中医药在防治急性心肌缺血再灌注损伤中研究进展.docVIP

中医药在防治急性心肌缺血再灌注损伤中的研究进展 　　[摘要] 急性心肌缺血/再灌注损伤是指在血运重建的同时，伴有再灌注引起的心肌损伤和心肌细胞的坏死。中医以本虚标实为基本病机。本文从中医病因病机、辨证施治方面阐述了中医药在防治急性心肌缺血/再灌注损伤中的机制及作用，病因病机包括气滞血瘀、热毒、气虚血瘀、心阳虚衰、痰瘀阻络、气阴两虚，治以活血化瘀、清热解毒、益气活血、温阳活血、痰瘀并治、益气养阴。同时，简明扼要地总结了目前存在的问题以及今后进一步研究的方向。 　　[关键词] 急性心肌缺血/再灌注损伤；中医药；心肌保护 　　[中图分类号] R542.22 [文献标识码] A [文章编号] 1673-7210（2015）10（b）-0031-04 　　Research progress of TCM on preventing and treating myocardial ischemia/reperfusion injury 　　ZHU Wenye1 WANG Xiaolong2 GAO Junjie2 CHEN Xiaokang1 CHEN Tiejun2 　　1.Postgraduate School， Shanghai University of Traditional Chinese Medicine， Shanghai 201203， China； 2.Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine， Shanghai 201203， China 　　[Abstract] Acute myocardial ischemia/reperfusion injury is that reperfusion causes myocardial injury and the necrosis of myocardial cells at the same time of reascularization. The virtual is the basic pathogenesis in TCM. The article unveils the mechanisms and effects of TCM on preventing and treating Chinese acute myocardial ischemia/reperfusion injury in terms of etiology， pathogenesis and syndrome differentiation in TCM. Pathogenesis include qi-stagnancy and blood stasis， hot toxin， blood stasis due to qi deficiency， deficiency of heart-yang， phlegm-blood stasis blocking， deficiency of both qi and yin， which were treated for promoting blood circulation and removing blood stasis， clearing away heat and toxic substances， supplementing qi and activating blood circulation， warming yang and activating the blood， synchronic treating phlegm and blood stasis， tonifying qi and yin. At the same time， this paper summarizes the existing problems and the direction of further research in the future. 　　[Key words] Acute myocardial ischemia / reperfusion injury； Traditional Chinese medicine； Cardioprotection 　　冠心病已经成为全世界最主要的死亡原因之一，平均每年约有680万人死于该病，急性心肌梗死是冠心病中最为危重的一种，具有发病急、病情重、死亡率高的特点。目前治疗急性心肌梗死最主要的手段是通过溶栓术、PCI术、抗凝治疗和冠状动脉旁路移植术（CABG）等及时恢复冠状动脉的血运，血运重建可以减少心肌梗死的坏死面积，改善左室的收缩功能，但是在血运重建的同时，常