基于脉络学说对动脉粥样硬化病因病机的认识

Understanding of Etiology and Pathogenesis of Atherosclerosis Based on Collateral Theory

根据中医络病理论,提出西医病理学概念动脉粥样硬化属于"脉络血管系统病"。动脉粥样硬化的发生发展是一个动态演变过程,络气郁滞/虚滞是血管病变的始动病机并贯穿病变全过程;脉络瘀阻与动脉粥样硬化斑块形成的病理变化相一致;脉络瘀阻易引起脉络绌急,而脉络绌急可进一步加重脉络瘀阻;脉络瘀阻或绌急发展加重可导致脉络完全性阻塞而使血流中断,脏腑组织由于血气供应中断而发生严重损伤,形成脉络瘀塞、络息成积。各种致病因素伤及脉络所致病机变化的实质是"不通",络病治疗的根本目的在于保持脉络通畅。"络以通为用"是"脉络血管系统病"的治疗总则,通络方药对于该系统病具有显著疗效。

Based on collateral theory in Chinese medicine and pathological concept in western medicine,the authors advance a new theory that atherosclerosis belong to vascular system diseases. The occurrence and development of atherosclerosis is a dynamic evolution process. Collateral Qi stagnation or deficient stagnation is the initial pathogenesis of vascular diseases,and it goes through the whole process. Stasis and obstruction of blood vessels correspond to atherosclerotic plaques＇ pathological changes. Stasis and obstruction of blood vessels could easily lead to spasm of blood vessels,and spasm of blood vessels could increase stasis and obstruction of blood vessels. The development of stasis and obstruction and spasm of blood vessels could lead to completely obstructing blood vessels so that blood flow will be interrupted. Then Zang-fu viscera will be damaged seriously,which will cause blockade of blood vessels. The nature of blood vessel pathogenesis changes caused by all kinds of pathogenic factors is stagnation. The fundamental purpose of collateral disease treatment is keeping collateral unobstructed. The general treatment principle of vascular system disease is unobstructed. Chinese herbal medicines for removing obstruction in collaterals have significant effect on this system disease.