Zhang Jin-Sheng, Zhang Bao-Xia, Hui Xiao-Shan, Wang Jie
Third Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450046, China.
First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450046, China.
Zhongguo Zhong Yao Za Zhi. 2024 Sep;49(17):4812-4817. doi: 10.19540/j.cnki.cjcmm.20240419.501.
Thrombolysis/thrombectomy treatment is an emergency medical intervention for patients with acute ischemic stroke. Its core purpose is to reduce brain tissue damage and improve patient prognosis by restoring blood flow to the brain, which is significantly advantageous in timely restoring blood flow to the brain and reducing post-stroke sequelae. However, research shows that even with successful thrombolysis/thrombectomy treatment, some patients may still experience re-occlusion of the target vessel, leading to secondary damage and worsening of the condition. This study retrospectively examined clinical, experimental, and theoretical aspects of thrombolysis/thrombectomy in both traditional Chinese medicine(TCM) and western medicine, and analyzed the characteristics of blood-activating and stasis-resolving therapy in different stages of thrombolysis/thrombectomy and the synergistic mechanism of different types of blood-activating and stasis-resolving drugs with thrombolysis/thrombectomy in combination of previous clinical studies by the research team. Furthermore, the "vessel hyperactivity" characteristics embodied by Yang vessel irritability and Yin vessel stagnation was explained, revealing the TCM mechanism by which blood-activating TCM drugs reduce the incidence of vessel re-occlusion after thrombolysis/thrombectomy through multiple targets and pathways from a theoretical perspective. It also explored how blood-activating and stasis-resolving drugs promoted the excretion of pathological products such as phlegm, fluid, stasis, and toxins from damaged brain tissue, enhanced self-repair of damaged brain tissue, and accelerated the reconstruction of the brain by facilitating the transformation of Qi, blood, and essence within the body. This study aims to deeply elucidate the TCM theoretical mechanism of blood-activating and stasis-resolving therapy in reducing the occurrence of "cerebral infarction and vascular re-occlusion" during thrombolysis/thrombectomy, which holds significant theoretical and practical significance.
溶栓/取栓治疗是急性缺血性脑卒中患者的一种紧急医疗干预措施。其核心目的是通过恢复脑血流来减少脑组织损伤并改善患者预后,这在及时恢复脑血流和减少脑卒中后遗症方面具有显著优势。然而,研究表明,即使溶栓/取栓治疗成功,一些患者仍可能出现靶血管再闭塞,导致继发性损伤和病情恶化。本研究回顾性考察了中西医溶栓/取栓的临床、实验及理论方面,并结合研究团队既往临床研究,分析了溶栓/取栓不同阶段活血化瘀疗法的特点以及不同类型活血化瘀药物与溶栓/取栓联合应用的协同机制。此外,阐释了阳脉躁急、阴脉郁滞所体现的“血管多动”特征,从理论层面揭示了活血化瘀中药通过多靶点、多途径降低溶栓/取栓后血管再闭塞发生率的中医机制。还探讨了活血化瘀药物如何促进受损脑组织中痰、水、瘀、毒等病理产物的排出,增强受损脑组织的自我修复能力,并通过促进体内气、血、精的转化加速脑重构。本研究旨在深入阐明活血化瘀疗法在降低溶栓/取栓过程中“脑梗与血管再闭塞”发生的中医理论机制,具有重要的理论和实践意义。