中医学报

冠心病与颈动脉粥样硬化同属动脉粥样硬化性疾病，二者病因同源、病理机制相关，临床共病多见，共存时会显著增加心肌梗死、缺血性脑卒中等严重心脑血管事件的风险。剖析二病共性，寒邪乃始动因素，“虚气”即正虚阳亏为本，日久寒邪收引脉络，久伏致瘀、凝滞生浊，邪气积聚于脉络，渐成寒凝、痰浊、瘀血、毒邪等邪实“留滞”为标的病机演变。临证倡导“从寒论治”的寒邪理论，辨治此共病应遵“温药和之”治则，秉持“以温为通、以温促通”理念，以温调气血扶正、温阳散寒泻浊、活血温通消积、解毒通脉化斑为主线构建诊疗方案。据病机寒热转化而灵活遣方用药，阳气得振奋，寒浊得消散，阴阳调和，每获良效。

Coronary heart disease and carotid atherosclerosis both belong to atherosclerotic diseases. They share the same etiology and related pathological mechanisms,and comorbidity is common in clinical practice. Their coexistence significantly increases the risk of severe cardiovascular and cerebrovascular events such as myocardial infarction and ischemic stroke. Analyzing the common patterns of the two diseases,cold pathogenic factors are considered the initiating cause,while " Xu Qi" represents the fundamental deficiency and Yang depletion. Over time,the Cold pathogen contracts the channels,leading to stagnation and accumulation of turbid substances,forming pathological changes characterized by Cold congealment,Phlegm and Turbidity,blood stasis as well as toxic pathogen retention. Clinically,the theory of " treating from perspective of Cold" is advocated,and the treatment of this comorbidity should follow the principle of " Wen Yao He Zhi",adhering to the concept of " Yi Wen Wei Tong and Yi Wen Cu Tong". The treatment plan is constructed around warming and regulating Qi and blood to support the healthy energy,dispersing Cold and clearing Turbidity,activating blood circulation to warm and remove stasis,and detoxifying to open the channels and resolve deposits. Prescriptions and medications are flexibly applied according to the transformation of Cold and Heat in the disease mechanism,thereby invigorating Yang energy,dispersing Cold-Turbidity accumulation as well as harmonizing Yin and Yang,achieving favorable therapeutic effects each time.