coronary atherosclerotic heart disease(CHD),with notable efficacy.While this study has achieved progress in exploring the pharmacological mechanisms and clinical applications of Trichosanthes and Chinese Chive and Pinellia Decoction,several limitations still exist as follows:(1)Clinical Trials:Many studies suffer from small sample sizes,poor quantification,and low scientific persuasiveness.Additionally,there is no unified standard for evaluating drug efficacy.So future clinical research should adopt evidence-based medical approaches,long-term efficacy observations,and artificial intelligence-assisted large-scale databases for data screening and target prediction.Large-scale,multicenter,high-quality randomized controlled trials are needed to enhance the credibility of findings.(2)Experimental Studies:Current animal models of myocardial ischemia do not align with the"disease-syndrome"framework of TCM pattern differentiation,so further research is required to pay more attention to TCM"syndrome-specific modeling,"precise dosing of herbal components,and toxicological evaluations to establish scientific criteria for the decoction′s indications.Pharmacological studies should focus on cellular,molecular,and genetic mechanisms.

关 键 词：冠状动脉粥样硬化性心脏病 心绞痛 瓜蒌薤白半夏汤 《金匮要略》 张仲景 

分 类 号：R259.414[医药卫生—中西医结合]