基于“清浊相干”理论辨治动脉粥样硬化

Differentiation and Treatment of Atherosclerosis Based on the Theory of"Disorder between Qing and Zhuo"

动脉粥样硬化(AS)是心血管疾病的关键发病机制,可导致心肌梗死、心绞痛、缺血性心脏病、缺血性脑卒中等动脉粥样硬化性心血管疾病(ASCVD)的发生。研究表明,与单独使用他汀类药物相比,中药联合他汀类药物治疗AS更有优势。在中医学理论中,AS的病机与“清浊相干”密切相关。本文基于“清浊相干”理论,从“脉损”“脉浊”“脉痹”三个层次阐释AS的病机演变过程,指出脾不升清、胃不降浊是“脉损”的病理基础,升降失常、清浊相干是“脉浊”的病机核心,浊邪害清、气虚血瘀是“脉痹”的“病进”转归;并提出升清降浊、益气活血的治疗总则,同时注重脑心同治同防,这为AS的中医防治提供了新思路。

Atherosclerosis(AS)is the key pathogenesis of cardiovascular diseases,which can lead to the occurrence of atherosclerotic cardiovascular disease(ASCVD)such as myocardial infarction,angina pectoris,ischemic heart disease and ischemic stroke.The method of combining traditional Chinese medicine and statins to treat AS is efficacy superior than only stains.In the theory of traditional Chinese medicine,the pathogenesis of AS is closely related to"Disorder between Qing and Zhuo".Based on the theory of"Disorder between Qing and Zhuo",this paper explains the pathogenesis evolution process of AS from the three levels of"pulse damage""pulse turbidity""pulse arthralgia",and points out that the pathological basis of"pulse damageis"that the spleen does not rise clear and the stomach does not drop turbidity;the disorder of ascending and descending and the coherence of clearing and turbidity are the core of the pathogenesis of"pulse turbidity";turbid evil harm clear,Qi deficiency and blood stasis is"disease progression"outcome of"pulse arthralgia".It also puts forward the general principles of treatment of ascending clear and descending turbidity,benefiting Qi and activating blood circulation,and pays attention to the simultaneous treatment of brain and heart,which provides a new idea for the prevention and treatment of AS in traditional Chinese medicine.