PCI术后常见问题的中医治疗研究进展

Research Progress in Traditional Chinese Medicine Treatment for Common Problems after PCI

摘要: 经皮冠状动脉介入治疗(PCI)是冠心病治疗的核心手段，但术后常并发心绞痛、造影剂肾病(CIN)及焦虑抑郁等问题，严重影响患者预后及生活质量。中医药凭借多靶点、整体调节的优势，在改善PCI术后并发症中展现出独特潜力。本文系统综述近年来中医对PCI术后常见问题的认识与治疗进展：1. 针对术后心绞痛，中医以“胸痹”“真心痛”为纲，遵循“阳微阴弦”病机，提出益气通络、活血化瘀、调畅气机等治法，临床研究证实其取得了良好的治疗效果；2. 针对CIN，中医立足“毒瘀互结”理论，采用解毒化瘀、调和脏腑等法，如川黄汤、八珍汤等，可有效改善肾功能；3. 针对术后焦虑抑郁，中医以“双心医学”为框架，结合疏肝解郁、养心安神等辨证论治策略，配合针灸、八段锦等非药物疗法，疗效优于单纯西药且安全性更佳。现有研究表明，中医药可有效改善PCI术后病理状态，但亟需构建规范化的诊疗体系及循证医学证据以提升临床转化价值。未来研究需进一步整合辨证论治与现代医学模式，优化疗效评价标准，为降低PCI术后并发症提供中西医结合新思路。

Abstract: Percutaneous coronary intervention (PCI) is a core treatment for coronary heart disease, but it is often complicated by post-operative angina pectoris, contrast-induced nephropathy (CIN), anxiety, and depression, which severely affect patients’ prognosis and quality of life. Traditional Chinese medicine (TCM), leveraging its advantages of multi-target regulation and holistic intervention, has demonstrated unique potential in improving post-PCI complications. This paper systematically reviews recent TCM insights and treatment advances for common post-PCI issues: 1. For post-operative angina pectoris, TCM classifies it under “chest bi” (chest obstruction) and “true heart pain,” following the pathogenesis of “yang deficiency and yin excess.” Therapeutic strategies such as replenishing qi to dredge collaterals, activating blood circulation to remove stasis, and regulating qi movement have been proposed. Clinical studies have confirmed that these approaches yield favorable therapeutic effects. 2. For CIN, based on the TCM theory of “toxicity-stasis interconnection,” methods such as detoxifying to resolve stasis and harmonizing zang-fu organs (e.g., Chuanhuang Decoction, Bazhen Decoction) are used, which can effectively improve renal function. 3. For post-operative anxiety and depression, TCM adopts the “dual heart medicine” framework, combining syndrome differentiation strategies like soothing the liver to relieve depression and nourishing the heart to calm the mind, alongside non-pharmacological therapies such as acupuncture and Baduanjin. These interventions show better efficacy and safety compared to Western medicine alone. Existing research indicates that TCM can effectively improve post-PCI pathological states, but there is an urgent need to establish standardized diagnostic and treatment systems and evidence-based medical evidence to enhance clinical translation value. Future studies should further integrate syndrome differentiation with modern medical models, optimize efficacy evaluation criteria, and provide new integrative approaches for reducing post-PCI complications.