Summary of 32 Patients with Cardiac Syndrome X Treated by TCM Therapy of Regulating Qi Relieving Chest Stuffiness and Promoting Blood Circulation

Objective： To evaluate the clinical effect of Liqi Kuanxiong Huoxue method （宽胸活血,LKH, traditional Chinese medicine, TCM therapeutic method for regulating qi, relieving chest stuffiness and promoting blood circulation） in treating patients with cardiac syndrome X （CSX）. Methods： The prospective, non-randomized controlled study was conducted on 51 selected patients with CSX, who were non-randomly assigned to 2 groups, the treated group treated with LKH in addition to the conventional treatment （32 patients）, and the control group treated with conventional treatment （19 patients） like nitrate, diltiazem hydrochloride, etc. The treatment course was 14 days. The changes of such symptoms as angina pectoris, TCM syndrome and indexes of treadmill exercise test before and after treatment were observed. Results： After treatment, such symptoms as chest pain and stuffy feeling and palpitation in the treated group were improved more than those in the control group （P〈0.05）; the total effective rate on angina pectoris and TCM syndrome in the treated group was better than that in the control group （P〈0.05）. The treadmill exercise test showed that the maximal metabolic equivalent （Max MET）, the time of angina onset and ST segment depression by 0.1 mV were obviously improved after treatment in both groups, but the improvement in the treated group was better than that in the control group respectively （P〈0.05）. Conclusion： The LKH method could reduce the frequency of angina attacks and improve the clinical condition of patients with CSX.

Mechanism of'Invigorating Qi and Promoting Blood Circulation'Drug Pair Ginseng-Danshen on Treatment of Ischemic Heart Disease Based on Network Pharmacology

Objective:Using network pharmacology to explore the mechanism of the'invigorating qi and promoting blood circulation'drug pair Ginseng-Danshen(Salvia miltiorrhiza)on treatment of ischemic heart disease(IHD).Methods:The chemical constituents of ginseng and Danshen drug pair were identified by searching the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),and the potential targets of the pair were identified.The pharmacodynamics of the pair was analyzed using network pharmacology.The targets of IHD were identified by database screening.Using protein-protein interaction network,the interaction targets of Ginseng-Danshen on IHD were constructed.A"constituent-target-disease"interaction network was constructed using Cytoscape software,Gene Ontology(GO)term enrichment analysis and biological pathway enrichment analysis were carried out,and the mechanism of improving myocardial ischemia by the Ginseng-Danshen drug pair was investigated.Results:Seventeen active constituents and 53 targets were identified from ginseng,53 active constituents and 61 targets were identified from Danshen,and 32 protein targets were shared by ginseng and Danshen.Twenty GO terms were analyzed,including cytokine receptor binding,cytokine activity,heme binding,and antioxidant activity.Sixty Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathways were analyzed,including phosphatidylinositol 3-kinase-serine-threonine kinase(PI3 K-AKT)signaling pathway,p53 signaling pathway,interleukin 17 signaling pathway,tumor necrosis factor signaling pathway,and the advanced glycation end product(AGE)-the receptor for AGE(RAGE)signaling pathway in diabetic complications.Conclusion:The specific mechanism of Ginseng-Danshen drug pair in treating IHD may be associated with improving the changes of metabolites inbody,inhibiting the production of peroxides,removing the endogenous oxygen free radicals,regulating the expression of inflammatory factors,reducing myocardial cell apoptosis and promoting vascular regeneration.

Invigorating Qi and Promoting Blood Circulation in Treatmentof Chronic Idiopathic Thrombocytopenic Purpura

Twenty patients of chronic idiopathic thrombocytopenic purpura (ITP) were treated with suchkind of Chinese herbal medicine as invigorating Qi and promoting blood circulation for 4-8 weeks. The ther-apeutic effect was observed and compared with that of the two control groups treated with prednisone and co-enzyme A respectively. In the TCM group, the number of patients with marked effect, good effect and im-provement were 2, 4 and 7, the total effective rate being 65% . This efficacy was higher than that of the co-enzyme group and lower than that of the prednisone group. The changes of antiplatelet IgG antibody and hap-toglobin were also observed in the meantime, and results showed that after TOM treatment, both of themwere decreased as disease improved.

Effect of Danggui Shaoyao San with Huangqi on adriamycin-induced nephrotic syndrome in rats

Objective:To determine the therapeutic effect of Danggui Shaoyao San with Huangqi on rats with nephrotic syndrome(NS)was discussed,and the scientific connotation of TCM treatment principle was elaborated,so as to provide experimental basis for its clinical application.Methods:The NS rat model was established by iv administration of adriamycin;The rats were divided into model group,Danggui Shaoyao San group,Danggui Shaoyao San with Huangqi group,Huangqi group and positive drug group,with 10 rats in control group;The best dosage ratio of Danggui Shaoyao San and Huangqi was screened by Excel;24 h urine protein was measured by BCA method;The electrolyte level was detected by automatic biochemical analyzer;In serum Urea nitrogen(BUN),Creatinine(SCr),Total cholesterol(TC),Triglyceride(TG),Total protein(TP),Albumin(ALB),Immunoglobulin M(Ig-M)and Immunoglobulin G(Ig-G)were detected by the kit;hematoxylin-eosin staining was used to observe the renal morphology;The Total water content(TBW),Extracellular water content(ECF)and Intracellular water content(ICF)were measured by experimental animal body composition analyzer.Results:Compared with the model group,the urine protein in the modified Astragalus group of Danggui Shaoyao Powder was significantly decreased(P<0.01);Urine electrolytes were significantly decreased and serum electrolytes were significantly increased(P<0.01);Serum BUN,SCR,TC and TG were significantly decreased(P<0.01),while TP,ALB,TBW and ICF were significantly increased(P<0.01);The levels of Ig-M and Ig-G were significantly increased(P<0.01),TBW and ICF were significantly increased,and ECF was significantly decreased(P<0.01);Histopathology showed that the pathological changes of renal tissue were obviously alleviated;The improvement of each index was better than that of Danggui Shaoyao San group and Huangqi group.Conclusion:Danggui Shaoyao San with Huangqi group can significantly improve the edema,proteinuria,blood lipid and immune function of NS rats,and the effect is better than that of Danggui Shaoyao San group and Huangqi group.It has the best therapeutic effect on NS,which indicates that Huangqi plays a key synergistic effect on Danggui Shaoyao San,which verifies the scientific connotation of"Yiqi Huoxue Lishui"in the treatment of NS.

4种治疗糖尿病周围神经病变补气活血类中成药的卫生技术评估

目的为临床选择糖尿病周围神经病变(DPN)治疗用补气活血类中成药提供参考。方法参考《医疗机构中成药遴选专家共识(第一版)》,结合临床实际,制订药物卫生技术评估细则,参考药品说明书、临床指南和文献,对4种中成药的安全性、有效性、经济性、适宜性、创新性、可及性、传承性进行评分,并计算总分。结果通心络胶囊、木丹颗粒、糖脉康颗粒、芪蛭降糖胶囊的评分分别为74.5分、72分、64.5分、57分。结论临床在选择治疗DPN的补气活血类中成药时,相对于糖脉康颗粒、芪蛭降糖胶囊,建议优先使用木丹颗粒、通心络胶囊。

王阶从“虚-痰-瘀-热-滞”论治冠状动脉狭窄经验

冠状动脉粥样硬化斑块导致冠状动脉狭窄是冠心病发病的关键和病理基础。目前,冠心病的常规治疗措施包括药物治疗和血运重建,在一定程度上能改善症状,但仍有发生不良心血管事件的风险。全国名中医王阶教授临证经验丰富,在中医辨治冠心病及用药方面独具特色。王教授提出,冠心病的核心病机是“痰瘀滞虚”,四大证候要素紧密结合,互相转化,贯穿于冠心病发生、发展的全过程。王教授认为,冠状动脉狭窄与“虚、痰、瘀、热、滞”病机密切相关,其中“虚”为内在致病之本,“血瘀、痰浊”是主要病理因素,“热毒内蕴”是重要病机,“气滞”是加重病情、干扰疾病转归的重要因素。王教授临证时强调治病求本,病机结合病理,脏腑辨证和病证结合,方证相应指导处方用药,药性结合药理,灵活配伍。治疗上,以益气补肾、活血化痰、清热解毒之法立法组方,擅用经方加减化裁,守机用之,遵旨变通;或合方治疗,兼顾病情;善用对药配伍,强化药效,颇具特色。现将王阶教授在冠状动脉狭窄治疗方面的临床经验总结如下,并附医案一则,以飨同道。

Traditional Chinese Medicines alleviated myocardial ischemia by regulating Qi and promoting blood circulation

OBJECTIVE:To investigate the efficacy of Chinese medicines on Qi stagnation and blood stasis in rats with myocardial ischemia.METHODS:Fifty male Wistar rats were randomly divided into five groups(n=10)as follows:(a)sham operation(Sham),(b)myocardial ischemia(Model),(c)treatment that regulates Qi(Qi),(d)treatment that promotes blood circulation(Blood),(e)treatment that both regulates Qi and promotes blood circulation(QB).The rat model was established via activities restriction for 6 h followed by tail clamp stimulation for 5 mins every day for 7 d and occlusion left coronary anterior descending artery.Afterwards rats were treated with medicines that regulate Qi and/or promote blood circulation via gavage for 14 d.Behavioral parameters were evaluated using open field and elevated plus-maze tests.The tongue color and sublingual vein were visually examined.Blood flow perfusion of tongue and auricle were detected using PIMⅡ.The mesenteric microcirculation was examined via capillaroscopy,and hemodynamics was assessed using a polygraph system.Serum homocysteine(Hcy),creatine kinase isoenzyme(CKMB)levels and endothelin-1(ET-1)were measured.Hematoxylin and eosin staining and transmission electron microscopy were employed to detect the myocardial morphology and ultrastructure,respectively.RESULTS:Compared with findings in Sham group,rats in model group had coarse hair,dark mucosa of the lips and claw,low activity,and increased anxiety.Compared with findings in Model group,rats in the three treatment groups exhibited a lighter tongue color without an extended and varicose sublingual vein.There were significant increases of auricle blood flow perfusion in the Qi group and tongue bottom blood flow perfusion in the QB group.Compared with findings in Model rats,rats in Blood group exhibited improved mesenteric microcirculation associated with increased mesenteric blood flow and a larger arteriole diameter.Moreover,compared with findings in Model rats,Qi and QB rats exhibited increased left ventricular±dp/dtmax,decreased serum CKMB,Hcy,ET-1 levels,and reduced myocardial ultrastructural damage.CONCLUSION:Myocardial ischemia damage was suppressed by Traditional Chinese Medicines that regulate Qi and promote blood circulation.

益气活血法调控自噬延缓失神经肌萎缩的理论

周围神经损伤后骨骼肌将不可避免地发生肌肉萎缩,而气虚血瘀是失神经肌萎缩发病的主要病理机制,益气活血法是防治失神经肌萎缩的重要治则。神经损伤后局部血脉瘀滞与远端靶组织气血亏虚,可能是导致自噬溶酶体系统过度激活的主要病理机制,益气活血法(补阳还五汤)可通过益气生血与活血化瘀,恢复靶组织的气血供应,改善神经血脉瘀滞与靶组织气血亏虚的病理状态,从而抑制自噬溶酶体系统过度激活,发挥失神经肌萎缩的保护作用。

脉通君安汤治疗气虚血瘀型冠心病心绞痛的临床疗效及转录组学研究

目的观察脉通君安汤治疗气虚血瘀型冠心病心绞痛的临床疗效,并通过转录组学方法初步阐明其可能的作用机制。方法将符合纳入标准的140例气虚血瘀型冠心病心绞痛患者依据随机数字法分为治疗组、对照组各70例,治疗期间对照组脱落3例。对照组予冠心病二级预防西医基础治疗,治疗组在对照组治疗基础上加服脉通君安汤,2组疗程均为8周。治疗前后评估2组患者中医证候积分、加拿大心血管学会(Canadian cardiovascular society,CCS)心绞痛分级、西雅图量表(Seattle angina questionnaire,SAQ)评分、焦虑自评量表(Self-rating anxiety scale,SAS)评分、抑郁自评量表(Self-rating depression scale,SDS)评分及不良反应,并基于性别、年龄、病程相匹配原则选取9例患者治疗前后外周血进行转录组学测序。结果治疗后,2组患者中医证候积分均明显下降(P<0.01),治疗组在改善胸痛、胸闷、气短、神倦乏力及总分方面优于对照组(P<0.05,P<0.01);治疗组CCS心绞痛分级总改善率优于对照组(P<0.05);2组治疗前后SAQ、SAS及SDS评分均显著改善(P<0.01),治疗组SAQ评分改善优于对照组(P<0.05,P<0.01)。转录组学结果显示,治疗前后具有显著差异表达的mRNA有862个,包括509个上调,353个下调;GO分析结果显示差异表达的mRNA生物学过程有666条,主要包括病毒基因表达、翻译启动、RNA分解代谢过程等,细胞组分112条,主要包括黏着斑、核糖体亚基、核斑点等;分子功能有94条,主要包括双链RNA结合、钙黏蛋白结合、转录共调节因子活性等;KEGG分析结果显示差异mRNA富集信号通路包括20条,主要包括甘油磷脂代谢通路、单磷酸腺苷激活的蛋白激酶(AMP-activated protein kinase,AMPK)信号通路、核糖体通路等。结论脉通君安汤能够改善气虚血瘀型冠心病心绞痛患者临床症状,其作用机制为多靶点多通路,可能与甘油磷脂代谢通路、AMPK信号通路、核糖体通路的调节相关。

单味中药有效成分治疗溃疡性结肠炎研究进展

研究表明,中药治疗溃疡性结肠炎不良反应少且复发率低,临床常用益气健脾、清热祛湿、活血化瘀、补血养阴类中药组方治疗,其主要药物的有效成分具有减轻炎症反应、修复黏膜损伤、调节肠道微生态、调节免疫反应等作用。本文对常用单味中药有效成分治疗溃疡性结肠炎的作用机制进行综述,为其临床治疗与中药新药研发提供参考。

从气、血、痰论治冠状动脉粥样硬化性心脏病的理论探索及临床应用

冠状动脉粥样硬化性心脏病(简称冠心病)与中医学胸痹心痛病联系密切,作为临床常见的心血管疾病目前已成为严重威胁中老年人生命健康的多发病、常见病。因此,寻找有效的冠心病防治方法已成为迫切需要。近些年来,在冠心病的治疗方式上,传统中医治疗手段已经逐渐步入主流,无论从预防、治疗及预后的任何角度,中医都有着不能替代的优势与作用。中医学在整体观的指导下,基于辨证论治的治疗思路对疾病进行干预。基于古典医籍和丰富的各家学说,并结合中医临床流行病学调查,冠心病中医证候以“阳微阴弦”即“本虚标实”为基本病机,本虚以气虚为主,标实以血瘀、痰浊为主,其中气虚、血瘀、痰浊三者关系密切。故文章以此为切入点,探究历代胸痹心痛病相关著作中关于气虚、血瘀、痰浊的致病机制及三者之间相互依存、互为因果的理论基础,从而以病机言治则,将“益气温阳”“活血化瘀”“化痰逐饮”三法作为中医治疗胸痹的大方向,三法结合,灵活辨证,既重视阴弦之标,又兼顾阳微之本。同时与现代医学相结合,述析“益气、活血、化痰”的现代医学本质,发现其与现代医学所提出的通过正性肌力、抗凝、调脂、稳定斑块等手段抑制动脉粥样硬化形成的理念不谋而合,为临床中西医结合治疗冠心病提供理论基础。通过案例介绍现代医家从气、血、痰论治冠心病的经验,以期为临床提供新思路、新方法。

基于“二阳结谓之消”探讨糖尿病性便秘病机及防治策略

“二阳结谓之消”语出《素问·阴阳别论篇》,是认识糖尿病性便秘的早期记载,但目前学界多据此仅从二阳(足阳明胃经、手阳明大肠经)结滞化热来解释消渴期发生便秘的病机,存在一定局限性。通过考究发现“二阳”并不单指手足阳明经脉或胃肠二腑,而是包括胃、大肠二腑及手足阳明经脉;“结”也并不完全指结热这一病邪,而是指病邪胶结难解、疾病难以治愈的程度,并且“二阳”之热易伤血脉,造成络脉瘀滞。基于对“二阳结谓之消”的重新理解,笔者认为糖尿病性便秘在糖尿病期以“热伤气阴”为主要病机,糖尿病并发症期以热伤血络、血脉瘀滞为主要病机。治疗方面,糖尿病期以清热益气养阴为本,糖尿病并发症期以活血化瘀为核心,此外还需重视体质从化,全面把握糖尿病性便秘的诊治。

基于中医血脉理论谈从脾论治糖尿病血管病变

糖尿病血管病变是糖尿病严重的慢性并发症之一,目前已成为糖尿病患者死亡和致残的主要原因,其巨额的医疗费用给家庭、社会带来沉重的经济负担。文章从血管与血脉的相关性出发,基于中医血脉理论,结合传统医学与现代医学观点,认为脾气虚,运化无力,气机不畅,脂浊不化,致痰浊、瘀血、热毒等病理产物壅滞血脉是糖尿病血管病变发生的重要原因,可累及多个靶器官。结合五脏一体观,从脾为四脏之长、脾与其他四脏的病变关系论述从脾论治糖尿病血管病变的理论依据以及古今医家从脾论治糖尿病血管病的临床思路,并将中西医思想融会贯通,突出从脾论治糖尿病血管病变的重要性。治疗上注重益气养阴、活血解毒、健脾化湿之法,为临床防治糖尿病血管病变提供新思路。

益气活血法治疗急性心肌梗死及并发症研究进展

气虚血瘀证为急性心肌梗死的常见证型,益气活血法作为急性心肌梗死的主要治法之一,常用于治疗急性心肌梗死后不同并发症如心绞痛、经皮冠脉介入治疗术后再狭窄、心室重构及心力衰竭等,临床效果显著。本文对益气活血法通过抑制炎症水平、改善心肌细胞凋亡与自噬、影响心肌纤维化及促进血管新生等方面治疗急性心肌梗死气虚血瘀证的作用机制进行综述,以期为益气活血法治疗急性心肌梗死气虚血瘀证的科学性与有效性提供理论参考。

基于病证结合从气血水辨治急性黄斑区神经视网膜病变

气、血、水是构成和维持目功能活动的基本物质,三者生理上同源互化、病理上交互为患,是辨治眼底病不可或缺的证候要素。基于病证结合的气血水理论,急性黄斑区神经视网膜病变主要病机为气、血、水输布和代谢障碍、目络阻塞,病位在黄斑目系络脉,与肝、脾、肾三脏密切相关,可采用中药联合针刺进行治疗。药物治疗以益气活血、利水通络法为治法,以补阳还五汤为基本方,根据气滞、血瘀、水停及肝、脾、肾脏腑功能障碍加减用药;针刺选穴以局部穴位为主、远端穴位为辅,以达益气化瘀、通络明目之功。

急性脑梗死患者中医证候与侧支循环、脑血流灌注及预后的相关性分析

【目的】探讨急性脑梗死(acute cerebral infarction,ACI)患者的中医证候特点,并分析其与侧支循环、脑血流灌注及预后的关系。【方法】选取急性脑梗死患者300例,均行头颈CT血管造影(CTA)联合CT灌注成像(CTP)检查,并随访观察30 d,通过改良Rankin量表(MRS)评分评估预后,同时观察中医证候动态演变,探索中医证候与侧支循环、病灶区脑血流灌注及预后的关系,另采用Logistic回归分析探讨中医证候、血流灌注参数及侧支建立对卒中结局的影响。【结果】(1)急性脑梗死患者痰、血瘀、风等证候要素占比最高;前/后交通动脉开放、颅外向颅内侧支建立的中医证候要素分布中均以气虚为多见;以侧支循环来看,发病第1天,侧支良好组比侧支不良组气虚证分布低(P<0.05),发病第30天时,侧支良好组的气虚、痰证素的分布均明显比侧支不良组低(P<0.01);相关分析结果显示,发病第1天患者气虚分布与感兴趣区域脑血容量(rCBV)呈负相关(r=-0.472,P<0.05)、阴虚分布与rCBV呈正相关(r=-0.557,P<0.01);按病灶区rCBV>1.0或降低rCBV<1.0分为2组,比较病灶区证候要素分布差异,得出rCBV减低组患者以气虚分布较多(P<0.01)、而rCBV升高组以阴虚分布较多(P<0.05)。(2)发病第1天的证候要素分布,预后不良组的气虚分布明显高于预后良好组(P<0.01);发病第30天,预后良好组的气虚、痰证素的分布均明显低于预后不良组(P<0.05或P<0.01);对2组患者发病第1天、第30天的痰证素的分布进行比较,发现预后良好组患者的痰证素在第30天时较第1天时显著减少(χ^(2)=7.409,P<0.01),而预后不良组患者无显著性差异(P>0.05)。(3)Logistic回归分析结果显示,中医证候(气虚、痰)、侧支分级、病灶区rCBV是卒中结局的独立危险因素。【结论】急性脑梗死患者侧支建立不良、血流灌注减低及预后不良均以气虚证候要素分布为特点,同时,预后较差患者还存在痰的证候要素贯穿病变始终的特点,体现出气虚、痰证在急性脑梗死发病和病程进展中的重要性。

尹连荣教授论治高度近视早期视网膜退行性病变经验探析

[目的]总结尹连荣教授治疗高度近视早期视网膜退行性病变的临床经验及学术观点。[方法]通过跟师临证,医案整理,从高度近视早期视网膜退行性病变的发病机制、理论依据入手,总结尹教授治疗本病的临证思想及化裁经验,并附验案加以佐证。[结结果]高度近视视网膜退行性病变呈缓慢进展状态,近视性黄斑病变严重损害视力且不可逆转,目前尚无有效治疗手段。因此,尹教授临证时将“治未病”思想与“目受血而能视”理论相结合,提出将治疗节点前移,即在发生不可逆的黄斑病变前加以干预,尹教授认为本病早期病机关键为气血亏虚,脉络瘀阻,治疗时应紧扣益气养血、活血通络之法,灵活运用经方补阳还五汤加减以改善脉络膜、视网膜血流,从而延缓眼底病变进展,临床疗效肯定。所举医案中,尹教授综合脉症及眼底检查结果,辨其为气血亏虚、脉络瘀阻之证,以益气活血之补阳还五汤加减治疗,疗效卓著。[结论]尹连荣教授将“治未病”思想与“目受血而能视”理论相结合,在高度近视视网膜退行性病变早期阶段给予干预,通过益气活血法使气旺血行、瘀去络通,从而改善脉络膜、视网膜血流,延缓疾病进展,其经验值得临床学习借鉴。

针刺联合活血通络法治疗耳鸣40例临床疗效观察

目的:对针刺联合活血通络法治疗气滞血瘀型耳鸣患者的临床疗效进行总结。方法:选取于我科门诊就诊,诊断为气滞血瘀型耳鸣患者80例。按随机数字表法,将患者分为对照组及观察组各40例。对照组以活血通络为治则,予以中药血府逐瘀汤加减口服;观察组在对照组基础上,加以针刺治疗;两组治疗时间均以7天为一疗程,在每个疗程之间间隔3天,连续治疗3个疗程。观察两组治疗前后的纯音听阈测听(PTA)、耳鸣残疾评估量表(THI)、耳鸣评估问卷(TEQ)、耳鸣视觉模拟评分法(VAS)、中医症状变化及总体临床疗效,对针刺联合活血通络法治疗气滞血瘀型耳鸣患者进行总体评估。结果:治疗3个疗程后,两组在PTA、TEQ、THI、VAS评分方面,治疗后与治疗前比较,均明显降低,且对照组评分下降幅度明小于观察组,差异均有统计学意义(P<0.05);两组在中医症状胸胁胀闷,走窜疼痛,胁下痞块,刺痛拒按评分方面,治疗后与治疗前比较均降低,且对照组评分明显高于观察组,差异均有统计学意义(P<0.05);对照组临床总有效率为77.5%,观察组临床总有效率为87.5%,两组总有效率差异有统计学意义(P<0.05)。结论:运用针刺联合活血通络法与单纯使用活血通络法治疗耳鸣相比较,有着更好的临床疗效。

孙郁芝运用益气活血行水法治疗肾性水肿经验

孙郁芝教授认为,脾肾两虚、气滞湿阻、瘀水互结是肾性水肿的主要病机,治以补肾健脾为主,佐以益气行水、活血化瘀,标本兼治,总结出“益气活血行水”特色疗法,治疗中运用经验方药,加以化裁,临床疗效满意。附验案一则分析。

益气活血类方治疗冠状动脉粥样硬化性心脏病气虚血瘀证的研究新进展

冠状动脉粥样硬化性心脏病(简称冠心病)是全球导致人类死亡的主要病因,具有较高的致残率与病死率,其病理机制包括冠状动脉脂质紊乱、血栓形成、炎症、血管平滑细胞活化/重塑、血小板活化、内皮功能障碍、氧化应激、基质代谢改变和遗传因素等,目前冠心病的病理机制虽然相对明确,二级预防用药也有效延缓了疾病进展、减少病死率,但冠心病患病人数仍不断攀升,现有药物治疗靶点单一,缺乏作用于多靶点、多途径的药物。近年来中医药在治疗冠心病的认知与作用机制上取得丰硕成果。冠心病属中医学“胸痹”“心痛”范畴,临床以气虚血瘀证最为常见,益气活血为主要治则。文章通过查阅大量的相关信息,整理了近五年益气活血类方治疗冠心病气虚血瘀证临床疗效的相关文献,发现其作用机制丰富,主要包括改善血液流变学、保护血管内皮、抑制炎症反应、抗氧化应激反应、改善心室结构及心功能、调脂、稳定斑块、改善冠状动脉血流量/慢血流、改善心肌损伤等,大量的研究结果表明在二级预防用药基础上加用益气活血类方治疗冠心病气虚血瘀证可以拓展该病的治疗靶点与途径,相较于现代医学具有独特优势,对后期临床实践与研究具有一定的理论参考价值。