从疮疡阴毒理论探讨动脉粥样硬化斑块侵蚀

Discussion of Atherosclerotic Plaque Erosion Based on the Theory of Yin Toxin in Sore and Ulcer

在急性冠脉综合征的病理发生机制中,“斑块侵蚀”与易损斑块引发的斑块破裂有本质区别,具有完整纤维帽的“斑块侵蚀”导致了约1/3的急性冠脉综合征和高达2/3的非ST段抬高型心肌梗死。精准分辨斑块侵蚀,辨证运用中西医结合诊疗可使斑块侵蚀患者有更大获益。动脉粥样硬化源于内皮受损,可从疮疡论之,疮疡之毒有阴阳之分,阴毒发于肝肾郁火,郁极发越,扰动气血,可能是斑块侵蚀的一类病机,治宜散轻而补重。

In the pathological mechanism of acute coronary syndrome,plaque erosion is fundamentally different from plaque rupture caused by vulnerable plaque.Plaque erosion with a complete fibrous cap causes approximately 1/3 of acute coronary syndromes and up to 2/3 of non-ST-segment elevation myocardial infarctions.Accurately distinguishing plaque erosion and using an integrated approach combining Chinese and Western medicine for diagnosis and treatment can be beneficial for patients with plaque erosion.Atherosclerosis originates from endothelial damage,which can be associated with sore and ulcer.The toxin of sores is divided into yin and yang.Yin toxin occurs in the case of Gan and Shen stagnation and fire.When the inhibition becomes extreme,it can disrupt qi and blood flow,which may be one of the pathological mechanisms of plaque erosion.In treating such diseases,tonics should be emphasized over evacuation drugs.