活血化瘀法治疗不稳定性心绞痛的中西医结合研究进展

Research Progress on Integrated Traditional Chinese and Western Medicine in Treating Unstable Angina Pectoris with Blood-Activating and Stasis-Resolving Therapy

摘要: 不稳定性心绞痛是临床常见的心血管急危重症，属中医“胸痹心痛”“真心痛”范畴，瘀血痹阻心脉为其核心病机。临床以活血化瘀、通脉止痛为主要治则，采用中药复方、中成药及中药注射剂联合西医常规治疗，可有效改善患者心肌缺血与心电图异常表现，缓解心绞痛症状，下调炎症与凝血异常水平。同时由于目前有较多的现代药理学研究证据表明此治法具有抗血小板凝聚、抗炎、抗氧化应激以及改善血管内皮、减缓动脉粥样硬化斑块进展等多种药效机制支持。但毋庸讳言，目前仍宜加强高质量临床研究及深层分子机制探索，此举有助于继续提高本病临床诊疗的规范性和精准度。本文对活血化瘀法治疗不稳定型心绞痛的共性特点、使用规律、疗效特色及其相关的现代药理学研究进行较为深入而系统的梳理总结，并将其作为临床提高诊治水平、指导合理用药和进一步开展相关基础及临床研究的重要依据。

Abstract: Unstable angina pectoris is a common acute and critical cardiovascular disorder in clinical practice, categorized as chest impediment and true heart pain in traditional Chinese medicine. Blood stasis blocking cardiac vessels serves as its core pathogenesis. The primary therapeutic principle focuses on activating blood circulation, removing stasis and unblocking vessels to relieve pain. Combined with routine Western medicine treatment, Chinese herbal compounds, proprietary medicines and injections can effectively alleviate myocardial ischemia and abnormal electrocardiogram manifestations, mitigate angina symptoms, and regulate abnormal inflammatory and coagulation indicators. Modern pharmacological studies have verified that this therapy can inhibit platelet aggregation, suppress inflammation and oxidative stress, protect vascular endothelium, and slow down the progression of atherosclerotic plaques. Nevertheless, high-quality clinical trials and in-depth research on molecular mechanisms still need further promotion, so as to enhance the standardization and accuracy of clinical diagnosis and treatment. This paper systematically summarizes the general characteristics, medication rules, therapeutic advantages and relevant pharmacological findings of blood-activating and stasis-eliminating therapy for unstable angina pectoris, aiming to provide references for clinical diagnosis, rational medication and subsequent fundamental and clinical research.