摘要
从中医理论基础探讨冠状动脉粥样硬化性心脏病(简称冠心病)在当今社会环境下的病理变化,上个世纪众多医家认为,痰浊、血瘀、气滞等是冠心病的主要致病因素。1999年,创新性提出的“炎症假说”,认为冠心病的发生是由炎症反应贯穿始终,炎性细胞浸润,大量炎性介质释放,形成易损斑块;其中斑块内具有标志性的炎症因子,如:C反应蛋白、白细胞介素6、肿瘤坏死因子α、基质金属蛋白酶等,易导致斑块破裂,引起恶性事件的发生。随后,国医大师根据炎症反应学说和实验研究,创新性提出“毒邪”理论。认为炎症因子引起的病理变化与祖国医学中毒邪的致病特点相似,并认为炎症的反应加快了疾病的恶化。痰、瘀、毒三者互结,是导致冠心病发生的重要致病因素,基于病人体质不同加以运用祛瘀化痰解毒法得到了明显的疗效。目前,根据现代人生活节奏加快,压力剧增常致肝气郁滞,郁久化热;饮食不节,多食辛辣油腻,脾失健运,聚久形成痰浊热毒。因此,医家提出痰毒、瘀毒蕴久皆可化热,“热毒”学说得到大家普遍认同,并通过基础动物实验和临床试验,证实清热解毒法抗炎症反应效果显著,能有效的抑制炎症反应,稳定易损斑块,减少炎症因子聚集,降低心血管恶性事件的发生。根据常见毒邪(瘀毒、痰毒、热毒)的致病特点、病机演变,结合临床观察,论证热毒是发生急性心血管事件的重要因素,运用清热解毒法可有效降低此事件发生。
Based on the theoretical basis of traditional Chinese medicine,the pathological changes of coronary atherosclerotic heart disease in today's social environment were discussed.In the last century,many doctors believed that phlegm-turbidity,blood stasis and stagnation of Qi were the main pathogenic factors of coronary heart disease.In 1999,an innovative"inflammatory hypothesis"was put forward,which believed that the occurrence of coronary heart disease was caused by inflammatory response throughout the whole process,inflammatory cells infiltrated,a large number of inflammatory mediators released,and vulnerable plaques formed.Among them,there are iconic inflammatory factors in plaques,such as C-reactive protein,interleukin 6,tumor necrosis factor alpha,matrix metalloproteinase,etc.,which are likely to lead to plaque rupture and malignant events.Later,according to the theory of inflammatory response and experimental research,the master of traditional Chinese medicine innovatively put forward the theory of"toxin and evil".It is believed that the pathological changes caused by inflammatory factors are similar to the pathogenic characteristics in traditional Chinese medicine,and that the inflammatory response accelerates the deterioration of the disease.Phlegm,blood stasis and toxin are interlinked,which are important pathogenic factors leading to coronary heart disease.According to different constitutions of patients,the method of removing blood stasis and removing phlegm and detoxification has obtained obvious curative effect.At present,according to the acceleratedpace of modern life,the pressure often causes liver Qi stagnation and stagnation heat.Improper diet,more spicy greasy food,spleen lost of function,would form phlegm-turbid and heat toxin.As a result,physicians put forward the phlegm and blood stasis accumulationg can cause heat.Heat toxin theory is widely approved,and proved through animal experiments and clinical trials.It is confirmed that the anti-inflammation effect is significant.The heat-clearing and detoxifying method can effectively restrain the inflammatory response,stabilize the vulnerable plaques,reduce inflammatory factor accumulation and reduce cardiovascular events of the malignant.According to the pathogenic characteristics and pathogenesis evolution of common toxic pathogens(blood stasis toxin,phlegm toxin and heat toxin)and combined with clinical observation,this paper demonstrated that heat toxin is an important factor in the occurrence of acute cardiovascular events.
作者
吴佳蔓
叶童
何信用
张哲
WU Jiaman;YE Tong;HE Xinyong;ZHANG Zhe(Graduate School,Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Major Research Platform of Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)
出处
《实用中医内科杂志》
2020年第1期46-48,共3页
Journal of Practical Traditional Chinese Internal Medicine
基金
辽宁省临床能力建设项目(LNCCC-B05-2014)。
关键词
冠心病
毒邪特点
痰毒
瘀毒
热毒
炎性反应
炎性因子
清热解毒法
coronary heartdisease
characteristics of toxin
phlegm toxin
blood stasistoxin
heattoxin inflammatory response
inflammatory factor
heat-clearing and detoxicating method
