基于“窠囊”理论探讨冠状动脉粥样硬化性心脏病病机与治疗

Exploration of the Pathogenesis and Treatment of Coronary Atherosclerotic Heart Disease Based on the “Ke Nang” Theory

摘要: 基于中医窠囊理论探讨冠心病的病理机制与分期论治思路。冠心病的核心病机为痰瘀互结，阻塞心脉，与窠囊理论所述“痰瘀胶结成囊”高度契合，脉中之痰浊对应现代医学脂质，有形瘀结对应纤维帽，根据疾病发生发展进程提出分期论治策略：初期以行气破滞调畅气机；中期重在化痰散结分化胶结；后期侧重祛瘀通络并兼顾扶正。该理论为冠心病的中医治疗提供了新思路，但需进一步临床验证。

Abstract: This study explores how the TCM “Ke Nang” (nest-like encapsulated mass) theory can elucidate the pathogenesis of coronary heart disease and guide its stage-specific treatment. The core pathogenesis of CHD in traditional Chinese medicine (TCM) is the intermingling of phlegm and blood stasis, which blocks the heart vessels. This is highly consistent with the description of “phlegm and blood stasis congealing into a capsule” in the “Ke Nang” theory. Specifically, the turbid phlegm in the vessels corresponds to lipids in modern medicine, while the tangible blood stasis masses correspond to fibrous caps. According to the progression of the disease, a stage-based treatment strategy is proposed: Early stage: Focus on promoting qi circulation to dispel stagnation and regulate qi movement. Middle stage: Prioritize resolving phlegm and dissipating masses to break down the congealed (phlegm-stasis) substances. Late stage: Emphasize eliminating blood stasis and dredging collaterals, while also supporting healthy qi (zheng qi) concurrently. This theory provides a new perspective for the TCM treatment of CHD, yet further clinical verification is required.