中医药防治PCI术后支架内再狭窄： 疗效与多靶点抗炎抗增殖机制研究
Research on the Efficacy and Multi-Target Anti-Inflammatory and Anti-Proliferation Mechanisms of Traditional Chinese Medicine in Preventing and Treating In-Stent Restenosis after PCI
摘要: 经皮冠状动脉介入治疗(PCI)是目前临床开展冠状动脉血运重建的核心手段，药物洗脱支架(DES)的临床应用虽有效降低了支架内再狭窄(ISR)的发生风险，却无法彻底规避该并发症，现阶段ISR仍以每年1%~2%的比例持续出现，临床针对远期ISR的处理仍以DES、药物涂层球囊(DCB)二次介入为主，治疗手段亟待创新升级。中医药立足整体调控理念，以“益气活血、化瘀通络、清热解毒”为核心治则，通过抗炎抗氧化、修复血管内皮功能、调控机体免疫及代谢等多靶点、多途径干预ISR发生发展的关键环节，在临床应用中展现出确切的干预效果。本文系统梳理PCI术后ISR的现代医学病理机制及核心调控细胞信号通路，归纳中医药经典复方、单味药及活性成分干预ISR的最新研究进展，深入剖析当前中医药干预ISR机制研究中存在的问题与不足，并进一步提出中西医协同防治PCI术后ISR的研究方向与发展思路，旨在为临床优化ISR防治方案、挖掘中医药的临床应用价值提供理论参考与实践依据。
Abstract: Percutaneous coronary intervention (PCI) is the core method for coronary revascularization in clinical practice. Although the clinical application of drug-eluting stents (DES) effectively reduces the risk of in-stent restenosis (ISR), it cannot completely avoid this complication. At present, ISR still occurs at an annual rate of 1%~2%. For long-term ISR, clinical treatment mainly relies on secondary intervention with DES and drug-coated balloons (DCB), and innovative therapeutic strategies are urgently needed. Based on the holistic regulation concept, traditional Chinese medicine (TCM) takes “replenishing qi and activating blood, resolving stasis and unblocking collaterals, clearing heat and detoxifying” as the core therapeutic principles. It intervenes in the key links of ISR occurrence and development through multi-target and multi-pathway effects such as anti-inflammation, anti-oxidation, vascular endothelial repair, and immune-metabolic regulation, showing definite clinical efficacy. This paper systematically reviews the modern medical pathological mechanisms and core regulatory signaling pathways of post-PCI ISR, summarizes the latest research progress of classic TCM compounds, single herbs and their active ingredients in intervening ISR, deeply analyzes the problems and deficiencies in current mechanism studies, and further proposes research directions and development strategies for integrated Chinese and Western medicine in preventing and treating post-PCI ISR. It aims to provide theoretical references and practical basis for optimizing ISR prevention and treatment strategies and exploring the clinical value of TCM.
文章引用：杨静, 刘昱含, 袁晖戍. 中医药防治PCI术后支架内再狭窄： 疗效与多靶点抗炎抗增殖机制研究[J]. 临床医学进展, 2026, 16(4): 4876-4886. https://doi.org/10.12677/acm.2026.1641761

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