中医对痰瘀互结型2型糖尿病合并高血压心脑血管危险事件的认识及防治

Traditional Chinese Medicine’s Understanding and Management of Phlegm-Stasis Interminglement Syndrome in Type 2 Diabetes Mellitus Complicated with Hypertension and Cardio-Cerebrovascular Risk Events

摘要: 动脉粥样硬化不稳定斑块破裂或脱落导致的心脑血管危险事件是中国居民的首要死亡原因，其发病率和死亡率持续攀升，构成重大健康威胁。T2DM作为DM中最常见的分型，与EH一同被公认为损害心脑血管的关键危险因素，二者在临床上常合并发生。近年来，随着中医药的发展，经临床研究发现：痰瘀互结型T2DM合并EH患者的动脉粥样硬化不稳定斑块的发病率及心脑血管危险事件发生率显著提升。而中医疗法在对不稳定斑块的防治上拥有广阔的潜力与确切的疗效。本文以不稳定斑块为核心，综述了中医T2DM合并EH及不稳定斑块的认识、痰、瘀与斑块形成的关系、痰瘀互结型患者斑块高发的原因，以及中医防治此类患者心脑血管事件的策略。

Abstract: The rupture or detachment of unstable atherosclerotic plaques leading to cerebrovascular and cardiovascular events constitutes the primary cause of mortality among Chinese residents, with its incidence and mortality rates persistently escalating, posing a significant health threat. Type 2 Diabetes Mellitus (T2DM), the most prevalent subtype of Diabetes Mellitus (DM), alongside Essential Hypertension (EH), is widely recognized as a critical risk factor for cerebrovascular and cardiovascular damage, often co-occurring in clinical settings. Recent advancements in Traditional Chinese Medicine (TCM) have revealed through clinical studies that patients with T2DM and EH characterized by phlegm-stasis syndrome exhibit a markedly increased incidence of unstable atherosclerotic plaques and cerebrovascular and cardiovascular events. TCM demonstrates substantial potential and proven efficacy in the prevention and treatment of unstable plaques. This paper centers on unstable plaques, providing a comprehensive review of TCM’s understanding of T2DM combined with EH and unstable plaques, the relationship between phlegm, stasis, and plaque formation, the reasons for the high incidence of plaques in patients with phlegm-stasis syndrome, and TCM strategies for preventing and managing cerebrovascular and cardiovascular events in such patients.