从“脉中积”认识动脉粥样硬化

Understanding Atherosclerosis from“Accumulation in Vessel”

动脉粥样硬化与中医积病在病理形态和发生机制上具有一定的相似性,“脉中积”即痰浊、瘀血和毒邪等有形之物凝滞脉中。从斑块微环境角度阐释“脉中积”的生物学内涵和病理演变规律。认为AS发病初期为脾肾亏虚、血浊脉弱,中期为脉道失柔、脉络绌急,后期为脉络骤闭、脏腑受损。以缺血性心脏病为例,根据其不同阶段病机特点,斑块形成早期治以化痰降浊、养血护脉,斑块易损期治以活血解毒、畅脉稳斑,心脏恢复期治以温经通络、保脉育心。

Atherosclerosis(AS)is similar to the traditional Chinese medicine(TCM)accumulation disease in pathological form and mechanism.The“accumulation in vessel”refers to the congealing and constraint of the tangibles such as phlegm-turbid,blood stasis,and pathogenic toxin in the vessels.This paper explained the biological connotation and pathological evolution law of“accumulation in vessel”from the perspective of plaque microenvironment,and discussed the pathogenesis at different stages of AS.It is believed that at the early stage of AS,the pathogenesis is mainly spleen-kidney depletion,internal generation of phlegm-turbidity,and insufficiency of vessel qi,which can be treated by dissolving phlegm and direct turbidity downward,regulate qi and harmonize blood.At the middle stage,it is mainly manifested as binding of phlegm and stasis,unsoftened vessels,and urgent vessel collaterals,and the method of invigorating blood and resolving toxins,unblocking vessels and stabilizing plagues is advised.At the late stage,it is characterized by obstruction of stasis and toxins,sudden blocking of vessel collaterals,and damaged zangfu(脏腑)organs,and the treatment method is warming channels and unblocking collaterals,protecting vessels and caring the heart.