摘要
难治性心绞痛是用于描述不适合进行血运重建的患者,尽管使用了最佳的药物治疗,但同时有心绞痛和缺血的客观依据的术语。难治性心绞痛的范围包括阻塞性冠状动脉疾病、心外膜冠状动脉未闭的微血管疾病、肥厚性心肌病和左室舒张功能障碍等。部分难治性心绞痛患者在采用西医西药治疗时依旧不能达到很好的缓解疼痛效果。还有部分患者是经过西医西药治疗手段后疼痛缓解,但会有胸闷心悸症状残留,此时应用中医药疗法来结合治疗,会取得更好效果,改善患者预后。难治性心绞痛的心绞痛症状超过3个月,反复发作,严重影响患者的生活质量,增加患者的经济负担,随着人口老龄化和冠状动脉疾病患者生存率的提高,难治性心绞痛患者的数量仍在不断增加,因此难治性心绞痛的治疗是当代心血管医学面临的重大难题。通过梳理难治性心绞痛国内外相关文献,综述了难治性心绞痛的治疗目标和策略,包括西医药物疗法,西医非药物疗法以及中医药疗法,并对未来治疗策略提出了展望。
Refractory angina pectoris is a term used to describe patients who are not suitable for revascularization.Although the best drug treatment is used,there is also objective basis for angina pectoris and ischemia.The scope of refractory angina pectoris includes obstructive coronary artery disease,microvascular disease of epicardial coronary artery patent,hypertrophic cardiomyopathy and left ventricular diastolic dysfunction.Some patients with refractory angina pectoris still can not achieve good pain relief effect when treated with western medicine.Some patients have pain relief after treatment with western medicine,but there will be residual symptoms of chest tightness and palpitation.At this time,combined treatment with traditional Chinese medicine will achieve better results and improve the prognosis of patients.The angina pectoris symptoms of refractory angina pectoris are more than three months and recur,which seriously affects the quality of life of patients and increases the economic burden of patients.With the aging of the population and the improvement of the survival rate of patients with coronary artery disease,the number of patients with refractory angina pectoris is still increasing.Therefore,the treatment of refractory angina pectoris is a major problem facing contemporary cardiovascular medicine.This article reviewed the treatment objectives and strategies of refractory angina pectoris,including western medicine,western medicine non-drug therapy and traditional Chinese medicine therapy,by combing the relevant literature at home and abroad,and put forward prospects for future treatment strategies.
作者
王天罡
王凤荣
WANG Tiangang;WANG Fengrong(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《中华中医药学刊》
CAS
北大核心
2023年第10期88-92,共5页
Chinese Archives of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81874415)
国家中医药管理局重大疑难疾病中西医临床协作项目(国中医药办医政发[2018]3号)
辽宁省中医药临床学(专)科能力建设项目(LNZYXZK201908)。
关键词
难治性心绞痛
中西医结合
治疗策略
refractory angina
integrated traditional Chinese and western medicine
treatment strategy
