颈动脉粥样硬化斑块合并高脂血症的中医认识与治疗策略OA

The prevalence of carotid atherosclerotic plaque and hyperlipidemia in China is high and continues to rise.Specifically,the incidence of hyperlipidemia among adults is 40.4%,and nearly one-third of asymptomatic adult patients present with carotid plaque;the co-occurrence rate of hyperlipidemia with carotid atherosclerotic plaque is as high as 48%-62%.Although modern medicine has made progress in lipid lowering,plaque stabilization,and surgical intervention,how to leverage the advantages of multi-target comprehensive intervention and simultaneously inhibit the core inflammatory pathways that drive disease progression to reduce high residual risk while improving lipid metabolism through single-target approaches,has become a pressing clinical challenge.In TCM,hyperlipidemia with carotid atherosclerotic plaque falls under the category of vessel impediment and is related to conditions such as"headache""dizziness",and"stroke".Its etiology includes dietary irregularities,emotional disturbances,and constitutional insufficiency.The pathogenesis involves the Qi depression pattern in the early stage,the phlegm-turbidity pattern in the progressive stage,and the dampness-heat pattern in the mid-to-late stage.Regarding treatment strategies,Chaihu-based formulas such as Dachaihu Decoction,Xiaochaihu Decoction,Xiaoyao Powder,Chaihu Shugan Powder,and Chaihu Longgu Muli Decoction are recommended for the Qi depression pattern;Wendan Decoction,Chaichen Zexie Decoction,and Banxia Baizhu Tianma Decoction are suggested for the phlegm-turbidity pattern;Gegen Qinlian Decoction is advised for the dampness-heat pattern.Clinical practice should adhere to the principles of"formula-syndrome correspondence"and"pathogenesis combined with pathology,medicinal nature combined with pharmacology",with flexible selection and combination of formulas to enhance therapeutic efficacy.Its mechanism of action may be associated with regulating lipid metabolism,inhibiting inflammatory responses,combating oxidative stress,protecting vascular endothelium,and stabilizing plaque structure.