摘要
病证结合是中西医结合临床的最佳模式,具有原始创新的重要价值.冠心病是危害人类健康的重大疾病,中医药以血瘀证为关键证候发展了冠心病病机新认识,从定性到定量确立了冠心病病证结合量化标准及诊断新标志物,以循证方法证实了相关药物的临床疗效与安全性,采用现代科学技术方法深入探索了以活血化瘀中药为代表的中医药防治冠心病的作用机理,构建了以病证结合为特色的冠心病中西医结合防治策略.病证结合血瘀证诊断标准的制定实现了中医证候的定量诊断,涌现了大量活血化瘀药物防治冠心病的随机对照研究(randomized controlled trial,RCT)用以证实其有效性与安全性.冠心病血瘀证生物学实质与活血化瘀机理研究涉及血小板功能、炎症介质、氧化应激等多方面,体现出中医药多靶点特征与优势.本文以冠心病血瘀证和活血化瘀为病证结合研究的切入点,系统梳理了60年来中西医结合防治冠心病的研究历程,并对未来的研究方向进行展望,以期为进一步完善、优化具有中国特色的冠心病防治的中国方案提供参考.
The combination of disease and syndrome might be the optimal pattern for integration of Chinese and western medicine with highly innovative value.Coronary artery disease(CAD)is a major disease that endangers health.Traditional Chinese medicine(TCM)has developed a new understanding of the pathogenesis of CAD by taking blood stasis as the key syndrome(Zheng).Quantitative criteria and new diagnostic markers of CAD were established,from qualitative to quantitative aspects.Through evidence-based methods and biotechnological methods,the clinical efficacy,safety and the mechanism of TCM against CAD were confirmed.Represented by activating blood circulation and resolving blood stasis,the strategy combining Chinese and Western medicine was established for the prevention and treatment of CAD,featuring disease-syndrome combination.Several blood stasis criteria enabled the quantitative scoring of the degree of blood stasis.Innumerable randomized controlled trials(RCTs)using activating blood circulation as the interventions confirmed the efficacy and safety of this therapy.The mechanisms of activating blood circulation involve platelet function,inflammatory mediators,and oxidative stress,and numerous relevant targets need further elaboration.Here,we review the research progress of integration of Chinese and western medicine in the prevention and treatment of CAD over the past 60 years,starting from activating blood circulation as the entry point of the disease-syndrome combination research,providing an outlook on the future research direction and reference for further optimizing the Chinese solution for the prevention and treatment of CAD with Chinese characteristics.
作者
李逸雯
罗斌玉
崔京
朱梦梦
刘玥
徐浩
史大卓
陈可冀
LI YiWen;LUO BinYu;CUI Jing;ZHU MengMeng;LIU Yue;XU Hao;SHI DaZhuo;CHEN KeJi(National Clinical Research Center for TCM Cardiology,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)
出处
《中国科学：生命科学》
CSCD
北大核心
2022年第6期797-811,共15页
Scientia Sinica(Vitae)
基金
国家自然科学基金优秀青年基金(批准号:82022076)
国家中医药管理局中医药创新团队及人才支持计划项目(批准号:ZYYCXTD-C-202007)
中国中医科学院科技创新工程项目(批准号:CI2021B004)资助。
关键词
冠心病
血瘀证
活血化瘀
病证结合
中西医结合
coronary artery disease
syndrome of blood stasis
activating blood circulation
combination of disease and syndrome
integration of Chinese and western medicine
