基于“肠道菌群”探讨益气健脾法治疗冠心病的临床进展

To Explore the Clinical Progress of Invigorating Qi and Invigorating Spleen Therapy for Coronary Heart Disease Based on “Intestinal Flora”

冠心病(CHD)是指冠脉粥样硬化引起冠脉狭窄、痉挛或闭塞,导致心肌缺血缺氧或坏死的心脏疾病。由于国民生活方式改变及其症状的复杂性,冠心病的发病率及病死率正逐年上升。目前西药结合介入治疗冠心病效果显著,但在冠心病早期症状防治、冠脉再狭窄等方面治疗有限。随着中医药现代化研究的深入,许多中医理论与西医机理共性被相继证实,中医药多靶点、多途径为冠心病的防治提供新的契机。近年来,干预肠道菌群防治心脑血管疾病成为心血管领域又一研究方向,同时中医益气健脾法治疗冠心病临床疗效确切,对肠道菌群亦有调节作用。因此基于“肠道菌群”探讨益气健脾法治疗冠心病的机制具有重要研究意义。本文将对益气健脾中药进行综述,主要包括调节脂代谢、抗炎、调节免疫、改善内皮功能、抗氧化应激,探讨“肠道菌群”及益气健脾法共性等多方面治疗冠心病。以期为临床运用益气健脾法治疗冠心病及其现代科学研究提供理论依据。

Coronary heart disease (CHD) means that coronary artery atherosclerosis causes coronary artery stenosis, spasm or occlusion, resulting in myocardial ischemia, hypoxia or necrosis of the heart dis-ease. The incidence and mortality of coronary heart disease are increasing year by year due to the change of national lifestyle and the complexity of symptoms. At present, western medicine com-bined with interventional treatment of coronary heart disease has a significant effect, but in the early symptoms of coronary heart disease prevention and treatment, coronary artery restenosis and other aspects of treatment is limited. With the deepening of TCM modernization research, many similarities between TCM theory and Western medicine mechanism have been confirmed one after another, and the multi-target and multi-approach of TCM provide new opportunities for the preven-tion and treatment of coronary heart disease. In recent years, intervention of intestinal flora to prevent and treat cardiovascular and cerebrovascular diseases has become another research direc-tion in the cardiovascular field. At the same time, the TCM method of invigorating qi and invigorat-ing spleen has a definite clinical effect on coronary heart disease, and also has a regulating effect on intestinal flora. Therefore, it is of great significance to explore the mechanism of invigorating qi and invigorating spleen in the treatment of coronary heart disease based on “intestinal flora”. This arti-cle will review the traditional Chinese medicines for invigorating qi and invigorating spleen, mainly including regulating lipid metabolism, anti-inflammation, regulating immunity, improving endo-thelial function, anti-oxidative stress, exploring “intestinal flora” and the commonness of invigorat-ing qi and invigorating spleen for the treatment of coronary heart disease. The aim is to provide theoretical basis for the clinical application of tonifying qi and invigorating spleen in the treatment of coronary heart disease and modern scientific research.