摘要
认为“虚气留滞”是经皮冠状动脉介入治疗(PCI)术后冠状动脉微血管功能障碍(CMD)的根本病机。PCI术前多心脉瘀阻较重,导致络脉失充,正气不足,气血津液运行无力,使心络易滞易瘀,痰瘀内生;术后易正伤气虚,引起气血津液失运,进而导致血瘀、痰浊留滞生变,化热生风,损伤心体。提出PCI术前防病当益气充络、逐瘀化痰,以改善心络“虚气”,预防术后“留滞”;术后调治当益气护络、祛邪防变,既避免正气损伤加重虚滞,又祛邪通络截断病机,以防“留滞”生变。
It is believed that"deficiency qi retention and stagnation"is the fundamental pathogenesis of coronary microvascular dysfunction(CMD)after percutaneous coronary intervention(PCI).Patients often have severe coro-nary vessel congestion before PCI,leading to emptiness in the heart's collaterals,which results in deficiency of healthy qi,poor movement of blood and body fluids,so the heart collaterals are susceptible to stagnation and stasis,then phlegm and stasis generate;after PCI,it is easy to damage the healthy qi then lead to qi deficiency,causing qi,blood,and body fluids fail to transport,thereby leading to blood stasis and phlegm turbidity retention,generating heat and wind to damage the heart and body.It is proposed that the prevention before PCI should replenish qi and collaterals,expel blood stasis and resolve phlegm,to support"deficient qi"in heart collaterals and prevent"stagnation"after PCI.Postoperative management should focus on replenishing qi and protecting the collaterals,eliminating pathogen and controlling development,so as to avoid exacerbating deficiency and stagnation by damaging healthy qi,and elimi-nate pathogen and unblock the collaterals to interrupt the pathogenesis,which prevent"retention and stagnation"from changes.
作者
李昀泽
宗慧琪
刘红旭
李明轩
李享
LI Yunze;ZONG Huiqi;LIU Hongxu;LI Mingxuan;LI Xiang(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing,100010;Beijing University of Chinese Medicine)
出处
《中医杂志》
北大核心
2025年第12期1273-1276,共4页
Journal of Traditional Chinese Medicine
基金
国家自然科学基金(82104767)
首都临床特色诊疗技术研究及转化应用项目(Z221100007422127)
河北省中医药管理局科研计划项目(B2025055)。
关键词
冠状动脉微血管功能障碍
经皮冠状动脉介入术
虚气留滞
coronary microvascular dysfunction
percutaneous coronary intervention
deficiency qi retention and stagnation
作者简介
通讯作者:刘红旭,lhx_@263.net。
