摘要
颈动脉粥样硬化易损斑块已被认为是引发缺血性脑卒中的独立危险因素,严重威胁人类健康。目前现代医学通过西药与手术治疗易损斑块有一定效果,但存在不良反应大、复发率高等问题。中医认为瘀、毒是导致动脉粥样硬化易损斑块形成的重要原因。该文通过梳理总结中医古籍中的“瘀”“毒”理论,并结合易损斑块的现代病理研究,认为“瘀”“毒”贯穿动脉粥样硬化疾病发展始终,“瘀毒互结”为易损斑块形成和发展的核心病机。早期外毒引动,浊瘀郁脉,伏毒渐生;中期热毒炽盛,毒损瘀破,“苛毒”流散;后期虚毒内生,腐瘀溃疡,积癥成瘀。“活血解毒”应为易损斑块的治疗大法,在疾病早、中、后期分别理气活血解毒、清热活血解毒、补气活血解毒,并列举方药,以期为颈动脉粥样硬化易损斑块的中医药防治提供新思路和新方案。
Vulnerable plaque of carotid atherosclerosis has been considered as an independent risk factor of ischemic stroke,which seriously threatens human health.At present,modern medicine has certain effects in treating vulnerable plaques through western medicine and surgery,but there are problems such as large side effects and high recurrence rate.Traditional Chinese medicine holds that blood stasis and poison are important reasons for the formation of atherosclerotic vulnerable plaque.Through sorting and summarizing the theories of“blood stasis”and“poison”in ancient books of Chinese medicine,and combining with the modern pathological research on vulnerable plaques,this paper believes that“blood stasis”and“poison”run through the development of atherosclerosis disease all the time,and“blood stasis and poison combination”is the core pathogenesis of the formation and development of vulnerable plaque:early latent toxin gradually emerging due to external poison gradual induction and turbid blood stasis stagnation in pulses;in the middle stage,the heated poison are rampant,damaging turbid blood stasis and making toxic substances spread all over the body;in the later stage,the deficiency poison is endogenous,corrupting blood stasis shape and forming ulcers which attracts the accumulation of blood coagulation becoming blood stasis.“Activating blood circulation and detoxifying”should be the major method for the treatment of vulnerable plaque.It is suggested that regulating Qi,activating blood circulation and detoxifying in the early stage of disease;in the middle stage of disease,clearing heat,activating blood circulation and detoxifying;in the late stage of the disease,supplementing Qi,activating blood circulation and detoxifying.We list prescriptions and drugs after each treatment,hoping to provide new ideas and new solutions for the prevention and treatment of carotid atherosclerosis vulnerable plaques in traditional Chinese medicine.
作者
李青筱
苏文全
杜雅薇
吴圣贤
LI Qingxiao;SU Wenquan;DU Yawei;WU Shengxian(Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100007,China)
出处
《辽宁中医药大学学报》
CAS
2024年第2期125-130,共6页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(82174340)。
关键词
颈动脉粥样硬化
易损斑块
瘀毒互结
活血解毒
carotid atherosclerosis
vulnerable plaque
blood stasis and poison combination
activating blood circulation and detoxication
