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颈动脉粥样硬化斑块作为心脑血管疾病的重要前驱病理环节,其高发病率及增长趋势对公共卫生构成严峻挑战。中医药在该领域的治疗作用既往未被重视,其基于“整体观念”指导,通过“未病先防”控制危险因素、“已病防变”延缓斑块进展、“瘥后防复”改善疾病预后,应当形成全周期健康管理体系。然而,当前中医药在该领域仍面临标准化缺失、高质量临床证据匮乏、基础研究深度不足等核心问题。未来可通过完善中医药标准化体系、推动高质量临床评价研究、借助现代科学技术解读中医药原理等多方面路径,充分释放中医药在该病防治中的潜力,为慢病综合防治提供支撑。
Abstract:Carotid atherosclerotic plaques,as a key precursor pathology of cardiovascular and cerebrovascular diseases,pose a severe challenge to public health due to their high prevalence and increasing trend. The therapeutic role of traditional Chinese medicine( TCM) in this field has been previously overlooked. Guided by the concept of " holism",TCM aims to control risk factors through " prevention before disease",delay plaque progression through " preventing transformation after disease",and improve disease prognosis through " preventing recurrence after recovery",thereby forming a full-cycle health management system. However,TCM in this field currently faces core issues such as lack of standardization,scarcity of high-quality clinical evidence,and insufficient depth in basic research. In the future,the potential of TCM in the prevention and treatment of this disease can be fully realized through various approaches,including improving the standardization system of TCM,promoting high-quality clinical evaluation studies,and interpreting TCM principles with the aid of modern scientific technology,thereby providing support for comprehensive chronic disease prevention and management.
[1]JI H Y,ZHAO X F,CHEN X Y,et al. Jinlida for diabetes prevention in impaired glucose tolerance and multiple metabolic abnormalities:the FOCUS randomized clinical trial[J]. JAMA Med Intern,2024,184(7):727-735.
[2]吴军,吕晓鹏,张悦清,等.血脂康联合PCSK9抑制剂治疗他汀不耐受冠状动脉粥样硬化性心脏病患者的安全性和有效性[J/OL].中华中医药学刊,2025:1-8[2025-06-06]. https://kns. cnki. net/kcms/detail/21. 1546. R.20250606. 1335. 014. html.
[3]闫京京,吴鸿.茯苓杏仁甘草汤对DGAT2介导的脂质代谢与动脉粥样硬化易损斑块的影响[J].中国比较医学杂志,2025,35(3):58-70.
[4]LI B X,DENG S Z,ZHUO B F,et al. Effect of acupuncture vs sham acupuncture on patients with poststroke motor aphasia:a randomized clinical trial[J]. JAMA Netw Open,2024,7(1):e2352580.
[5]《老年人颈动脉粥样硬化性疾病诊治中国专家建议》写作,中华医学会老年医学分会,《中华老年医学杂志》编辑委员会,等.老年人颈动脉粥样硬化性疾病诊治中国专家建议[J].中华老年医学杂志,2013,32(2):113-120.
[6]国家心血管病专家委员会心血管代谢医学专业委员会.他汀不耐受的临床诊断与处理中国专家共识[J].中国循环杂志,2024,39(2):105-115.
[7]王劲松.从疏肝扶脾法探讨青木百本汤对他汀类药物致肌损伤的影响[D].沈阳:辽宁中医药大学,2020.
[8]申绎莛.补中益气化裁方对他汀类药物引起的肌肉损伤临床观察[D].沈阳:辽宁中医药大学,2020.
[9]王劲松,王连志.补中益气法治疗他汀类药物致肌无力[J].实用中医内科杂志,2019,33(6):71-73.
[10]周恩,汤叶华,徐建欧,等.血脂康联合低剂量他汀类药物治疗颈动脉粥样硬化斑块患者的有效性和安全性观察[J].中华老年心脑血管病杂志,2025,27(7):867-870.
[11]张云帆,赵迪,魏竞竞,等.病证结合诊断标准的优势与展望[J/OL].中华中医药学刊,2025:1-8[2025-07-21]. https://link. cnki. net/urlid/21. 1546. R. 20250228.1624. 006.
[12]罗慜婧,柴倩云,冯玉婷,等.中医药临床研究证候标准化诊断的研究思路与方法[J].中医杂志,2023,64(24):2505-2510.
[13]潘万旗,邓素玲,杨英豪,等.关于中医药标准化的思考[J].中医学报,2015,30(6):795-797.
[14]黄璐琦.中医药科技创新基础研究重点方向思考[J].中国科学基金,2024,38(3):383-386.
[15]孟骊冲,廉坤,郭瑾,等.中医药标准化研究现状与热点的可视化分析[J].中国医药导报,2024,21(31):21-29.
[16]黄江荣,常凯,向楠,等.中医药标准化发展战略思考[J].世界科学技术:中医药现代化,2013,15(1):40-44.
[17]王建新,杨丰文,高学敏,等.“循证为主,共识为辅,经验为鉴”在中医药/中西医结合临床实践指南中应用方法解读[J].中国循证医学杂志,2025,25(4):454-459.
[18]张俊华.循证中医药研究的几个关键问题[J].天津中医药,2025,42(1):40-44.
[19]罗魏敏,张昊,王成晨.中医药临床试验研究的现状与提升策略[J].中医药管理杂志,2024,32(20):202-205.
[20]刘腾文,施逸凡,王天园,等.病证结合体系下中医临床循证评价的思考与实践[J].中国实验方剂学杂志,2024,30(22):127-136.
[21]尤良震,方子寒,李耿,等.新时代我国中医药学科学术发展现状及趋势[J].中国中药杂志,2024,49(11):2841-2852.
[22]钟梦媛,王春洋,庄铭,等.中药临床安全性评价存在的问题与思考[J].中国中药杂志,2023,48(12):3404-3408.
[23]郑文科,金鑫瑶,张俊华,等.基于全生命周期理念的中药安全性真实世界研究模式[J].世界中医药,2019,14(12):3111-3114.
[24]谭婧,王雯,李玲,等.系统循证医学:推动中医药疗效研究的新方向[J].中国循证医学杂志,2025,25(2):125-133.
[25]纪茜茜,庄子涵,隆红艳.系统生物学在中医药现代化发展中的应用[J].时珍国医国药,2025,36(3):520-524.
[26]王泽浩,吴余凡,税嘉诚,等.不同创新主体视角下的中医药科技成果转化比较研究[J].四川中医,2025,43(6):1-8.
[27]王天琳,姚魁武.深度学习方法应用于中医药领域的优劣势及展望[J].中国医药导报,2024,21(6):193-196.
[28]FERNANDEZ-FRIERA L,PENALVO J L,FERNANDEZORTIZ A,et al. Prevalence,vascular distribution,and multiterritorial extent of subclinical atherosclerosis in a middleaged cohort:the PESA(progression of early subclinical atherosclerosis)study[J]. Circulation,2015,131(24):2104-2113.
[29]ZHAO S P,LIU L,CHENG Y C,et al. Xuezhikang,an extract of cholestin,protects endothelial function through antiinflammatory and lipid-lowering mechanisms in patients with coronary heart disease[J]. Circulation,2004,110(8):915-920.
[30]MORIARTY P M,ROTH E M,KARNS A,et al. Effects of Xuezhikang in patients with dyslipidemia:a multicenter,randomized,placebo-controlled study[J]. J Clin Lipidol,2014,8(6):568-575.
[31]MACH F,BAIGENT C,CATAPANO A L,et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias:lipid modification to reduce cardiovascular risk[J]. Eur Heart J,2020,41(1):111-188.
[32]王增武,刘静,李建军,等.中国血脂管理指南(2023年)[J].中国循环杂志,2023,38(3):237-271.
[33]张宗博,马国婧,杨红娟,等.补阳还五汤加减治疗他汀类药物不耐受型高脂血症验案举隅[J].中国民族民间医药,2024,33(24):87-90.
[34]孙伟,钱成霞,霍艳明.参浦降脂颗粒干预他汀不耐受高脂血症的疗效分析[J].北京中医药,2017,36(8):742-743.
[35]林晓云,慕文会,梁卓莹.他汀类药物不耐受高脂血症患者应用清痰降脂饮的临床疗效观察[J].内蒙古中医药,2011,30(20):12-13.
[36]郭冰,肖圣超.依折麦布联合血脂康对他汀类药物不耐受NSTE-ACS患者血脂的影响[J].临床合理用药,2025,18(5):43-46.
基本信息:
DOI:10.16368/j.issn.1674-8999.2026.01.001
中图分类号:R259
引用信息:
[1]姚魁武.中医药防治颈动脉粥样硬化斑块的几个关键问题[J].中医学报,2026,41(01):1-6.DOI:10.16368/j.issn.1674-8999.2026.01.001.
基金信息:
癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项项目(四大慢病重大专项)(2024ZD0528300,2024ZD0528304); 2024年岐黄学者培养项目(中医药领军人才培养项目){国中医药人教函[2025]182号}
2025-08-09
2025
2026-01-27
2026
2
2026-01-09
2026-01-09