慢性阻塞性肺疾病合并冠心病心肺相关机制浅析.docVIP

慢性阻塞性肺疾病合并冠心病心肺相关机制浅析 　　摘要：临床上，慢性阻塞性肺疾病（COPD）和冠心病（CAD）常相互影响，促进疾病进展。本文从生理上论述宗气为心肺相关的功能基础，营卫相关是心肺相关的核心；从病理上探讨宗气亏虚是COPD和CAD发病基础，营卫交会生化紊乱是COPD合并CAD的核心机制，痰瘀毒互结难解，进一步损伤精气是COPD合并CAD进展的关键因素。由此为下一步临床辨证及制定综合治疗方案与临床科研奠定基础。 　　关键词：慢性阻塞性肺疾病；冠心病；心肺相关；宗气；痰；瘀；毒 　　DOI：10.3969/j.issn.1005-5304.2017.05.027 　　中图分类号：R259.63；R259.414 文献标识码：A 文章编号：1005-5304（2017）05-0112-04 　　Analysis on Heart-Lung Correlation of Chronic Obstructive Pulmonary Disease Concomitant Coronary Artery Disease LIU Yu-jin1，2， JIA Zhen-hua2，3 （1. Graduate School of Hebei Medical University， Shijiangzhuang 050017， China； 2. Yiling Hospital of Hebei Province， Shijiangzhuang 050091， China； 3. Yiling Pharmaceutical Research Academy， Key Laboratory of State Administration of TCM， Key Laboratory of Collateral Disease of Hebei Province， Shijiangzhuang 050035， China） 　　Abstract： Clinically， chronic obstructive pulmonary disease （COPD） and coronary heart disease （CAD） often interact to promote disease progression. This article discussed that zongqi is the heart-lung correlation functional basis and yingwei relevant is heart-lung correlation core. Zongqi deficiency is the incidence basis of COPD and CAD from the pathology. Communication and transformation of nutrient and defensive qi is the core mechanism of COPD combined with CAD. Phlegm and blood stasis are toxic intricate. Further damage to jingqi is the key to combination of COPD and CAD. It lays the foundation for next clinical syndrome differentiation， development of comprehensive treatment programs and clinical research. 　　Key words： chronic obstructive pulmonary disease； coronary artery disease； heart-lung correlation； zongqi； phlegm； stasis； toxins 　　?R床上，慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）和冠心病（coronary artery disease，CAD）常相互影响而合并存在。COPD与CAD风险增加相关[1]，也与心血管原因的住院率增加相关，且独立于先前存在的心血管疾病（CVD）风险因子[2]，表明在COPD患者中CAD的发病率明显高于年龄和风险因子匹配的对照人群。但COPD患者中CAD常常漏诊[3-5]。 　　根据临床常见的心肺共病现象，为了更好理解其病理生理关系，Ukena C等[6]提出“心肺一体”假说，认为共同的风险因子产生了全身炎症反应过程，这导致了动脉粥样硬化性疾病和COPD的进