急性冠脉综合征中医药干预的理论与实践探讨

Theory and practice of traditional Chinese medicine in acute coronary syndrome

在现代医学背景下,中医药对急性冠脉综合征(ACS)的认识不断加深,同时中医药治疗ACS的疗效、安全性及是否有优势始终为临床所关注。围绕这些关键问题,从文献回顾、专家调查、临床研究等不同角度进行了剖析,结果表明:①ACS中医证候多属本虚标实证,气虚血瘀是其共性,亦是贯穿于本病全过程的主要矛盾,但不同类型的ACS中医证候特征并不完全一致;②加载中医药干预ACS安全、有效;③中医药干预涉及多重机制,在抑制心室重构、改善无复流/慢血流、改善阿司匹林抵抗等方面显示了潜在优势;④在卫生经济学方面有好的趋势。总结这些既往研究成果将有助于规范中医药对ACS的认识,便于在此基础上开展更多高质量的临床研究。

The understanding of Traditional Chinese Medicine （TCM） on acute coronary syndrome （ACS） is broadened in the modem medicine background. The efficacy, safety and advantages of TCM treatment for ACS has been concerned by the clinic. With regards to the above mentioned points, the various perspectives were analyzed in the literature reviews, expert consultations, clinical practice and etc., with hope to raise the standards of TCM clinical research. Results showed： ①The common syndrome type for ACS was origin deficiency presenting with excess symptoms, qi deficiency and blood stasis was the general characteristic and also the main contradiction throughout the progress of the disease. However the different syndrome characteristics of ACS may not be exactly the same.②Integration of TCM in the treatment of ACS was safe and efficient.③TCM intervention involved multiple mechanism. It showed potential advantages in ventricular remodeling inhibition, improvement in no re-flow/slow flow and aspirin resistance etc. ④In the aspect of medical economics, it had shown trends of benefits. Study on the previous trial results could help to better understand TCM treatment in ACS and thus conduct more high quality clinical trials.