中医药治疗气虚血瘀型慢性冠状动脉综合征的研究进展

Research Progress of Traditional Chinese Medicine in Treating Chronic Coronary Syndrome with Qi Deficiency and Blood Stasis Syndrome

摘要: 慢性冠状动脉综合征(chronic coronary syndrome, CCS)是冠心病长期管理的重要阶段，气虚血瘀证是其常见中医证型之一。西医治疗以抗缺血、抗栓、调脂、危险因素控制及血运重建为主，虽能改善患者预后，但部分患者仍存在残余心绞痛、运动耐量下降、微循环障碍及症状反复等问题。中医药在整体调节、辨证论治及长期康复管理方面具有一定研究和应用基础。现有研究提示，益气活血类汤药及中成药可能有助于改善心绞痛症状、减少抗心绞痛药物使用，并提高运动耐量和生活质量；针灸可作为辅助干预缓解症状并减少发作频率；八段锦等导引术可能有助于改善心肺功能及康复依从性。联合治疗模式亦值得进一步研究，但针对汤药、针灸与导引术三法联合干预气虚血瘀型CCS的高质量证据仍显不足。本文对近年来相关中英文文献进行综述，以期为气虚血瘀型CCS的中医药临床治疗及进一步研究提供参考。

Abstract: Chronic coronary syndrome (CCS) represents an important stage in the long-term management of coronary heart disease, and qi deficiency with blood stasis syndrome is one of its common traditional Chinese medicine patterns. Contemporary Western treatment focuses on anti-ischemic therapy, antithrombotic therapy, lipid lowering, risk factor control, and revascularization. Although these strategies improve prognosis, some patients still experience residual angina, reduced exercise tolerance, microcirculatory dysfunction, and recurrent symptoms. Traditional Chinese medicine has a certain research and application basis in overall regulation, pattern differentiation, and long-term rehabilitation management. Available studies suggest that qi-supplementing and blood-activating decoctions and patent medicines may relieve angina symptoms, reduce the use of anti-anginal drugs, and improve exercise tolerance and quality of life; acupuncture may be used as an adjunctive therapy to relieve symptoms and reduce attack frequency; and Daoyin exercises such as Baduanjin may improve cardiopulmonary function and rehabilitation adherence. Combined treatment models merit further investigation, but high-quality evidence for the joint use of herbal therapy, acupuncture, and Daoyin exercises in CCS with qi deficiency and blood stasis syndrome remains insufficient. This article reviews relevant Chinese and English literature in recent years to provide a reference for clinical treatment and further research on traditional Chinese medicine for CCS with qi deficiency and blood stasis syndrome.