1.中国中医科学院广安门医院,北京市西城区北线阁5号,100053
2.中国中医科学院西苑医院
liulongtao1976@126.com
收稿:2025-12-12,
修回:2026-02-23,
录用:2026-01-27,
纸质出版:2026-06-17
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王亚杰,吴敏,张子浩等.从“脉内痈疡”论治动脉粥样硬化易损斑块[J].中医杂志,2026,67(12):1349-1352.
WANG Yajie,WU Min,ZHANG Zihao,et al.Treating Vulnerable Atherosclerotic Plaque from the Perspective of "Abscess and Ulcer within the Vessels"[J].Journal of Traditional Chinese Medicine,2026,67(12):1349-1352.
王亚杰,吴敏,张子浩等.从“脉内痈疡”论治动脉粥样硬化易损斑块[J].中医杂志,2026,67(12):1349-1352. DOI: 10.13288/j.11-2166/r.2026.12.018.
WANG Yajie,WU Min,ZHANG Zihao,et al.Treating Vulnerable Atherosclerotic Plaque from the Perspective of "Abscess and Ulcer within the Vessels"[J].Journal of Traditional Chinese Medicine,2026,67(12):1349-1352. DOI: 10.13288/j.11-2166/r.2026.12.018.
动脉粥样硬化(AS)易损斑块的形质特征和演变规律与中医学中的“痈疡”高度相似,故将AS易损斑块类比为“脉内痈疡”,认为虚、瘀、毒为其核心病机,病理演变历经因虚着形、痰瘀成积,积化为腐、内败外薄,因腐蕴毒、毒聚将溃三个阶段,终致斑块失稳。据此确立分期论治策略,初期宜补虚消积、散瘀防腐,方选六君子汤合丹参饮加减;中期宜化腐生新、扶正固形,方选托里消毒散加减;末期宜清解腐毒、凉血防溃,方选四妙勇安汤合犀角地黄汤加减。
The morphological characteristics and pathological progression of vulnerable plaques in atherosclerosis (AS) exhibit a high degree of similarity to the concept of "abscesses and ulcers" in traditional Chinese medicine (TCM). Therefore, vulnerable atherosclerotic plaques can be analogized as "abscesses and ulcers within the vessels", for which deficiency, stasis and toxin constitute the core pathogenesis. The pathological evolution progresses through three sequential stages, deficiency leading to pathological substances, with phlegm and stasis accumulating into a mass; the mass transforming into putridity, with internal decay and external thinning; putridity brewing toxin, and toxin accumulation threatening rupture, ultimately resulting in plaque instability. Accordingly, a stage-specific treatment strategy is established. In the early stage, it is suggested to supplement deficiency, resolve the mass, dissipate stasis, and prevent putridity, using
Liujunzi Decoction
(六君子汤) combined with
Danshen Decoction
(丹参饮) with modifications. In the middle stage, the treatment should focus on transforming putridity to generate new tissue, and rectifying healthy
qi
to consolidate the body, with modified
Tuoli Xiaodu Powder
(托里消毒散). In the late stage, the treatment principle is clearing and resolving putridity toxin, cooling the blood, and preventing ulcerative rupture, using modified
Simiao Yong'an Decoction
(四妙勇安汤) combined with
Xijiao Dihuang Decoction
(犀角地黄汤).
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