Yu Gui, Wang Jie
Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
Chin J Integr Med. 2014 Apr;20(4):300-6. doi: 10.1007/s11655-013-1332-3. Epub 2013 Jul 27.
The medical community as a whole is attempting to start preventive therapy for coronary heart disease (CHD) patients earlier in life. However, the main limitations of such interventions are drug resistance and adverse reactions. Additionally, traditional biomarker discovery methods for CHD focus on the behavior of individual biomarkers regardless of their relevance. These limitations have led to attempting novel approaches to multi-dimensionally investigate CHD and identify safe and efficacious therapies for preventing CHD. Recently, the benefit of Chinese medicine (CM) in CHD has been proven by increasing clinical evidence. More importantly, linking CM theory with modern biomedicine may lead to new scientific discoveries. According to CM theory, all treatments for patients should be based on patients' syndromes. A recent epidemiological investigation has demonstrated that blood stasis syndrome (BSS) is the major syndrome type of CHD. BSS is a type of complex pathophysiological state characterized by decreased or impeded blood flow. Common clinical features of BSS include a darkish complexion, scaly dry skin, and cyanosis of the lips and nails, a purple or dark tongue with purple spots, a thready and hesitant pulse, and stabbing or pricking pain fixed in location accompanied by tenderness, mass formation and ecchymosis or petechiae. The severity of BSS is significantly correlated with the complexity of coronary lesions and the degree of stenosis, and is an important factor affecting the occurrence of restenosis after percutaneous coronary intervention. The mechanisms of BSS of CHD patients should be investigated from a modern medicine perspective. Although many studies have attempted to explore the biomedical mechanisms of BSS of CHD, from hemorheological disorders to inflammation and immune responses, the global picture of BSS of CHD is still unclear. In this article, the current status of studies investigating the biomedical mechanisms of BSS of CHD and future perspectives are discussed.
整个医学界都在尝试在冠心病(CHD)患者生命的更早阶段开始预防性治疗。然而,此类干预措施的主要局限性在于耐药性和不良反应。此外,传统的冠心病生物标志物发现方法侧重于单个生物标志物的行为,而不考虑它们之间的相关性。这些局限性促使人们尝试采用新方法从多维度研究冠心病,并确定预防冠心病的安全有效的治疗方法。最近,越来越多的临床证据证明了中医(CM)在冠心病治疗中的益处。更重要的是,将中医理论与现代生物医学相结合可能会带来新的科学发现。根据中医理论,对患者的所有治疗都应基于患者的证候。最近的一项流行病学调查表明,血瘀证(BSS)是冠心病的主要证候类型。BSS是一种复杂的病理生理状态,其特征是血流减少或受阻。BSS的常见临床特征包括面色晦暗、皮肤干燥脱屑、口唇和指甲青紫、舌质紫暗或有瘀斑、脉细涩、固定部位刺痛伴压痛、肿块形成以及瘀斑或瘀点。BSS的严重程度与冠状动脉病变的复杂性和狭窄程度显著相关,是影响经皮冠状动脉介入治疗后再狭窄发生的重要因素。应从现代医学角度研究冠心病患者BSS的机制。尽管许多研究试图探索冠心病BSS的生物医学机制,从血液流变学紊乱到炎症和免疫反应,但冠心病BSS的整体情况仍不清楚。本文讨论了冠心病BSS生物医学机制的研究现状和未来展望。