南京中医药大学附属医院 江苏省中医院 南京 210029
王雨涵,女,在读硕士生
#刘福明,男,博士,主任医师,博士生导师,主要研究方向:中医药防治心血管疾病,E-mail: doctor.liufuming@outlook.com
纸质出版日期:2023-02-28,
网络出版日期:2022-12-16,
收稿日期:2022-08-15,
移动端阅览
王雨涵, 刘福明. 基于“脉损”学说辨治早期动脉粥样硬化[J]. 北京中医药大学学报, 2023,46(2):186-190.
WANG Yuhan, LIU Fuming. Treatment of early atherosclerosis based on the theory of "Channel Injury"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(2):186-190.
王雨涵, 刘福明. 基于“脉损”学说辨治早期动脉粥样硬化[J]. 北京中医药大学学报, 2023,46(2):186-190. DOI: 10.3969/j.issn.1006-2157.2023.02.008.
WANG Yuhan, LIU Fuming. Treatment of early atherosclerosis based on the theory of "Channel Injury"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(2):186-190. DOI: 10.3969/j.issn.1006-2157.2023.02.008.
动脉粥样硬化是动脉硬化中典型的病变之一,其特征为早期受累血管自内膜开始,先后堆积丰富的黄色粥样脂质,逐渐形成病灶。针对早期动脉粥样硬化的病机辨治特点,提出“脉损”学说,即以病位论治为起始,“浊逆则损脉,营卫不调则脉道自损”二者互为因果的核心观点。从早期动脉粥样硬化的分子机制和发病机制延伸出内皮细胞机械调节血流剪切应力通量与“脉损”学说的相关性。依据“浊逆则损脉,营卫不调则脉道自损”的核心观点,提出了以“复脉扶正”为大法,“从其气则愈”为原则的防治措施。强调脉道自损,治疗仍需疗脉为本。旨在修复动脉粥样硬化早期临床症状难以察觉的缺陷,提高中医药对动脉粥样硬化防治的准确性。
Atherosclerosis (AS) is one of the typical diseases in arteriosclerosis and is characterized by the accumulation of rich yellow atheromatous lipids in the affected vessels starting from the intima and gradually forming lesions. Considering the pathogenesis differentiation and treatment of early AS
we propose the theory of "Channel Injury"
which starts with treatment of the main location. This core of this theory is the mutual causality of "turbidity reversal will damage the pulse pathway
and the disharmony between nutrient qi and defensive qi will damage the pulse pathway" . The correlation between the mechanical regulation of hemodynamic shear stress by endothelial cells and the theory of "Channel Injury" are extended from the medical molecular mechanism and pathogenesis of early AS. Based on the core view that "turbidity reversal with damage the pulse pathway
and the disharmony between nutrient qi and defensive qi will damage the pulse pathway"
the prevention and treatment measures are based on the method of "restoring the pulse and helping the righteousness" and the principle of "healing from its qi" . As the pulse pathway is self-damaging
the treatment still needs to heal the pulse as the basis. The aim is to detect clinical symptoms in the early stage of AS
and improve the accuracy of Chinese medicine in its prevention and treatment.
脉损动脉粥样硬化血流剪切应力复脉从气
Channel Injuryatherosclerosishemodynamic shear stressrecovering the channel and healing qi
DZAU VJ, ANTMAN EM, BLACK HR,et al. The cardiovascular disease continuum validated: clinical evidence of improved patient outcomes: part I: Pathophysiology and clinical trial evidence (risk factors through stable coronary artery disease) [J].Circulation, 2006,114(25): 2850-2870.
HERRINGTON W, LACEY B, SHERLIKER P,et al. Epidemiology of Atherosclerosis and the Potential to Reduce the Global Burden of Atherothrombotic Disease[J]. Circ Res, 2016, 118(4): 535-546.
胡力丹,钱袁媛,揭晓,等.基于中医时空医学探讨瘀、毒、郁所致动脉粥样硬化性心血管疾病[J]. 中医杂志,2022, 63(7): 624-627.
王纶.明医杂著[M]. 沈凤阁,校注. 北京:人民卫生出版社,1995:8.
周仲瑛,金妙文,顾勤,等. 滋肾养肝、化痰消瘀法治疗动脉粥样硬化的理论探讨[J]. 南京中医药大学学报(自然科学版), 2002,18(3): 137-139.
吴相君,常成成. 基于脉络学说分析通心络胶囊对临床心血管疾病的系统干预价值[J]. 中国实验方剂学杂志,2018,24(8): 7-11.
WILHELM K, HAPPEL K, EELEN G,et al.FOXO1 couples metabolic activity and growth state in the vascular endothelium[J]. Nature, 2016, 529(7585): 216-220.
张介宾.类经 [M].太原:山西科学技术出版社,2013.
陈文强,王玉来.基于“脉浊”理论对动脉粥样硬化发病的再认识[J]. 中医杂志,2013,54(17): 1450-1452.
吴圣贤,何芳,武荣荣. 以“脉生痰核”理论指导动脉粥样硬化研究[J]. 中医杂志,2017,58(3): 262-264.
徐文弼.寿世传真[M].吴林鹏,校注.北京:中医古籍出版社,1986:10.
苏文全,杜雅薇,吴圣贤. 从脉郁毒损论治动脉粥样硬化[J]. 中医学报,2021, 36(5): 960-963.
MALEK AM, ALPER SL,IZUMO S.Hemodynamic shear stress and its role in atherosclerosis[J]. JAMA, 1999,282(21): 2035-2042.
王琳,王文婷,吴斯佳,等.基于“一气周流”学说探析心衰的病机与治疗[J]. 中国中医基础医学杂志,2021,27(12): 1954-1956.
STEFFENSEN LB,MORTENSEN MB,KJOLBY M,et al. Disturbed Laminar Blood Flow Vastly Augments Lipoprotein Retention in the Artery Wall: A Key Mechanism Distinguishing Susceptible From Resistant Sites[J]. Arterioscler Thromb Vasc Biol, 2015,35(9): 1928-1935.
秦臻,张彦燕,韦正新,等. 当归补血汤在流体剪切应力环境中对内皮细胞功能的影响[J]. 北京中医药大学学报,2018,41(8): 630-635.
沈文娟. 补阳还五汤联合他汀类药物治疗动脉粥样硬化性心血管疾病的效果分析[J]. 现代实用医学,2017,29(12): 1573-1575.
张红珍,郭春兰,焦瑞,等.补阳还五汤对动脉粥样硬化大鼠主动脉超微结构的影响[J]. 中国临床药理学杂志,2018,34(5): 555-557.
常方圆,冯泽瑞,许迎春,等. miR-21在黄芪甲苷保护ox-LDL诱导的内皮细胞炎症损伤过程中的作用[J]. 分子诊断与治疗杂志,2019,11(4): 276-282.
林珮琴.类证治裁[M].孙玉信,朱平生,校注.上海:第二军医大学出版社,2008:76.
王清任.医林改错[M].李天德,张学文,校注.北京:人民卫生出版社,1991:11.
咸楠星,裴宇鹏,宋囡,等.基于“毛脉合精”与“毛脉失和”探讨脉的功能实现与脉病机理证治[J]. 北京中医药大学学报,2021, 44(12): 1086-1092.
谭静,李静,张迎花,等. 冠状动脉早期粥样硬化症患者冠状动脉钙化的影响因素分析[J]. 首都医科大学学报,2020, 41(6): 978-981.
0
浏览量
14
下载量
2
CSCD
关联资源
相关文章
相关作者
相关机构