益气活血化痰中药治疗动脉粥样硬化的研究进展

Research Progress of Traditional Chinese Medicine for Yiqi Huoxue Huatan in Treatment of Atherosclerosis

总结了益气活血化痰中药治疗动脉粥样硬化(AS)的临床用药情况与基础研究进展,从AS发病的不同部位归纳了益气活血化痰中药治疗AS的临床研究进展,总结了治疗AS的常用益气活血化痰中药,益气药物多选用黄芪、党参、西洋参、茯苓、白术、红景天等,活血药物多选用川芎、丹参、三七、赤芍、白芍、当归、桃仁、红花、牛膝、茶树根等,化痰药物多选用瓜蒌、半夏、石菖蒲、陈皮、胆南星、天竺黄、枳实、竹沥等。发现益气活血化痰中药治疗颈动脉粥样硬化(CAS)多搭配虫类药物与藤类中药,治疗冠心病多配合行气、止痛、散瘀、化痰中药,治疗下肢硬化时多配合舒筋活络、化痰利窍与健脾利湿药物的使用,并对用药时间、合并用药情况、改善指标方面进行了归纳;基础研究方面,从减轻炎症反应、改善脂质代谢异常及改善内膜损伤方面归纳了该类药物治疗AS的实验进展,发现目前开展基础研究较多的药物主要为丹参酮、西洋参茎叶总皂苷、瓜蒌提取物,芪参益气滴丸、护心康片、丹蒌片、补阳还五汤合瓜蒌薤白汤、化浊通脉散等,并从造模动物、造模特点与作用机制方面进行了总结。该文对益气活血化痰方药治疗AS的应用规律、药物作用机制与特点及未来研究方向开展了总结与述评,以期为合理应用该类中药治疗AS提供参考。

The application of clinical medication and basic research progress of traditional Chinese medicine(TCM)for Yiqi Huoxue Huatan in the treatment of atherosclerosis(AS)were summarized.According to the different pathogenic sites of AS,the clinical research progress of TCM for Yiqi Huoxue Huatan in the treatment of AS and the commonly used TCM for the treatment of AS were summarized.Astragali Radix,Salviae Miltiorrhizae Radix,Quinquefolium Panax,Cocos Wolf Poria,Atractylodis Rhizoma,Rosea Rhodiola,which were Yiqi herbs,were mostly used for the treatment of AS.Wallichii Ligusticum,Salviae Miltiorrhizae Radix,Notoginseng Radix,Paeoniae Rubra Radix,Paeoniae Alba Radix,Angelicae Sinensis Radix,Semen Persicae,Tinctorius Carthamus,Achyranthis Bidentatae Radix,tea root,which were Huoxue herbs,were mostly used for the treatment of AS.Huatan herbs,including Kirilowii Maxim Trichosanthes,Pinelliae Rhizama,Acorus Tatarinowii Schott,Citri Reticulatae Pericarpium,Cum Bile Arisaema,Silicea Bambusae Concretio,Aurantii Immaturus Fructus,Bamboo Juice,were commonly used for the treatment of AS.According to the findings,TCM for Yiqi Huoxue was mostly combined with insect medicine and rattan medicine for the treatment of carotid atherosclerosis,combined with TCM for promoting Qi,relieving pain,dissipating blood stasis and reducing phlegm for the treatment of coronary heart disease,and combined with TCM for relaxing tendons and activating collaterals,resolving phlegm to benefit orifices,and invigorating spleen to remove dampness combined for the treatment of lower extremity sclerosis.In addition,the medication time,drug combination and improvement indexes were summarized.In basic studies,the experimental progress of this kind of medicine for the treatment of AS were summed up in the aspect of reducing inflammatory reaction,improving the abnormal lipid metabolism and improving the damage of inner membrane.At present,it was found that tanshinone,total saponins of stem and leaf of Panax Quinquefolium,extract of Trichosanthis Pericarpium.Qishen Yiqi dropping pill,Huxinkang tablet,Danlou tablet,Buyang Huanwutang combined with Gualou Xiebaitang,Huazhuo Tongmai powder were the main drugs for basic research,and the animal model,model characteristics and the mechanism of action were summarized.In order to provide a reference for the rational application of TCM for Yiqi Huoxue Huatan in the treatment of AS,the application law,the mechanism and characteristics of action and the future research directions of TCM for Yiqi Huoxue Huatan were summarized and reviewed.