高利教授中西医结合治疗心肌淀粉样变性继发急性脑梗死的经验总结

Professor Gao Li's experience in integrative Chinese and western medicine treatment of myocardial amyloidosis complicated by acute cerebral infarction

淀粉样变性是一组由错误折叠的淀粉样蛋白细胞外沉积引起的疾病,心肌淀粉样变性是淀粉样变性心肌受累的表现,以限制性心肌病、难治性心力衰竭、各种类型的心律失常为主要表现。心肌淀粉样变性合并急性脑梗死患者较为少见。目前淀粉样变性尚无特异性的治疗方法,且合并急性脑梗死西医治疗上有一定的矛盾之处。现介绍1例就诊于首都医科大学宣武医院神经内科的心肌淀粉样变性继发急性脑梗死患者的诊疗过程,从中西医结合角度探讨其治疗方法。高利教授结合临证经验和疾病特点,以及中医标本虚实理论,以健脾涤痰通络为核心治疗原则,结合临床案例进一步介绍心肌淀粉样变性继发急性脑梗死中西医结合治疗的经验。

Amyloidosis is a group of diseases caused by the extracellular deposition of misfolded amyloid proteins.Myocardial amyloidosis is the manifestation of amyloidosis affecting the myocardium,characterized by restrictive cardiomyopathy,refractory heart failure,and various types of arrhythmias.It is relatively rare for patients with myocardial amyloidosis to also suffer from acute cerebral infarction.Currently,there is no specific treatment for amyloidosis,and there were certain contradictions in the treatment of acute cerebral infarction with western medicine.Here,we present the diagnosis and treatment process of a patient with myocardial amyloidosis secondary to acute cerebral infarction who was treated at the department of neurology of Xuanwu Hospital,Capital Medical University.This case is discussed from the perspective of integrating traditional Chinese and western medicine.Professor Gao Li combined with clinical experience and the characteristics of the disease,along with the traditional Chinese medicine theory of deficiency and excess,used the core treatment principles of strengthening the spleen,removing phlegm,and promoting circulation.The clinical case is used to further introduce the experience of integrating traditional Chinese and western medicine in the treatment of myocardial amyloidosis secondary to acute cerebral infarction.