基于痰瘀相关理论探讨慢性阻塞性肺疾病急性加重的高凝状态

Discussion on the Hypercoagulable State of Acute Exacerbation of Chronic Obstructive Pulmonary Disease based on the Theories of Phlegm and Stasis

基于痰瘀相关理论,认为高凝状态作为慢性阻塞性肺疾病急性加重过程中的一种病理表现,其病机本质为痰瘀互结,总以痰为要,疾病早期以痰浊内阻为主,随着疾病进展逐渐影响血液运行,导致血行不畅、停而为瘀,痰瘀相互影响,共同推进病情进展。故在临床治疗中应重视清化痰浊之关键,以解决高凝状态产生之本,同时灵活配伍活血化瘀药,以直达病所。如此痰瘀同治可更好地缓解患者临床症状,降低血栓性疾病的发生。

According to the theories of phlegm and stasis,the hypercoagulable state is considered to be a pathological manifestation in the acute exacerbation of chronic obstructive pulmonary disease(AECOPD). The pathogenesis of AECOPD is,in essence,the blinding of phlegm and stasis,with phlegm taken as the pivot. At the early stage of the disease,it is predominated by the internal obstruction of phlegm-turbidity;as the disease progresses,the blood circulation is gradually affected resulting in poor blood flow,and the stasis can then be developed when the blood flow is obstructed;the phlegm and the stasis interact with each other,and jointly promote the progress of the disease.Therefore,in the clinical practice,it is important to clear and dissolve the phlegm-turbidity,which is the root of the hypercoagulable state. Meanwhile,blood-invigorating and stasis-dissolving medicinals are flexibly combined and used,so as to promote the arrival of medicinals at the location of disease. In this way,the phlegm and stasis are treated simultaneously,and thus the effect is increased,mainly manifested as the improved clinical symptoms and the reduced incidence of thrombotic diseases.