摘要
泛血管疾病(panvascular diseases)是以动脉粥样硬化(atherosclerosis,AS)为核心病理改变的全身性血管病变综合征,泛血管疾病虽以整体阴阳失衡,寒邪内生为本,然其病机演变与脏腑功能失调密切相关,尤以心、脾、肾三脏为要。AS相关泛血管疾病以“阴阳失衡”为核心病机,其本质在于阳气虚损与阴邪壅盛的交织,心阳不足则血行无力,脾阳虚弱则痰湿内生,肾阳亏虚则气化无权,导致寒邪内生,寒伏脉络则痰、瘀等病理产物聚集,久则伤及脉道,导致相应疾病的发生。临证应以“温阳固本,燮理阴阳”为治疗总纲,旨在通过温通心阳、健运脾阳、温补肾阳的三脏同调策略,重建机体阴阳动态平衡。同时根据斑块形成不同阶段进行分期论治,实现精准干预。疾病初期痰瘀初结,脉络尚未瘀滞,症状不显,治当健运中焦,温化浊邪。病情进展至中期,痰瘀纠结成斑,管腔逐渐狭窄,此时痰浊血瘀征象明显,治当祛瘀化痰,散结消斑为主。及至末期,痰浊瘀血阻滞日久化生邪热,酿生浊毒,毒热壅滞,斑块破裂之际,急当清热解毒、稳定易损斑块,预防AS进展。
Panvascular diseases are systemic vascular syndromes characterized by atherosclerosis(AS)as the core pathological change.Although panvascular diseases are fundamentally viewed as an overall imbalance of Yin and Yang with the internal generation of Cold Evil Factor,their pathogenesis is closely related to dysfunctions of the internal Zang and Fu,particularly the Heart,Spleen and Kidney.AS related panvascular diseases have"Yin-Yang imbalance"as the core pathogenesis,essentially representing an intertwining of Yang deficiency and excess Yin.Insufficient Heart Yang leads to weak blood circulation,Spleen Yang deficiency causes internal generation of Phlegm and Dampness,and Kidney Yang deficiency results in impaired Qi transformation.All of the above lead to the internal presence of Cold.When Cold obstructs the vessels,pathological products such as Phlegm and blood stasis accumulate,and with prolonged disease development,the vascular pathways are damaged,leading to the onset of some related conditions.Clinically,treatment should follow the principle of"warming Yang to consolidate the root and then harmonizing Yin and Yang",aiming to restore the body's dynamic Yin-Yang balance through a coordinated approach that warms Heart Yang,strengthens Spleen Yang,and supplements Kidney Yang.Additionally,treatment should be staged according to the formation phase of atherosclerotic plaques to achieve precise intervention.In the early stage,when Phlegm and blood stasis are initially congealed but the vessels are not yet obstructed and symptoms are not pronounced,the treatment focuses on strengthening the Middle Jiao and warming Yang to dissolve Turbidity.In the middle stage,when Phlegm and blood stasis have formed plaques and lumen narrowing is evident,the signs of Phlegm Dampness and blood stasis are prominent,and treatment should focus on removing stasis,transforming Phlegm,dispersing nodules,and eliminating plaques.In the late stage,when prolonged obstruction by Phlegm Dampness and blood stasis transforms into pathogenic Heat and Turbidity,and when plaques are prone to rupture,the solution lies in clearing Heat,detoxifying,stabilizing vulnerable plaques and preventing AS progression.
作者
仝彤
杨玉涵
姜凌燕
王擎擎
王泽祺
姚魁武
TONG Tong;YANG Yuhan;JIANG Lingyan;WANG Qingqing;WANG Zeqi;YAO Kuiwu(Graduate School,Beijing University of Chinese Medicine,Beijing China 100029;Guang anmen Hospital,China Academy of Chinese Medical Sciences,Beijing China 100053;Eye Hospital,China Academy of Chinese Medical Sciences,Beijing China 100040)
出处
《中医学报》
2026年第1期7-13,共7页
Acta Chinese Medicine
基金
癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项项目(四大慢病重大专项)(2024ZD0528300,2024ZD0528304)
2024年岐黄学者培养项目(中医药领军人才培养项目){国中医药人教函[2025]182号}
中国中医科学院眼科医院中央高水平中医医院项目(GSP3-08)。
关键词
泛血管疾病
动脉粥样硬化
阴阳失衡
寒伏脉络
脏腑失衡
痰瘀互结
免疫稳态
氧化应激
血管内皮功能
肠道微生态
panvascular disease
atherosclerosis
Yin Yang imbalance
Cold obstructs the vessels
imbalance of Zang and Fu
phlegm and blood stasis intermingling
immune homeostasis
oxidative stress
endothelial function of blood vessels
gut microbiota
