从"郁结-肉腐-脓溃"探讨动脉粥样硬化斑块的病机演变及分期辨治思路OA

Atherosclerotic plaques arise within the vessels,yet their morphological evolution parallels that of carbuncles and abscesses.Drawing on the pathomechanism progression of carbuncles and abscesses,this paper pro-poses a dynamic pathogenesis model of"constraint-putrefaction-ulceration"for atherosclerotic plaques.The formation of atherosclerotic plaque begins with phlegm-turbidity obstruction and qi-blood stagnation(constraint stage);pro-longed constraint transforms into heat that scorches the vessels and forms plaques(putrefaction stage);ultimately,toxin invades inward and ruptures the vessels,injuring the heart(ulceration stage).Accordingly,staged differentia-tion and treatments are proposed.During the constraint stage,the focus is venting constraint and unblocking collaterals,clearing and relieving constraint-heat,for which Yue Jyu Pills(越鞠丸)and Danzhi Xiaoyao Powder(丹栀逍遥散)with modifications can be used.During the putrefaction stage,the method is clearing heat and dispelling abscesses,resolving stasis and dissipating knot,with modified Wuwei Xiaodu Beverage(五味消毒饮)and Xuefu Zhuyu Decoction(血府逐瘀汤).During the ulceration stage,it is suggested to expell toxin and stasis,benefit qi and nourish yin using modified Gualou Xiebai Banxia Decoction(瓜蒌薤白半夏汤)and Sheng Mai Powder(生脉散).This framework offers new perspectives for the differentiation and treatment of atherosclerotic plaques in traditional Chinese medicine.