从痰、瘀、虚探讨动脉粥样硬化的中西医病机

中医无动脉粥样硬化相对应病名,常归属于"胸痹"、"心痛"、"真心痛"、"中风"等范畴,其病机以痰、瘀、虚为主。现代医学研究表明,动脉粥样斑块的形成和发展过程始终伴随着炎症反应及其诱发的细胞坏死,而炎症反应与中医的痰、瘀、虚存在紧密的联系。以"虚"是炎症产生的根本,"痰瘀"是炎症激发和加剧的条件,痰瘀为标,互为因果,恶性循环的理论为指导,从痰、瘀、虚与炎症的关系,进一步探讨动脉粥样硬化的中西医病机,并结合最新研究发现,如清道夫受体内陷导致胆固醇逆转运异常、清道夫受体同时可介导低密度脂蛋白进入血管内皮、巨噬细胞转化为泡沫细胞、激活炎症通路诱发血管慢性炎症持续状态和激活细胞坏死相关通路诱发细胞坏死,最终引起动脉粥样硬化的发生和进展,为临床认识动脉粥样硬化的病机提供理论依据,有助于拓展临床对于动脉粥样硬化相关疾病的诊疗思路。

Discussion on the pathogenesis of atherosclerosis from phlegm,blood stasis and asthenia

TCM has no corresponding disease name of atherosclerosis,which is often classified as"chest apoplexy","heartache","true pain"and"stroke".Its pathogenesis is mainly phlegm,blood stasis and deficiency.Modern medical studies have shown that the formation and development of atherosclerotic plaque is always accompanied by inflammatory response and cell necrosis induced by it,and inflammatory response is closely related to phlegm,blood stasis and deficiency in TCM.With "virtual"produce inflammation is fundamental,"phlegm and blood stasis"is a condition of inflammation,stimulate and aggravate,phlegm and blood stasis as the standard,causal,vicious cycle theory as the instruction,the relationship between phlegm,blood stasis,deficiency and inflammation,and further explore the pathogenesis of Chinese and western medicine of atherosclerosis,and combined with a new study has found that,as a scavenger receptor invagination of scavenger receptor leads to abnormal reverse cholesterol transport,at the same time can be mediated low density lipoprotein into the vascular endothelium,macrophages into foam cells,activation of inflammation induced vascular chronic inflammatory state and activation and cell death pathways induced cell necrosis resulting in the occurrence and progress of atherosclerosis,It provides theoretical basis for clinical understanding of the pathogenesis of atherosclerosis and helps to expand clinical thinking for diagnosis and treatment of atherosis-related diseases.