中医外治冠心病心绞痛概况

General Situation of External Treatment of Coronary Heart Disease with Angina Pectoris

冠心病心绞痛亦可内病外治,药物贴敷发挥经皮吸收以及经络穴位效应双重治疗特性,外敷穴位可刺激腧穴,经络激发全身经气;雾化吸入将药物雾化成颗粒,直达肺泡;滴鼻通过鼻黏膜的吸收途径而起到治疗作用;针灸可刺激激发机体经气,加强气血运行,使雍滞的经络得以疏通;腧穴注射既有针刺的机械效应,又通过药物局部吸收增加了穴位刺激时间;按摩及推拿通过刺激摩擦穴位敏感痛点或胸壁,增加心肌供血和纠正心脏功能;穴位埋线温阳益气通脉;激光照射改变血液流变学性质,降低全血黏度及血小板凝集能力;涂擦促进气血运行,调整脏腑功能之功效,不但润滑,而且促使药物直接渗入皮下组织,到达病所;离子导入在局部形成的"离子堆",可比其他给药途径延长,从而更充分地发挥药物治疗作用。内病外治,通过肌表、孔窍、穴位作用于经络、气血、脏腑、局部病灶,祛除机体内在疾患,调整和提高机体机能。冠心病防治是现代医学领域中重点、难点,在以药物、介入等为主流防治冠状动脉粥样硬化性心脏病、不稳定型心绞痛前提下,中药外治法仍然在本病防治中占有一席之地,尤其对于因身体条件所限,不宜内服药物及应用介入等其他疗法时,更加显示其外治法的独特功效。因制剂工艺落后,造成外治药物有效成分溶解度不高、吸收率低等,限制药效。未来应运用高新科技手段注重穴位外治作用机制、提高药物吸收率及吸收速度与剂型研究,加大临床观测样本量,结合现代科技检测手段,使疗效评价更加客观充分。

Coronary atherosclerotic heart disease is a serious harm to human health and life of the common disease and angina pectoris is one of the main clinical manifestations, except for the oral administration of drugs, but also used in disease treatment, through the skin surface, opening of the body, the role of acupuncture points on meridian, Qi and blood, viscera, local lesions so as to achieve dispel body internal diseases, adjust and improve body function. Sticking therapy function and pharmacological effects combined with the meridian point and the treatment effect of double skin absorption characteristics, external application of acupoint can stimulate acupoints, meridians by stimulating the body; atomizing spray into particles, direct alveolar; intranasal absorption way through the nasal mucosa and plays a role in the treatment of acupuncture can stimulate the body; stimulate the Qi strengthen the circulation of Qi and blood, so that the Yong stagnation meridian to be clear, to achieve the purpose of treating disease; both the mechanical effect of acupuncture aeupoint injection, and through the local drug absorption increased by stimulation of acupoint stimulation time; friction sensitive points or chest wall pain point massage and massage, increase cardiac function of myocardial blood supply and correct; acupoint catgut embedding Wenyang Yiqi Tongmai; laser irradiation; to promote blood running, adjust the function of viscera function, not only can play the role of lubrication, And can promote the drug directly into the subcutaneous tissue, reaching the disease institute; ion into the local formation of the ＂ion heap＂ , can be extended to other ways, so as to give full play to the role of drug treatment. Prevention and treatment of coronary heart disease is the focus and difficulty in the field of modern medicine, in the drug or intervention for mainstream prevention and treatment of coronary heart disease, unstable type of angina pectoris premise, external treatment of TCM still in the prevention and treatment of the disease occupies a place, especially to the because of physical conditions for the limit, not medicine and application of interventional other therapy shows the unique effect of external treatment. Because the preparation process is backward, the effective component of the external medicine is not high solubility and low absorption rate. Future should use high-tech means to focus on acupoint treatment mechanism, improve drug absorption rate and absorption rate and dosage form, increase clinical observation sample size, combined with modem scientific and technological means of detection, the curative effect appraisal to be more objective and full.