从肝肾阴虚浅析女性围绝经期冠心病病机及中医治疗

Analysis of the Pathogenesis and TCM Treatment of Female Perimenopausal Coronary Heart Disease from the Perspective of Liver-Kidney Yin Deficiency

摘要: 围绝经期是女性由育龄期向老年期过渡的关键阶段，此时天癸将竭、冲任虚衰，阴精暗耗，脏腑失濡，其中肝肾阴虚构成本阶段最具特征的内在体质基础。冠心病作为严重威胁该年龄段女性健康的心血管疾病，在其发病过程中，肝肾阴亏既不能上济以养心脉，又易催生气滞、痰浊、瘀血等实邪，形成典型的本虚标实、虚实夹杂之候。本文以肝肾阴虚为切入点，系统梳理围绝经期冠心病的病机演变规律，阐述滋补肝肾、养心通脉的核心治则，结合辨证分型探讨方药配伍思路，并对现有证据的强度和局限性进行分析，旨在为中医药干预围绝经期冠心病提供较为系统的理论参考。

Abstract: Perimenopause is a critical transitional stage for women from reproductive age to senescence. During this period, Tiankui (reproductive essence) is declining, Chong and Ren vessels are deficient, yin essence is consumed, and the zang-fu organs lose moisture. Among them, liver-kidney yin deficiency constitutes the most characteristic internal constitutional basis at this stage. Coronary heart disease (CHD), as a cardiovascular disease seriously threatening women’s health at this age, in its pathogenesis, liver-kidney yin deficiency can neither ascend to nourish the heart vessels nor easily generate excess pathogens such as qi stagnation, phlegm turbidity, and blood stasis, forming a typical pattern of root deficiency and branch excess, intermingled deficiency and excess. This article takes liver-kidney yin deficiency as the starting point, systematically reviews the pathogenesis evolution of perimenopausal CHD, expounds the core therapeutic principle of nourishing liver and kidney and cultivating heart and unblocking vessels, discusses the compatibility of formulas based on syndrome differentiation, critically evaluates the strength and limitations of existing evidence, aiming to provide a relatively systematic theoretical reference for TCM intervention in perimenopausal CHD.