从“痰瘀互根”论针灸治疗动脉粥样硬化的机制

Mechanism of Acupuncture in the Treatment of Atherosclerosis Based on the Theory of “Phlegm and Blood Stasis Interdependence”

目的:动脉粥样硬化(Atherosclerosis, AS)是导致心脑血管疾病的主要病理基础。中医学认为,AS的发生与痰瘀互结密切相关。本文旨在从“痰瘀互根”理论出发,探讨针灸治疗AS的作用机制。方法:检索中国知网、PubMed等数据库,以“动脉粥样硬化”“针灸”“痰瘀”“机制”等为检索词,纳入与痰瘀互根理论和针灸治疗AS机制相关的文献,进行归纳总结和分析。结果:痰浊与瘀血是导致AS的两个关键病理因素,二者可相互促进,形成恶性循环。针灸疗法具有多靶点、多环节、多层面的调节作用,可有效化痰祛瘀,阻断AS发生发展。具体机制包括:(1) 针灸可调节脂质代谢,减轻脂质在血管内皮的沉积;(2) 针灸可抑制炎症反应,改善氧化应激,保护血管内皮;(3) 针灸可调节免疫功能,维持脏腑平衡;(4) 针灸可平衡自主神经张力,缓解交感神经兴奋导致的血管收缩。上述作用环环相扣,共同介导针灸防治AS的整体效应。结论:痰瘀互根是AS的核心病机,针灸疗法通过多重机制调节痰瘀,可显著改善AS患者的临床症状,延缓疾病进程。深入探索针灸防治AS的作用机理,有助于优化治疗方案,丰富AS防治手段。同时,发挥针灸“治未病”的特点,在AS的早期、亚临床阶段积极干预,可取得更好的预防和治疗效果。Objective: Atherosclerosis (AS) is the primary pathological basis of cardiovascular and cerebrovascular diseases. Traditional Chinese Medicine (TCM) considers that the occurrence of AS is closely related to the interconnection of phlegm and blood stasis. This article aims to explore the mechanism of acupuncture in the treatment of AS based on the theory of “phlegm and blood stasis interdependence.” Methods: Literature related to the theory of phlegm and blood stasis interdependence and the mechanisms of acupuncture in the treatment of AS was retrieved from databases such as CNKI and PubMed using keywords like “atherosclerosis,” “acupuncture,” “phlegm and blood stasis,” and “mechanism.” The relevant literature was summarized and analyzed. Results: Phlegm and blood stasis are two key pathological factors leading to AS, and they can mutually promote each other, creating a vicious cycle. Acupuncture exerts a multi-target, multi-link, and multi-dimensional regulatory effect, effectively resolving phlegm and eliminating stasis, thereby halting the progression of AS. The specific mechanisms include: (1) Acupuncture can regulate lipid metabolism, reducing lipid deposition in the vascular endothelium;(2) Acupuncture can inhibit inflammatory responses, improve oxidative stress, and protect the vascular endothelium;(3) Acupuncture can modulate immune function, maintaining the balance of internal organs;(4) Acupuncture can balance autonomic nervous tension, alleviating vasoconstriction caused by sympathetic nervous excitement. These mechanisms are interconnected and collectively mediate the overall effect of acupuncture in preventing and treating AS. Conclusion: The interdependence of phlegm and blood stasis is the core pathogenesis of AS. Acupuncture can significantly improve clinical symptoms in AS patients and slow disease progression through various mechanisms that regulate phlegm and blood stasis. Further exploration of the mechanisms by which acupuncture prevents and treats AS can help optimize treatment plans and enrich the methods of AS prevention and treatment. Additionally, acupuncture’s characteristic of “preventive treatment” suggests that early and proactive intervention during the early or subclinical stages of AS can achieve better preventative and therapeutic outcomes.