摘要
随着冠状造影技术在临床上大量应用发现,约有40%的疑似冠状动脉粥样硬化性心脏病患者并未有明显的冠状动脉狭窄,而是存在冠状动脉微循环障碍问题。冠状动脉微循环障碍是因为冠状动脉微血管在结构、功能上出现异常而促使心肌缺血缺氧,其病理生理学机制复杂,涉及人群较为广泛,严重影响患者的生活、生存及预后。西医方面,经过学者们多年来的不懈努力及通过对其发病机制的不断探究,提出了可通过经胸超声心动图、心肌声学造影、正电子发射断层扫描、心脏磁共振检查等无创的评估方法和热稀释法和气体洗脱法等有创的评估方法来诊断此病,并提出用β受体阻滞剂、钙离子通道阻滞剂、硝酸酯类、血管紧张素转化酶抑制剂、α受体拮抗剂药物、尼克地尔、曲美他嗪、伊伐布雷定、雌激素等治疗此病。中医方面,将其归属于“真心痛”“胸痹”的范畴,认为本病病性属于本虚标实,虚实夹杂,提出了用单味中药丹参、人参、红花、桃仁、川芎及中药方剂天香丹、血府逐瘀汤、温胆汤等治疗此病。对于冠状动脉微循环疾病的诊疗,中医、西医各有其优点,因此,解决了临床上的许多问题。现将冠状动脉微循环障碍的中医、西医诊治进展综述如下,希望对临床诊治冠状动脉微循环疾病有一定的参考意义。
With the extensive application of coronary angiography in clinic,it is found that about 40%of patients with suspected coronary heart disease do not have obvious coronary artery stenosis,but suffer from coronary artery microcirculation disturbance.Coronary microcirculation disturbance is caused by myocardial ischemia and anoxia due to structural and functional abnormalities of coronary microvessels.The pathophysiology mechanism is complex and involves a wide range of people,it seriously affects the life,survival and prognosis of patients.In Western medicine,after many years of unremitting efforts by scholars and through the unceasing exploration of its pathogenesis,non-invasive assessment methods such as chest echocardiography,myocardial contrast echocardiography,positron emission tomography,cardiac magnetic resonance imaging,and invasive assessment methods such as thermal dilution and gas elution are proposed to diagnose the disease.β-blockers,calcium channel blockers,nitrates,angiotensin converting enzyme inhibitors,α-receptor antagonists,nicorandil,trimetazidine,epidine,estrogen,etc.,are suggested to treat the disease.In the aspect of traditional Chinese medicine,it belongs to the category of“heartache”and“chest arthralgia”,it is believed that the disease is asthenia in origin and asthenia in superficiality,and a mixture of deficiency and excess.The single traditional Chinese medicine Danshen(丹参)(salvia miltiorrhiza),Renshen(人参)(ginseng),Honghua(红花)(safflower),Taoren(桃仁)(peach kernel),Chunxiong(川芎)(Ligusticum Chuanxiong)and traditional Chinese medicine prescription Tianxiang Dan(天香丹),the Xuefu Zhuyu decoction(血府主逐瘀汤)and the Wendan decoction(温胆汤)are put forward to treat the disease.Traditional Chinese medicine and Western medicine have their own advantages in the diagnosis and treatment of coronary artery microcirculation disease,so many clinical problems have been solved.This article reviews the progress in the diagnosis and treatment of coronary artery micr
作者
赵若楠
杜雨柔
何美云
邵静
ZHAO Ruonan;DU Yurou;HE Meiyun;SHAO Jing
出处
《中医临床研究》
2022年第30期49-52,共4页
Clinical Journal Of Chinese Medicine
基金
国家自然科学基金(816411471011854)
河南省中医药管理局,重大专项课题(2018ZYZD08)。
关键词
冠状动脉微循环障碍
西医
中医
诊疗
进展
Coronary artery microcirculation disturbance
Western medicine
Traditional Chinese medicine
Treatment
Progress
