下肢静脉血栓防治的中西医研究进展

Research Progress of Traditional Chinese and Western Medicine in the Prevention and Treatment of Lower Extremity Deep Vein Thrombosis

摘要: 在下肢静脉血栓(DVT)的防治中，中医药展现出独特的临床优势与广阔的应用前景。现代医学视DVT为血流淤滞、血管壁损伤及高凝状态综合作用的结果；中医学则多将其归属“脉痹”、“脉阻”范畴，核心病机为气滞血瘀、湿热壅阻与正虚邪实。临床上，中医药以活血化瘀、益气扶正、祛湿清热及疏通经络为治则，涵盖内服、外治、针灸针刀及中西医结合等多元疗法。现代研究表明，中医药能够通过抗凝、抗炎、抗氧化、改善血液流变及保护内皮等途径，并调控PI3K/Akt、NF-κB等信号通路，发挥多靶点干预作用。针对当前研究存在的临床设计局限、辨证标准不一及机制探讨不深等问题，未来亟待加强高质量循证医学研究与微观机制探索，以推动DVT标准化与精准化防治体系的建设。

Abstract: In the prevention and treatment of lower extremity deep vein thrombosis (DVT), traditional Chinese medicine (TCM) has demonstrated unique clinical advantages and broad application prospects. Modern medicine considers DVT as the result of the combined effects of blood flow stasis, vascular wall injury, and a hypercoagulable state. In contrast, TCM mostly categorizes it under the concepts of “Maibi” (vessel impediment) and “Maizu” (vessel obstruction), with the core pathogenesis being Qi stagnation and blood stasis, damp-heat accumulation, and the coexistence of healthy Qi deficiency and pathogenic excess. Clinically, TCM promotes blood circulation and removes blood stasis, replenishes Qi and strengthens healthy Qi, eliminates dampness and clears heat, and dredges collaterals as its therapeutic principles. It encompasses multiple therapies, including internal administration, external treatment, acupuncture, and needle-knife, as well as the integration of traditional Chinese and Western medicine. Modern research indicates that TCM can exert multi-target intervention effects through pathways such as anticoagulation, anti-inflammation, antioxidation, improving hemorheology, and protecting the endothelium, while also regulating signaling pathways like PI3K/Akt and NF-κB. Addressing current research issues—such as clinical design limitations, inconsistent syndrome differentiation standards, and inadequate mechanism exploration—there is an urgent need to strengthen high-quality evidence-based medical research and microscopic mechanism investigation in the future. This will help promote the construction of a standardized and precise prevention and treatment system for DVT.