冠心病PCI术后的中医辨证论治探析

Analysis on TCM Syndrome Differentiation and Treatment of Coronary Heart Disease after PCI Operation

冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)是当前社会严重威胁人类健康的常见疾病,随着社会的发展、人类生活质量的提高、饮食习惯的改变、作息时间的变化以及生活压力的增大,其发病率和病死率在我国逐年增长。经过近半个世纪的研究与探索,经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)技术已经成为冠心病的最常见治疗手段。但随着PCI术的广泛应用,PCI术的预后不良的问题逐渐被临床工作者所发现,支架内再狭窄等问题也越来越为临床工作者所重视。针对冠心病PCI术后再狭窄的问题,常规的西医治疗,包括双抗药物(阿司匹林、氯吡格雷)的常规口服等治疗措施并不能显著改善PCI术后心绞痛的发生率。而面对越来越多的PCI术后心绞痛的出现,临床工作者逐渐发现中医药对于减轻患者PCI术后心绞痛有明显的治疗作用。中医通过对病因病机的研究,从气虚、血瘀、气滞、痰浊等方面辨证论治,为防治冠心病PCI术后、改善预后提供新的思路。随着临床工作者对于中医药的重视日益增加,对于中医药的研究也不断完善,发现中医药对防治PCI术后心绞痛以及改善患者预后有着明显的优势,其显著的疗效也越发为临床工作者所肯定。查阅相关文献,从病因、病机入手,对冠心病PCI术后进行中医辨证论治的探析,为中医药防治冠心病PCI术后、改善其预后提供思路。

Coronary heart disease(CHD)is a common disease that seriously threatens human health in current society.With the development of society,the improvement of human life quality,the change of eating habits,the change of schedule and the increase of life pressure,the incidence and mortality of CHD are increasing year by year in China.After nearly half a century of research and exploration,percutaneous coronary intervention(PCI)has become the most common treatment method for coronary heart disease.However,with the wide application of PCI,the poor prognosis of PCI has been gradually discovered by clinical workers,and problems such as in-stent restenosis have been paid more and more attention to by clinical workers.For the stenosis of coronary heart disease after PCI,conventional western medicine treatment,including conventional oral administration of double-anti-drug(aspirin,clopidogrel),cannot significantly improve the incidence of angina pectoris after PCI.In the face of more and more patients with angina pectoris after PCI,clinical workers have gradually found that traditional Chinese medicine has an obvious therapeutic effect on relieving patients with angina pectoris after PCI.Through the study of etiology and pathogenesis,TCM treats patients with syndrome differentiation from the aspects of Qi deficiency,blood stasis,Qi stagnation and phlegm-turbidity,providing new ideas for the prevention and treatment of coronary heart disease after PCI and improving the prognosis of patients.With the increasing attention paid by clinical workers to traditional Chinese medicine and the continuous improvement of research on traditional Chinese medicine,it is found that traditional Chinese medicine has obvious advantages in the prevention and treatment of angina pectoris after PCI and in improving the prognosis of patients,and its remarkable efficacy is more and more recognized by clinical workers.After consulting relevant literature,the author analyzed the syndrome differentiation and treatment of coronary heart disease after PCI from the perspective of etiology and pathogenesis,and provided ideas for TCM prevention and treatment of coronary heart disease after PCI and improvement of its prognosis.