活血化瘀治疗冠脉微循环障碍的研究进展

Research Progress on Promoting Blood Circulation and Removing Blood Stasis in The Treatment of Coronary Microvascular dDysfunction

冠状动脉微循环障碍广泛存在于多种心血管疾病中,与左室重构、心血管事件密切相关。本病病机演变以血瘀为核心,活血化瘀法可改善患者冠状动脉血流储备及微循环阻力指数,对于冠状动脉微循环障碍具有良好的治疗效果。机制方面,活血化瘀诸法可调节冠状动脉微血管功能障碍的诸多关键病理生理环节:如,活血化瘀可有效抑制炎症、氧化应激及血栓形成;活血化痰可保护血管内皮;益气活血能改善能量代谢;补肾活血促进血管新生、建立冠脉侧支循环。应用现代科学深入挖掘活血化瘀诸法治疗本病的机制,或为解决本病治疗提供新的思路。

Coronary microvascular dysfunction(CMD)is widely present in various cardiovascular diseases and is closely related to left ventricular remodeling and cardiovascular events.The evolution of this disease is centered around blood stasis.The method of promoting blood circulation and removing stasis can improve the coronary flow reserve(CFR)and index of microcirculatory resistance(IMR)of patients,and has a good therapeutic effect on CMD.In terms of mechanism,the various methods of promoting blood circulation and removing blood stasis regulate many key pathological and physiological aspects of CMD.For example,promoting blood circulation for removing blood stasis can effectively inhibit inflammation,oxidative stress,and thrombosis formation.Dissipating phlegm for promoting blood circulation can protect vascular endothelium,benefiting qi for activating blood circulation can improve energy metabolism,tonifying kidney for promoting blood circulation to promote angiogenesis,and establishing coronary collateral circulation.Applying modern science to deeply explore the mechanisms of various methods for promoting blood circulation and removing blood stasis in the treatment of this disease,to provide a new idea for solving the treatment of this disease.