徐凤芹从“瘀毒虚”论治冠心病PCI术后心绞痛

Professor XU Fengqin′s Experience in Treating Angina Pectoris After PCI from Perspective of"Blood Stasis,Toxin and Deficiency"

经皮冠状动脉介入(percutaneous transluminal coronary intervention,PCI)术后心绞痛的发病关键在于“瘀毒虚”,其病位在心,与肝、脾、肾三脏功能失调相关,病机转化为因虚致实、因实致虚及虚实夹杂。PCI治疗过程中存在造成斑块脱落及微血栓形成的风险,能诱发、加重炎症反应,进一步损伤内皮,引起血管痉挛或形成新的狭窄,从而反复出现心绞痛症状。针对PCI术后患者“瘀毒虚”的病机,徐凤芹教授在继承陈可冀院士“愈梗通瘀汤”基础上化裁,结合临床经验与科研实验,运用“清解不妄泻,瘀毒不忘虚”法治疗,主方由栀子、川芎、赤芍、丹参、黄芪、人参、虎杖、广藿香组成。

The key to the pathogenesis of angina pectoris after percutaneous coronary intervention(PCI)is"blood stasis,toxin and deficiency",which is located in the Heart and is related to the dysfunction of the Liver,Spleen and Kidney.The pathogenesis can be transformed from deficiency to excessiveness,or from excessiveness to deficiency,or the mixture of both.There is a risk of plaque detachment and micro-thrombosis during PCI treatment,which can induce and aggravate the inflammatory reaction,further damage the endothelium,cause vasospasm or form new stenosis,and cause repeated symptoms of angina pectoris.In view of the pathogenesis of"blood stasis,toxin and deficiency"in patients after PCI,Professor Xu Fengqin,on the basis of inheriting the"Yugeng Tongyu Decoction"created by Academician Chen Keji,by combining with her own clinical experience and scientific research experiments,she used the method of"clearing away Heat without excessive diarrhea and not forgetting deficiency in removing blood stasis and toxin".The main prescription is composed of Zhizi(gardenia),Chuanxiong(ligusticum wallichii),Chishao(root of red peony),Danshen(salvia miltiorrhiza),Huangqi(astragalus),Renshen(ginseng),Huzhang(polygonum cuspidatum)and Guanghuoxiang(pogostemon cablin).