作者：周曼丽，简维雄

单位：

1.410208湖南省长沙市，湖南中医药大学中医学院 2.410208湖南省长沙市，湖南中医药大学国家重点学科中医诊断学实验室 湖南省重点实验室 通信作者：简维雄，E-mail：daxiong20001977@163.com

Units：

1.College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, China 2.National Key Discipline of TCM Diagnositics/Hunan Provincial Key Laboratory, Hunan University of Chinese Medicine,Changsha 410208, China Corresponding author: JIAN Weixiong, E-mail: daxiong20001977@163.com

关键词：

冠心病; 血瘀; 中医时空医学; 依时性; 依空性; 自噬;

Keywords：

Coronary disease; Blood stasis; Spatiotemporal medicine of traditional Chinese medicine; Time dependent; Space-dependent; Autophagy

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.322

Funds：

国家自然科学基金资助项目（81973753）；湖南省自 然科学基金资助项目（2022JJ30433）；湖南省研究生科研创新项目 （CX20220781）

摘要：

冠心病血瘀证的发生发展具有依时性、依空性，其依时性体现在以正气亏虚为始，痰浊内聚、营血瘀滞为时间推移之产物，分阶段、渐次形成心血瘀阻证；依空性指在痰瘀互结等病理产物的影响下促使冠心病血瘀证不断发生病位的传变，从而导致血瘀证不同亚型的衍生。在缺乏对血瘀证起始、转归整个过程的研究时，这种孤立存在、缺乏联系的病理学现象并不能诠释冠心病血瘀证形成过程中病机变化的特点。本文以中医时空医学理论为指导，详细阐述了冠心病血瘀证的证型演变过程，并从现代基础医学的角度出发，以自噬为切入点探讨了冠心病血瘀证形成过程中不同阶段的病理演变机制，从整体上把握冠心病血瘀证证候的生物学基础，以期为中医冠心病血瘀证的精准诊疗开拓思路。

Abstract：

【Abstract】 The occurrence and development of coronary heart disease with blood stasis syndrome are time-dependent and space-dependent. The time-dependent syndrome is reflected in the fact that it starts with the deficiency of Qi, the cohesion of phlegm and blood stasis are the products as time goes by, and gradually forms blood stasis syndrome. Space-dependent syndrome refers to the influence of pathological products such as phlegm-stasis cementation to promote the continuous transmission of the disease site of coronary heart disease with blood stasis syndrome, which leads to the derivation of different subtypes of blood stasis syndrome. In the absence of research on the whole process of initiation and outcome of blood stasis syndrome, this isolated pathological phenomenon would not explain the characteristics of pathogenesis changes in the formation of coronary heart disease with blood stasis syndrome. In this paper, the evolution process of coronary heart disease with blood stasis syndrome is described in detail under the guidance of the theory of spatiotemporal medicine of traditional Chinese medicine. From the perspective of preclinical medicine, autophagy was taken as the breakthrough point to discuss the pathological evolution mechanism of blood stasis syndrome in different stages of the formation process, and grasp the biological basis of blood stasis syndrome on the whole, in order to explore the idea of accurate diagnosis and treatment of coronary heart disease with blood stasis syndrome.

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