| 引用本文:刘深1，2，3，张兆旭4，孔令博1，2，高颖1，2.从脉络学说构建脑梗死血管再通后无复流的理法方药体系[J].世界中医药,2023,(13):. |
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| 从脉络学说构建脑梗死血管再通后无复流的理法方药体系 |
| A Principle-method-prescription-medicine System for No Reflow after Vascular Recanalization in Ischemic Stroke Based on the Theory of Vessels and Collaterals in Traditional Chinese Medicine |
| 投稿时间：2023-05-10 |
| DOI：10.3969/j.issn.1673-7202.2023.13.008 |
| 中文关键词: 脑梗死 无复流 脉络学说 孙络 微血管 气虚络阻 益气通络 理法方药 |
| English Keywords:Stroke No reflow Theory of vessels and collaterals in TCM Tertiary collateral vessels Microvessel Qi deficiency and collateral obstruction Tonifying Qi and dredging collaterals Principle-method-prescription-medicine system |
| 基金项目:国家自然科学基金项目（82004323）；中国博士后科学基金项目（2022T150070） |
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| 中文摘要: |
| 近年来，静脉溶栓及血管内治疗为急性脑梗死血管再通带来了突破性进展，然而血管再通并不等于脑组织发生再灌注。据Stroke杂志报道血管再通后的脑梗死患者中约1/4存在组织再灌注障碍，即“无复流”现象，并指出该现象是脑梗死的潜在治疗靶点。目前西医尚缺乏针对脑梗死血管再通后无复流防治的有效方法，无复流已成为制约脑梗死临床疗效进一步提高的瓶颈之一。现基于中医脉络学说，从“孙络-微血管”相关性切入，针对脑梗死血管再通后无复流，提出其病机为气虚络阻，进而确定其治法为益气通络，主要代表性方药为补阳还五汤、通心络胶囊等，建立了其完整的理、法、方、药体系。这将为脑梗死血管再通后无复流的防治提供“中医方案”，对该类病变的防治具有重要临床指导价值。 |
| English Summary: |
| In recent years，intravenous thrombolysis and intravascular therapy have brought major breakthroughs in the treatment of acute ischemic stroke(IS).However，vascular recanalization does not equate with successful tissue reperfusion.The authoritative journal Stroke has reported that 1/4 patients with successful vascular recanalization in IS have impaired tissue reperfusion，termed as no-reflow phenomenon，which is a potential therapeutic target for stroke.Of note，the lack of effective therapeutic strategies in Western medicine for no reflow after vascular recanalization has become one of the major bottlenecks constraining further improvement of clinical efficacy for IS.According to the theory of vessels and collaterals in traditional Chinese medicine(TCM)，we established the principle-method-prescription-medicine system for no reflow after vascular recanalization in IS.Specifically，on the basis of the major pathogenesis of qi deficiency and collateral obstruction，the therapeutic principle is tonifying qi and unblocking collaterals，which can be achieved by the representative prescriptions such as Buyang Huanwu Decoction and Tongxinluo Capsules.The system provides a novel TCM strategy for the prevention and treatment of no reflow after vascular recanalization in IS，which is of great significance in the clinical practice. |
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