老年冠心病与衰弱综合征的相关性及中西医研究现状

Correlation between Coronary Heart Disease in the Elderly and Frailty Syndrome and Research Status of Integrated Traditional Chinese and Western Medicine

冠心病在老年人中患病率高,是危害我国老年人生命健康的主要原因之一。衰弱综合征作为老年综合征中最为特殊的一种,近年来在老年医学领域越来越受到重视。两种疾病不仅给老年人的身体健康带来危害,亦给老年患者的家庭及社会带来负担,更不利于我国老龄化社会的建设。目前,国内对于冠心病的研究较多,但对于衰弱综合征的研究仍然较少,特别是探讨老年冠心病和衰弱综合征之间的相关性的文章更是寥若晨星。由此,针对老年冠心病与衰弱综合征提出了一种双向关系,从西医研究及中医的病因病机、治疗等多方面相结合,探讨老年冠心病与衰弱综合征之间的相关性。并提出慢性炎症是老年冠心病与衰弱综合征主要的发病机制,且两者均与肌少症、肠道菌群等存在极其密切的关系。中医方面可将衰弱综合征命名为"衰弱病"或"衰老病",并提出"多虚"是老年冠心病及衰弱综合征的主要病机特点,且以"脾虚、肾虚"为主。指出衰弱综合征评估的重要临床意义,在评估时鼓励使用中西医结合的评估量表,以求更加全面、客观反映患者的疾病情况。治疗方面更应该采取中西医结合治疗方法,强调中医治疗在老年冠心病及衰弱综合征治疗中的必要性。中医治疗方面应重视脾肾,以"补脾益肾"作为疾病治疗的基本原则,以期为老年冠心病与衰弱综合征的研究提供思路。

Coronary heart disease(CHD)has a high prevalence in the elderly,which is one of the main reasons that endanger the life and health of the elderly in China.As one of the most special types of senile syndrome,frailty syndrome has attracted more and more attention in the field of geriatrics in recent years.The two diseases not only bring harm to the health of the elderly,but also bring burden to the family and society of the elderly patients,which is not conducive to the construction of an aging society in China.At present,there are many studies on CHD in China,but there are still few studies on frailty syndrome.Especially,there are fewer articles about the correlation between senile CHD and frailty syndrome.Therefore,a bidirectional relationship between CHD and frailty syndrome in the elderly is proposed.This article explored the correlation between CHD in the elderly and frailty syndromeby combining the research of Western medicine with the etiology,pathogenesis and treatment of traditional Chinese medicine.It is suggested that chronic inflammation is the main pathogenesis of senile CHD and frailty syndrome,and both of them are closely related to sarcopenia and intestinal flora.In TCM,the frailty syndrome can be named frailty disease or senility disease,and it is proposed that multiple deficiency is the main pathogenesis of CHD in the elderly and frailtysyndrome,with insufficiency of the spleen,deficiency of the kidney as the main pathogenesis.It pointed out the important clinical significance of the evaluation of frailty syndrome,and encouraged the use of integrated traditional Chinese and Western medicine evaluation scalesin order to reflect the patients’disease situation more comprehensively and objectively.In terms of treatment,we should adopt integrated traditional Chinese and Western medicine,emphasizing the necessity of traditional Chinese medicine in the treatment of CHD in the elderly and frailty syndrome.The spleen and kidney should be emphasized in the treatment of TCMand take"invigorating spleen and benefiting kidney"as the basic principle of disease treatmentso as to provide ideas for the study of CHD in the elderly and frailty syndrome.