Research advances in mechanism of lipid infiltration of coronary heart disease and simultaneous treatment of phlegm and blood stasis based on phlegm-blood stasis correlation theory / 中国中药杂志

Atherosclerosis(AS) is the key pathological basis of coronary heart disease(CHD), and lipid infiltration is a classical theory to explain the pathological mechanism of AS. The theory highlights that the occurrence and development of AS are closely related to abnormal lipid metabolism, with the essence of the pathological reaction caused by the invasion of lipids into arterial intima from plasma. Phlegm and blood stasis are physiologically homologous and subject to pathological co-existence. Phlegm-blood stasis correlation is the basic theory to explain the pathogenesis characteristics of CHD and has important guiding significance for revealing the mecha-nism of lipid infiltration of CHD. Phlegm is the pathological product of abnormal metabolism of Qi, blood, and body fluid, and a gene-ral summary of a series of abnormally expressed lipid substances. Among them, turbid phlegm invades the heart vessels, gradually accumulates, and condenses to achieve the qualitative change from "invisible pathogen" to "tangible pathogen", which corresponds to the mechanism of lipid migration and deposition in the intima of blood vessels, and is the starting factor of the disease. Blood stasis is the continuous development of phlegm, and it is a result of pathological states such as decreased blood fluidity, increased blood coagulation, and abnormal rheology. The fact that blood stasis caused by phlegm accords with the pathological process of "lipid abnormality-circulatory disturbance" and is the central link of the disease. Phlegm and blood stasis aggravate each other and lead to indissoluble cementation. The phlegm-blood stasis combination serves as common pathogen to trigger the disease, which is the inevitable outcome of the disease. Based on the phlegm-blood stasis correlation theory, the simultaneous treatment of phlegm and blood stasis is established. It is found that this therapy can simultaneously regulate blood lipid, reduce blood viscosity, and improve blood circulation, which can fundamentally cut off the biological material basis of the reciprocal transformation between phlegm and blood stasis, thus exerting a significant curative effect.

Professor ZHU Liang-Chun's Academic Experience in Treating Unstable Carotid Plaques Based on Theory of Phlegm and Blood Stasis / 中国实验方剂学杂志

Unstable carotid plaque is an independent risk factor for serious cerebrovascular events including stroke， making it considered as an intervention target for the primary and secondary prevention of cardiovascular diseases. Professor ZHU Liang-chun is a national distinguished master of traditional Chinese medicine （TCM） who is adept at treating difficult miscellaneous diseases with insects. He believes that the unstable carotid plaque falls into the category of “vessel impediment” in TCM according to the disease location and characteristics. The core pathogenesis of unstable carotid plaque lies in asthenia in origin and sthenia in superficiality， with spleen-kidney deficiency as the root cause and combined phlegm and blood stasis as the manifestations. He has pointed out that both phlegm and blood stasis should be emphasized in the treatment. In addition to the commonly used herbs for strengthening spleen， removing stasis， and resolving phlegm， the insects with strong effects of searching wind and dredging collateral can be added as appropriate to strengthen the power of removing stasis and dredging collateral. According to the pathogenesis of this disease， he develops the Qutan Tongluo Wenbanfang， which has been confirmed by modern pharmacological research to be efficient in resisting inflammation， regulating endothelial cell functions， lowering lipids， adjusting metabolism， and improving blood circulation， thereby ameliorating the related biological processes of atherosclerosis， suppressing atherosclerosis， and stabilizing plaques. As proved by clinical practice， Qutan Tongluo Wenbanfang helps to reduce blood lipids and reduce the area of unstable carotid plaque， indicating that it deserves clinical promotion.