冠心病中西医发病机制及治疗研究进展

Research Progress on the Pathogenesis and Treatment of Coronary Heart Disease with Traditional Chinese and Western Medicine

摘要: 冠心病又称为冠状动脉粥样硬化性心脏病，是临床最常见的缺血性心血管疾病，因冠状动脉粥样硬化导致血管管腔狭窄、痉挛或闭塞，引发心肌缺血、缺氧甚至坏死，具有发病率高、致残率高、死亡率高、年轻化趋势显著等特点。研究显示，我国成年人冠心病患病率已达12.3%，每年心血管死亡患者中冠心病患者超60%，已成为威胁国民生命健康的首要慢性心血管疾病。目前西医认为，冠心病发病核心与脂质代谢紊乱、血管内皮损伤、慢性炎症反应、血小板异常活化、氧化应激及血管重构等多重因素密切相关。中医将冠心病归属于“胸痹”、“心痛”、“真心痛”等范畴，以气虚、阳虚、气阴两虚为本，以血瘀、痰浊、气滞、寒凝为标，病位在心，与肝、脾、肾三脏功能失调密切相关。本文汇总近年冠心病中西医发病机制及临床治疗研究进展，总结当前研究存在的问题，并展望未来发展方向，为冠心病临床防治提供理论依据与实践参考。

Abstract: Coronary heart disease, also known as coronary atherosclerotic heart disease, is the most common ischemic cardiovascular disease in clinical practice. It is caused by coronary atherosclerosis, leading to vascular lumen stenosis, spasm, or occlusion, which can trigger myocardial ischemia, hypoxia, and even necrosis. It is characterized by a high incidence rate, high disability rate, high mortality rate, and a significant trend towards younger patients. Studies show that the prevalence of coronary heart disease among adults in China has reached 12.3%, with coronary heart disease patients accounting for over 60% of cardiovascular deaths each year, making it the primary chronic cardiovascular disease threatening national life and health. Currently, Western medicine believes that the core pathogenesis of coronary heart disease is closely related to multiple factors such as lipid metabolism disorder, vascular endothelial injury, chronic inflammatory response, abnormal platelet activation, oxidative stress, and vascular remodeling. Traditional Chinese medicine categorizes coronary heart disease under terms such as “chest obstruction”, “heartache” and “true heartache” with qi deficiency, yang deficiency, and qi and yin deficiency as the root causes, and blood stasis, phlegm turbidity, qi stagnation, and cold coagulation as the superficial manifestations. The disease is located in the heart and is closely related to dysfunction of the liver, spleen, and kidney organs. This article summarizes recent research progress on the pathogenesis and clinical treatment of coronary heart disease in both Western and traditional Chinese medicine, highlights existing research issues, and looks forward to future development directions, providing theoretical basis and practical reference for the clinical prevention and treatment of coronary heart disease.