活血化瘀类中药防治深静脉血栓形成的机制 研究进展

Research Progress on the Mechanisms of Blood-Activating and Stasis-Resolving Traditional Chinese Medicines in the Prevention and Treatment of Deep Vein Thrombosis

摘要: 深静脉血栓形成(deep vein thrombosis, DVT)是临床常见的周围血管疾病，严重时可并发肺栓塞，危及生命。目前DVT的治疗主要包括抗凝、溶栓及介入治疗等，虽疗效确切，但仍存在出血风险及部分患者预后改善有限等问题。中医认为DVT核心病机为血瘀阻络，活血化瘀法贯穿治疗始终。近年来研究表明，活血化瘀类中药可通过抑制炎症反应、调控中性粒细胞胞外诱捕网形成、改善血液流变学状态、保护血管内皮功能及调节凝血–纤溶系统等多途径发挥抗血栓作用。本文围绕上述机制对近年来相关研究进展进行归纳分析，以期为活血化瘀类中药防治DVT的进一步研究与临床应用提供参考。

Abstract: Deep vein thrombosis (DVT) is a common clinical peripheral vascular disease. In severe cases, it can be complicated by pulmonary embolism, which is life-threatening. Current treatments for DVT mainly include anticoagulation, thrombolysis, and interventional therapy. Although these treatments are effective, they still carry the risk of bleeding and provide limited prognostic improvement in some patients. In traditional Chinese medicine, the core pathogenesis of DVT is blood stasis obstructing the collaterals, and the therapeutic principle of activating blood circulation and resolving stasis is applied throughout the treatment. In recent years, studies have demonstrated that traditional Chinese medicines with the effect of activating blood circulation and resolving stasis exert antithrombotic effects through multiple pathways, including inhibiting inflammatory responses, regulating the formation of neutrophil extracellular traps, improving hemorheological status, protecting vascular endothelial function and alleviating endothelial injury, and regulating the coagulation-fibrinolysis system. This paper reviews and analyzes the recent research progress on the above mechanisms, aiming to provide a reference for further research and clinical application of blood-activating and stasis-resolving traditional Chinese medicines in the prevention and treatment of DVT.