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中医药治疗动脉粥样硬化:问题与困惑。

Treatment of atherosclerosis by traditional Chinese medicine: Questions and quandaries.

机构信息

Department of Pharmacology, College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, China; Department of Molecular Pathology, Faculty of Medicine, Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan.

Department of Molecular Pathology, Faculty of Medicine, Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan.

出版信息

Atherosclerosis. 2018 Oct;277:136-144. doi: 10.1016/j.atherosclerosis.2018.08.039. Epub 2018 Aug 30.

Abstract

Atherosclerosis and its complications, such as myocardial infarction and stroke, are the major causes of morbidity and mortality, and development of effective therapies for both prevention and treatment of this disease is critically important. Currently, there are many drugs available for atherosclerotic disease, but the lipid-lowering drugs statins are still the first-choice for treatment of hypercholesterolemia, a major risk factor for atherosclerosis. On the other hand, traditional Chinese medicines, mainly Chinese herbal medicines (CHM), have been widely used in China and in other Asian countries for the treatment of atherosclerotic diseases. Although many CHMs have been reported to be effective for treating atherosclerotic diseases for more than two thousand years, there are still many difficulties for their use, such as lack of scientific evidence assessed by rigorous clinical trials, complicated components and unclear pharmacological mechanisms, which often hamper the widespread use of CHMs in Western countries. Due to these concerns, CHMs are usually considered as complimentary or alternative treatment for atherosclerotic diseases. In this review, we provide an overview of the pathophysiology of atherosclerosis viewed by Western and traditional Chinese medicine, summarize pros and cons on the efficacy of CHMs for atherosclerosis and discuss what is necessary for CHM use to spread to Western societies.

摘要

动脉粥样硬化及其并发症,如心肌梗死和中风,是发病率和死亡率的主要原因,因此开发有效的预防和治疗这种疾病的疗法至关重要。目前有许多药物可用于治疗动脉粥样硬化疾病,但降脂药物他汀类药物仍然是治疗动脉粥样硬化主要危险因素高胆固醇血症的首选药物。另一方面,中药主要是中草药(CHM),在中国和其他亚洲国家已被广泛用于治疗动脉粥样硬化疾病。尽管许多 CHM 被报道在治疗动脉粥样硬化疾病方面已有两千多年的历史,但它们的使用仍然存在许多困难,例如缺乏经过严格临床试验评估的科学证据、复杂的成分和不明确的药理机制,这常常阻碍了 CHM 在西方国家的广泛应用。由于这些担忧,CHM 通常被认为是动脉粥样硬化疾病的辅助或替代治疗方法。在这篇综述中,我们提供了一个西医和中医对动脉粥样硬化病理生理学的概述,总结了 CHM 治疗动脉粥样硬化的优缺点,并讨论了 CHM 传播到西方社会所需的条件。

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