络病研究推动微血管病变防治,创新成果赋能慢病管理

2022-08-09 MedSci原创 MedSci原创

络病理论作为新时期中医药传承与创新的典型代表之一,走出了一条理论、临床、科研、产业、教学相互促进,共同发展的道路,取得了可喜的成果,为推动中医药科技创新体系建设和中医药产业发展提供了有益的借鉴。

      为推动河北省心脑血管等慢性病防治水平的整体发展。8月6日,由河北省中西医结合学会心血管疾病专业委员会、河北省中医药学会心脑血管病专业委员会、河北省中西医结合学会络病专委会和河北省急救医学会胸痛专业委员会共同主办的第四届河北省中西医结合心血管病大会暨河北省络病年会在石家庄顺利召开。中国工程院院士、络病研究与创新中药国家重点实验室吴以岭教授受邀参会并发表主旨演讲。国医大师、河北省中医药学会络病专委会主委、河北省中医院李佃贵教授,中华中医药学会络病分会主任委员、河北医科大学附属以岭医院贾振华教授共同担任大会主席,省内多位专家共同参与报告与讨论,共享应用中医络病理论防治慢性疾病的重大创新成果。

 

大会现场

      在致辞中,李佃贵国医大师指出,脉络学说围绕微血管病变的国际难题,分别从理论、机制、临床三个方面开展研究,取得了重大突破,希望络病研究继续发挥中医药防病治病的独特优势,为全面建设健康中国作出新的贡献,更好的服务于全人类健康。河北省中西医学结合学会戴明启秘书长表示,络病理论作为新时期中医药传承与创新的典型代表之一,走出了一条理论、临床、科研、产业、教学相互促进,共同发展的道路,取得了可喜的成果,为推动中医药科技创新体系建设和中医药产业发展提供了有益的借鉴。

 

吴以岭院士:络病研究与转化为中医药传承与创新发展做出示范

       吴以岭院士在题为“络病研究与成果转化”的专题报告中指出,络病研究是历史留给当代的重大课题。研究团队主要从络病理论创新发展研究、临床重大疾病防治研究、有效组方创新中药技术研究3个方面开展系统研究并推进成果转化。

      第一,系统构建络病理论体系,根据证候类型、辨证方法、治疗原则等开展难治性疾病中医病机、干预策略、有效组方的系统研究。如应用肺络理论指导SARS、流感证治规律研究,研发的连花清瘟已成为治疗呼吸系统传染病的代表中成药,为世界疫情防控发挥积极作用。

      第二,首次系统构建脉络学说指导微血管病变防治属重大理论原创,提出脉络学说的核心内容-营卫理论。建立了临床辨证、诊断标准、用药规律的系统理论,用来指导临床,特别是为心脑血管病、糖尿病及其血管并发症的防治开辟了新的治疗途径。国家973计划专家组评价:“脉络学说营卫理论形成了指导微血管病变性重大疾病防治的新理论,属于中医药学术研究的原创成果”。“中医脉络学说构建及指导微血管病变防治”项目获2019年度国家科技进步一等奖。

       第三,系统构建气络学说。气络学说精气神理论指导八子补肾胶囊抗衰老研究,提出精是生命起源,气是生命动力,神是生命体现。

      吴以岭院士总结指出,络病理论体系构建及应用形成的“理论+临床+新药+实验+循证”一体化的中医学术创新与转化新模式,推动中医传统理论创新与现代科学技术相结合,产生重大原创成果,为中医药传承与创新发展做出了示范。

 

吕佩源教授:ASA-T方案,缺血性卒中治疗方案的理想选择

      河北省人民医院吕佩源教授作了题为“神经血管单元与通络治疗”的报告。他指出,脑梗死导致的脑损伤是一个复杂的病理生理过程,缺血性卒中治疗中要大血管、小血管并重。络病理论从整体出发,发挥多途径、多环节、多靶点病因治疗作用,兼顾了大血管与小血管。在络病理论指导下研发的通心络胶囊经多项研究证实,能够保护微血管结构,促进血管新生,增加缺血区微血管密度,改善血流灌注,减少脑梗死体积。通心络胶囊干预颈动脉斑块的临床循证研究表明,通心络延缓颈动脉内中膜厚度进展,延缓斑块面积进展,降低一年卒中复发率33%,提高患者生活质量

      吕佩源教授倡导在临床中使用ASA-T的方案,即在临床常用的抗血小板药+他汀+降压药的基础上加用通心络胶囊,是缺血性卒中治疗方案的理想选择之一。

 

谢瑞芹教授:重视室性心律失常的综合管理,正确应用抗心律失常药物

      河北医科大学第二医院谢瑞芹教授结合室性心律失常管理策略及用药原则进行了详细的阐述。她指出,对室性心律失常的处理,改善血流动力学是首要目标,同时要重视基础疾病和诱发因素的处理,另外要正确选择和应用抗心律失常的药物,应当根据心脏病的类型及心功能选药。《2020室性心律失常中国专家共识》将参松养心胶囊治疗室早列为IIa类推荐,A级证据。谢瑞芹教授强调,对于室早合并窦缓的心律失常患者,参松养心胶囊在降低室早次数的同时,不仅不降低心率,反而能够提高窦性心律,是治疗室性心律失常安全有效的药物。

 

丁超教授:多靶点干预,通络中药为心衰治疗带来曙光

      白求恩国际和平医院丁超教授在题为“心力衰竭药物治疗现状和未来”的报告中介绍,ARN1类、SGLT-2抑制剂、sGCC刺激剂维力西呱片药物的问世,给心衰治疗、改善预后带来新的希望,金三角由此升级为新四联疗法。然而不论是金三角还是新四联,都只是从某一个领域来治疗心衰,缺少多机制多靶点干预心衰的创新药物。从上述角度出发,中药为心衰治疗带来了新曙光。 

      一项发表于JACC杂志的临床研究表明,代表性通络中药芪苈强心胶囊可显著降低NT-proBNP水平,降低心血管复合终点事件率,提高6分钟步行距离,改善美国纽约心脏病分级,增加左室射血分数,提高患者生存质量。基于此,芪苈强心胶囊成为《中国心力衰竭诊断和治疗指南》2018版和《中国扩张型心肌病诊断和治疗指南》2018版中唯一推荐的中成药。

 

陈树春教授:中西结合改善血糖波动、防治糖尿病微血管并发症

      糖尿病治疗过程中,血糖波动与糖尿病并发症关系密切,平稳降糖、良好控制血糖波动亦不容忽视。河北省人民医院陈树春教授在“血糖波动异常与津力达干预研究”报告中介绍了多项临床研究,其中一项随机、双盲、平行对照、多中心临床研究证实,在二甲双胍稳定剂治疗的基础上,联合使用津力达颗粒可使2型糖尿病患者血糖水平得到更好的控制,且耐受性良好。陈数春教授表示,《2020版中国2型糖尿病防治指南》(以下简称:CDS指南)再次推荐糖尿病气阴两虚症,在二甲双胍等降糖药的基础上,可加服津力达颗粒,进一步证明了津力达颗粒调节糖脂代谢,保护胰岛β细胞,改善胰岛素抵抗,改善血糖波动,防治微血管并发症的有效性。目前津力达颗粒是CDS指南唯一推荐的中成药,相信通过西药降糖,中药调糖,中西医结合一定可以改善血糖波动进而防治糖尿病微血管并发症。

      据悉,河北省中西医结合心血管病大会暨络病年会已成功举办多届,大会通过深入交流探讨通络药物在冠心病、心律失常、慢性心衰、糖尿病等疾病防治中发挥的确切疗效及重大研究成果。为河北省广大医务工作者提供学术沟通与科研创新交流的平台,为促进河北省心血管领域中西医协作结合,提升慢病防治水平作出了积极贡献。

 

 

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    2022-11-20 wgx306
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    2022-08-11 mgqwxj
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    2022-08-10 ms3000001100640413

    络病学说

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