周亚滨辨治冠心病支架植入术后再狭窄经验
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摘要
周亚滨教授从中医药角度认为,支架植入术后再狭窄的病因病机为本虚标实,病机关键是心阳不足,瘀血阻滞,临床上患者气虚症状明显,提出"益气温阳,活血通络"的治法。遣方用药中辨证应用养心汤和柴胡加龙骨牡蛎汤加减化裁,同时善用补气药和活血药,发挥益气温阳、活血通络、补养心神的功效。临证中详辨标本虚实,扶正祛邪,降低支架植入术后再狭窄的发生率,改善患者的生活质量及预后。
Professor Zhou Yabin believed that the pathogenesis of restenosis after stent implantation was deficiency of heart yang and blood stasis. It was found that symptoms of qi deficiency in patients with this disease were obvious, and the treatment of "invigorating qi and warming yang to promote blood circulation" was proposed. In clinical practice, Yangxin Decoction and Chaihu Plus Longgu Muli Decoction were modified according to syndrome dif ferentiation. At the same time, qi-tonifying drugs and blood-activating drugs were used to bring into play the ef fects of invigorating qi and warming yang, activating blood circulation and dredging collaterals, and nourishing heart and spirit. It is also necessary to distinguish deficiency or excess and manifestation or root cause, strengthen the body and dispel pathogenic factors for reducing the incidence of the disease, so as to improve the quality of patients' life.
Professor Zhou Yabin believed that the pathogenesis of restenosis after stent implantation was deficiency of heart yang and blood stasis. It was found that symptoms of qi deficiency in patients with this disease were obvious, and the treatment of "invigorating qi and warming yang to promote blood circulation" was proposed. In clinical practice, Yangxin Decoction and Chaihu Plus Longgu Muli Decoction were modified according to syndrome dif ferentiation. At the same time, qi-tonifying drugs and blood-activating drugs were used to bring into play the ef fects of invigorating qi and warming yang, activating blood circulation and dredging collaterals, and nourishing heart and spirit. It is also necessary to distinguish deficiency or excess and manifestation or root cause, strengthen the body and dispel pathogenic factors for reducing the incidence of the disease, so as to improve the quality of patients' life.
引文
[1]张辉,许官学.冠状动脉支架内再狭窄研究进展[J].岭南心血管病杂志, 2016, 22(3):357-360, 370.
[2]韦喻镪.利拉鲁肽对急性心肌梗死PCI术后心肌的保护作用[J].中国临床药理学与治疗学, 2018, 23(2):184-188.
[3]徐亚宁,丁翔,邹勇,等.冠心病患者PCI术后感染病原菌、耐药性及危险因素分析[J].中国病原生物学杂志, 2019,14(4):464-467.
[4]王敏,崔春利,刘世军,等.影响急性心肌梗死PCI术后患者心功能的危险因素分析[J].西安交通大学学报(医学版),2018, 39(6):871-875.
[5]李杰,赵英强,武强斌.通脉降脂方对冠心病介入治疗后心绞痛疗效的影响[J].长春中医药大学学报, 2013, 29(5):783-785.
[6]胡根胜,邵正斌.中医药对冠心病PCI术后炎症因子的影响[J].中医药临床杂志, 2017, 29(10):1592-1595.
[7]张辰浩,刘冠男,孔晓琳,等. 801例冠心病患者PCI术后中医证候及相关因素的回顾性研究[J].中医杂志, 2018,59(20):1766-1770.
[8]陈金锋,党群.釜底抽薪法在冠心病PCI术后的应用探讨[J].吉林中医药, 2011, 31(3):193-194.
[9]孙野.从伏邪论治冠心病[J].长春中医药大学学报, 2019,35(1):39-42.
[10]赵永法,马丽娜,皇甫海全,等.周亚滨教授治疗稳定性心绞痛经验[J].浙江中医药大学学报, 2017, 41(7):580-589.
[11]孙光伟,崔海英,崔洪涛,等.温阳通脉法在冠状动脉粥样硬化性心脏病中的应用[J].吉林中医药, 2019, 39(2):148-150.
[12]杨焱,张文风.周亚滨治疗冠心病经皮冠状动脉成形术后再狭窄经验介绍[J].中国中医药信息杂志, 2010,17(4):87.
[13]张冰睿,薛一涛.从情志论治谈冠心病治疗[J].吉林中医药, 2018, 38(2):133-136.
[14]彭成.中药药理学[M].北京:中国中医药出版社, 2012:142-143.
[15]阎卉芳,徐昊,彭熙炜,等.黄芪和当归配伍对大鼠血管内膜增生血管平滑肌细胞增殖的影响[J].中国临床药理学与治疗学, 2018, 23(4):361-369.
[16]治丁铭,孙聪,韩冬,等.葛根、牡蛎治疗高脂血症研究[J].长春中医药大学学报, 2018, 34(1):49-51.
[17]王肯堂.证治准绳[M].上海:上海科技出版社, 1959:8-9.
[18]赵永法,杨建飞.柴胡加龙骨牡蛎汤在心系疾病中临床应用的研究进展[J].中国中医急症, 2016, 25(6):1081-1083.
[19]代永兴,焦扬,周亚滨.周亚滨运用柴胡加龙骨牡蛎汤经验撷菁并验案3则[J].国医论坛, 2017, 23(5):10-11.
[20]付鹏,姚凤祯,赵方鹏,等.周亚滨从气血亏虚辨治冠心病心绞痛的理论认识[J].中华中医药杂志, 2016, 31(7):2636-2638.
[2]韦喻镪.利拉鲁肽对急性心肌梗死PCI术后心肌的保护作用[J].中国临床药理学与治疗学, 2018, 23(2):184-188.
[3]徐亚宁,丁翔,邹勇,等.冠心病患者PCI术后感染病原菌、耐药性及危险因素分析[J].中国病原生物学杂志, 2019,14(4):464-467.
[4]王敏,崔春利,刘世军,等.影响急性心肌梗死PCI术后患者心功能的危险因素分析[J].西安交通大学学报(医学版),2018, 39(6):871-875.
[5]李杰,赵英强,武强斌.通脉降脂方对冠心病介入治疗后心绞痛疗效的影响[J].长春中医药大学学报, 2013, 29(5):783-785.
[6]胡根胜,邵正斌.中医药对冠心病PCI术后炎症因子的影响[J].中医药临床杂志, 2017, 29(10):1592-1595.
[7]张辰浩,刘冠男,孔晓琳,等. 801例冠心病患者PCI术后中医证候及相关因素的回顾性研究[J].中医杂志, 2018,59(20):1766-1770.
[8]陈金锋,党群.釜底抽薪法在冠心病PCI术后的应用探讨[J].吉林中医药, 2011, 31(3):193-194.
[9]孙野.从伏邪论治冠心病[J].长春中医药大学学报, 2019,35(1):39-42.
[10]赵永法,马丽娜,皇甫海全,等.周亚滨教授治疗稳定性心绞痛经验[J].浙江中医药大学学报, 2017, 41(7):580-589.
[11]孙光伟,崔海英,崔洪涛,等.温阳通脉法在冠状动脉粥样硬化性心脏病中的应用[J].吉林中医药, 2019, 39(2):148-150.
[12]杨焱,张文风.周亚滨治疗冠心病经皮冠状动脉成形术后再狭窄经验介绍[J].中国中医药信息杂志, 2010,17(4):87.
[13]张冰睿,薛一涛.从情志论治谈冠心病治疗[J].吉林中医药, 2018, 38(2):133-136.
[14]彭成.中药药理学[M].北京:中国中医药出版社, 2012:142-143.
[15]阎卉芳,徐昊,彭熙炜,等.黄芪和当归配伍对大鼠血管内膜增生血管平滑肌细胞增殖的影响[J].中国临床药理学与治疗学, 2018, 23(4):361-369.
[16]治丁铭,孙聪,韩冬,等.葛根、牡蛎治疗高脂血症研究[J].长春中医药大学学报, 2018, 34(1):49-51.
[17]王肯堂.证治准绳[M].上海:上海科技出版社, 1959:8-9.
[18]赵永法,杨建飞.柴胡加龙骨牡蛎汤在心系疾病中临床应用的研究进展[J].中国中医急症, 2016, 25(6):1081-1083.
[19]代永兴,焦扬,周亚滨.周亚滨运用柴胡加龙骨牡蛎汤经验撷菁并验案3则[J].国医论坛, 2017, 23(5):10-11.
[20]付鹏,姚凤祯,赵方鹏,等.周亚滨从气血亏虚辨治冠心病心绞痛的理论认识[J].中华中医药杂志, 2016, 31(7):2636-2638.