冠心病与阻塞性睡眠呼吸暂停综合征:基于中医“心肺同治”的解读与思考

Coronary Heart Disease and Obstructive Sleep Apnea Syndrome:Interpretation and Reflection Based on Simultaneous Treatment of Heart and Lung in Traditional Chinese Medicine

随着超重与肥胖人群的不断增加,阻塞性睡眠呼吸暂停的发病率逐渐上升,且大多数合并冠心病等心血管疾病,二者互相影响,严重危害患者健康,已经成为一个全球关注的重大公共卫生问题。积极探索中西医结合防治策略具有十分重要的临床意义。不少学者基于中医理论探讨两者关系后发现,二者分属“胸痹”与“鼾症”的范畴,其并病发生与心肺两脏生理功能异常密切相关,心不主血,致瘀血内生,肺不主气,致痰浊内阻,“痰瘀互结”留于胸前而致“胸痹”,阻于气道而致“鼾症”。基于此,该文从中医“心肺相关”出发,深入探讨了冠心病与阻塞性睡眠呼吸暂停综合征的中西医发病机制的内在联系,提出心肺同治、活血化痰为二者并病防治的重要策略,以期为冠心病合并阻塞性睡眠呼吸暂停的临床防治治疗提供理论依据。

As the overweight and obese population is growing,the incidence of obstructive sleep apnea is rising,and most of the cases are complicated with coronary heart disease and other cardiovascular diseases.The two diseases affect each other and seriously endanger the patients'health,becoming a major public health problem of global concern.It is of great clinical importance to explore the combination of Chinese and Western medicine in the prevention and treatment of coronary heart disease complicated with obstructive sleep apnea syndrome.Researchers have explored the relationship between the two based on traditional Chinese medicine(TCM)theory and found that the two diseases belong to the TCM disease categories of chest impediment and snoring,respectively,and their co-morbidity is associated with the abnormal physiological functions of the heart and lungs.The failure of the heart to govern blood leads to the generation of blood stasis,and that of the lung to govern Qi movement leads to the generation of phlegm.The accumulation of phlegm and blood stasis in the chest causes chest impediment and snoring due to obstruction of the airway.This paper discusses the internal linkage between the pathogenesis of coronary heart disease and obstructive sleep apnea syndrome in Chinese and Western medicine from the TCM theory of heart-lung correlation.Furthermore,this paper proposes the treatment principles of simultaneously treating the heart and lung and activating blood and resolving phlegm,aiming to provide a theoretical basis for the clinical prevention and treatment of coronary heart disease complicated with obstructive sleep apnea.