开放期刊系统

绝经后女性冠心病的中西医诊疗进展

秦 王蓓, 孟 庆海, 童 黄锦, 黄 丹, 卞 慧敏, 吴溧 兴*

摘要

女性确诊冠心病的年龄通常较晚,特别是进入绝经期之后,随着雌激素水平下降患冠心病的风险会显著上升。中
医在治疗绝经后女性冠心病方面提供了多种方法,包括中药治疗、针灸干预等,均有显著的临床效果,能够有效改善患者
的心血管健康和提高升高质量。与此同时,在西医学领域,雌激素替代疗法是目前较为常用的治疗方法之一。然而目前对
于绝经后女性冠心病的临床认识仍存在一定的局限性,需要进一步深入研究和探索。本文旨在为绝经后女性中医及西医治
疗冠心病的临床研究提供新思路。

关键词

绝经后;冠心病;动脉粥样硬化;雌激素

全文:

PDF

参考

[1]Khamis RY, Ammari T, Mikhail GW. Gender differences

in coronary heart disease.[J].Heart. 2016 Jul 15;102(14):1142-9.

[2]Markku A. Oxidized lipoprotein lipids and atherosclerosis.

[J].Free radical research,2017,51(4).

[3]Silverstein-Metzler MG, Justice JN, Appt SE, Groban

L, Kitzman DW, Carr JJ, Register TC, Shively CA. Long-term

sertraline treatment and depression effects on carotid artery

atherosclerosis in premenopausal female primates.[J]. Menopause.

2017 Oct;24(10):1175-1184.

[4]El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN,

Johnson AE, Langer RD, Limacher MC, Manson JE, Stefanick

ML, Allison MA; American Heart Association Prevention Science

Committee of the Council on Epidemiology and Prevention;

and Council on Cardiovascular and Stroke Nursing. Menopause

Transition and Cardiovascular Disease Risk: Implications

for Timing of Early Prevention: A Scientific Statement From

the American Heart Association.[J]. Circulation. 2020 Dec

22;142(25):506-532.

[5]Hashmi S, Shah PW, Aherrahrou Z, Aikawa E, Aherrahrou

R. Beyond the Basics: Unraveling the Complexity of Coronary

Artery Calcification.[J]. Cells. 2023 Dec 12;12(24):2822.

[6]Brahmbhatt Y, Gupta M, Hamrahian S. Hypertension in

Premenopausal and Postmenopausal Women.[J]. Curr Hypertens

Rep. 2019 Aug 26;21(10):74.

[7]Coutinho T, Yam Y, Chow BJW, Dwivedi G, Inácio J.

Sex Differences in Associations of Arterial Compliance With

Coronary Artery Plaque and Calcification Burden. [J]. J Am Heart

Assoc,2017,19;6(8):006079.

[8]Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S,

Rumberger J, Badimon JJ, Stefanadis C, Moreno P, Pasterkamp

G, Fayad Z, Stone PH, Waxman S, Raggi P, Madjid M, Zarrabi

A, Burke A, Yuan C, Fitzgerald PJ, Siscovick DS, de Korte CL,

Aikawa M, Juhani Airaksinen KE, Assmann G, Becker CR,

Chesebro JH, Farb A, Galis ZS, Jackson C, Jang IK, Koenig W,

Lodder RA, March K, Demirovic J, Navab M, Priori SG, Rekhter

MD, Bahr R, Grundy SM, Mehran R, Colombo A, Boerwinkle E,

Ballantyne C, Insull W Jr, Schwartz RS, Vogel R, Serruys PW,

Hansson GK, Faxon DP, Kaul S, Drexler H, Greenland P, Muller

JE, Virmani R, Ridker PM, Zipes DP, Shah PK, Willerson JT.

From vulnerable plaque to vulnerable patient: a call for new

definitions and risk assessment strategies: Part I.[J]. Circulati

on,2003,108(14):1664-72.

[9]Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S,

Rumberger J, Badimon JJ, Stefanadis C, Moreno P, Pasterkamp

G, Fayad Z, Stone PH, Waxman S, Raggi P, Madjid M, Zarrabi

A, Burke A, Yuan C, Fitzgerald PJ, Siscovick DS, de Korte CL,

Aikawa M, Airaksinen KE, Assmann G, Becker CR, Chesebro

JH, Farb A, Galis ZS, Jackson C, Jang IK, Koenig W, Lodder

RA, March K, Demirovic J, Navab M, Priori SG, Rekhter MD,

Bahr R, Grundy SM, Mehran R, Colombo A, Boerwinkle E,

Ballantyne C, Insull W Jr, Schwartz RS, Vogel R, Serruys PW,

Hansson GK, Faxon DP, Kaul S, Drexler H, Greenland P, Muller

JE, Virmani R, Ridker PM, Zipes DP, Shah PK, Willerson JT.

From vulnerable plaque to vulnerable patient: a call for new

definitions and risk assessment strategies: Part II.[J]. Circulati

on,2003,108(15):1772-8.

[10]van Dijk GM, Kavousi M, Troup J, Franco OH. Health

issues for menopausal women: the top 11 conditions have common

solutions.[J].Maturitas,2015,80(1):24-30.

[11]R S K E ,Brooke A ,M T B , et al. Menopause Transition

and Cardiovascular Disease Risk: Implications for Timing of Early

Prevention: A Scientific Statement From the American Heart

Association.[J]. Circulation,2020,142(25)

[12] 陈美颖 , 陈木欣 , 王明欣等 . 重症急性胰腺炎患

者并发急性肾损伤危险因素的 Mete 分析 [J]. 中国全科医

学 ,2022,25(30):3834-3842。

[13] 王帅 , 赵红丽 , 李潞等 . 绝经期后女性同型半胱氨酸。

高敏 C 反应蛋白水平与冠状动脉病变及传统危险因素的关

系 [J]. 中国实验方剂学杂志 ,2013,19(6):301-304.

[14]Kiani AN, Vogel Claussen J, Arbab Zadeh A, et al.

Semiquantified noncalcified coronary plaque in systemic lupus

erythematosus[J]. J Rheumatol, 2012, 39(12): 2286- 2293.

[15]Vierboom M, Breedveld E, t Hart BA. New drug

discovery strategies for rheumatoid arthritis: A niche for nonhuman

primate models to address systemic complications in inflammatory

arthritis[J]. Expert Opin Drug Disc,2012,7(4):315-325.

[16]Mineo C. Inhibition of nitric oxide and antiphospholipid

antibody-mediated thrombosis[J]. Curr Rheumatol Rep, 2013,

15(5): 324.

[17]Brown MC, Best KE, Pearce MS, Waugh J, Robson SC,

Bell R. Cardiovascular disease risk in women with pre-eclampsia:

systematic review and meta-analysis.[J].Eur J Epidemiol. 2013

Jan;28(1):1-19.

[18]Zhu D, Chung HF, Dobson AJ, Pandeya N, Brunner EJ,

Kuh D, Greenwood DC, Hardy R, Cade JE, Giles GG, Bruinsma

F, Demakakos P, Simonsen MK, Sandin S, Weiderpass E, Mishra

GD. Type of menopause, age of menopause and variations in

the risk of incident cardiovascular disease: pooled analysis of

individual data from 10 international studies. Hum Reprod. 2020

Aug 1;35(8):1933-1943.

[19] 童黄锦 , 杨月东 , 邓良英 , 陈子雯 , 丁峰 , 卞慧敏 ,

沈建平 , 吴溧兴 . 六味地黄丸对肾阴虚型绝经后女性冠心病

经皮冠状动脉介入治疗术后的临床研究 [J]. 中国医院药学杂

志 , 2022, 42 (14): 1469-1473

[20] 陶诗怡 , 杨德爽 , 张兰鑫 , 于林童 , 张高钰 , 樊佳溶 ,

黄力 , 邵明晶 . 中医药治疗绝经后冠心病的 CiteSpace 科学知

识图谱分析 [J]. 中药药理与临床 ,2024,40(01):118-123.

[21] 张延武 . 绝经后冠心病从肾论治的理论探讨 [J]. 中

国中医基础医学杂志 , 2015, 21 (07): 785-786

[22] 宋琦 , 宋海萍 , 戴彦成 , 赵国定 . 赵国定从脾胃论治

冠心病临床经验探析 [J]. 时珍国医国药 ,2017,28(01):223-224.

[23] 安冬青 , 吴宗贵 . 动脉粥样硬化中西医结合诊疗专

家共识 [J]. 中国全科医学 , 2017, 20 (05): 507-511.

[24] 刘兰椿 , 段练 , 刘超 , 王阶 . 雌激素水平与冠心病

肾虚证的相关性及补肾中药的干预作用 [J]. 中国中药杂志 ,

2021, 46 (07): 1738-1742

[25] 王常普 . 加用六味地黄丸加减治疗冠心病心绞痛 30

例 [J]. 广西中医药 ,2015,38(04):27-28.

[26] 刘 洋 , 贾 孟 晓 , 赵 婷 , 等 . 基 于 UPLC-Q-Exactive

Orbitrap-MS 和网络药理学的芪参益气滴丸治疗心肌缺血

的配伍机制研究 [J/OL]. 中国中药杂志 ,1-18[2024-06-19].

https://doi.org/10.19540/j.cnki.cjcmm.20240313.301.

[27] 姜燕华 , 王昱涵 , 刘燕君 , 向丽华 , 张治国 , 陈彦静 .

二仙汤对去卵巢大鼠心肌微血管及血液流变学的影响 [J]. 中

国实验方剂学杂志 , 2020, 26 (24): 59-67.

[28] 迟艳艳 . 右归丸化裁方、针灸联合序贯疗法治疗卵

巢早衰的临床观察 [J]. 世界中医药 , 2019, 14 (09): 2474-2478

[29] 吴松 , 严江天 . 足三里、关元温针灸联合八髎穴隔

姜灸治疗卵巢早衰的临床观察 [J]. 中国针灸 , 2018, 38 (12):

1267-1271.

[30] 王晓彤 , 林海雄 , 陈梓轩 , 陈贵珍 . 系统评价温针灸

防治绝经后骨质疏松的临床疗效及对骨代谢的影响 [J]. 辽宁

中医杂志 , 2018, 45 (03): 479-483.

[31] 管炜 , 左封 . 温针灸联合青娥丸对绝经后骨量减少

肾虚血瘀证的疗效 [J]. 中国骨质疏松杂志 ,2021,27(08):1192-

1194+1208.

[32]Singh S, Anshita D, Ravichandiran V. MCP-1: Function,

regulation, and involvement in disease. [J]. Int Immunopharmacol.

2021 Dec;101(Pt B):107598.

[33]Gunnersen S, Shim JT, Liu F, Tietge UJF, Sørensen CB,

Bentzon JF. Conditional deletion of Ccl2 in smooth muscle cells

does not reduce early atherosclerosis in mice. [J]. Atheroscler

Plus. 2023 Dec 20;55:12-20.

[34]Pekayvaz K, Gold C, Hoseinpour P, Engel A, MartinezNavarro A, Eivers L, Coletti R, Joppich M, Dionísio F, Kaiser

R, Tomas L, Janjic A, Knott M, Mehari F, Polewka V, Kirschner

M, Boda A, Nicolai L, Schulz H, Titova A, Kilani B, Lorenz M,

Fingerle-Rowson G, Bucala R, Enard W, Zimmer R, Weber

C, Libby P, Schulz C, Massberg S, Stark K. Mural cell-derived

chemokines provide a protective niche to safeguard vascular

macrophages and limit chronic inflammation. [J].Immunity. 2023

Oct 10;56(10):2325-2341.e15.

[35]Meng Q, Bi Y, Feng H, Ding X, Zhang S, Chen Q, Wang

L, Zhang Q, Li Y, Tong H, Wu L, Bian H. Activation of estrogen

receptor α inhibits TLR4 signaling in macrophages and alleviates

the instability of atherosclerotic plaques in the postmenopausal

stage. [J]. Int Immunopharmacol. 2023 Mar;116:109825.

[36]Flores VA, Pal L, Manson JE. Hormone Therapy in

Menopause: Concepts, Controversies, and Approach to Treatment.

[J]. Endocr Rev. 2021 Nov 16;42(6):720-752.

[37]Koskinas KC, Windecker S, Pedrazzini G, Mueller

C, Cook S, Matter CM, Muller O, Häner J, Gencer B, Crljenica

C, Amini P, Deckarm O, Iglesias JF, Räber L, Heg D, Mach F.

Evolocumab for Early Reduction of LDL Cholesterol Levels in

Patients With Acute Coronary Syndromes (EVOPACS)[J].J Am

Coll Cardiol. 2019 Nov 19;74(20):2452-2462. doi: 10.1016/

j.jacc.2019.08.010.

[38]Han Y, Chen J, Chopra VK, Zhang S, Su G, Ma C, Huang

Z, Ma Y, Yao Z, Yuan Z, Zhao Q, Kuanprasert S, Baccara-Dinet

MT, Manvelian G, Li J, Chen R. ODYSSEY EAST: Alirocumab

efficacy and safety vs ezetimibe in high cardiovascular risk

patients with hypercholesterolemia and on maximally tolerated

statin in China, India, and Thailand[J].J Clin Lipidol. 2020 JanFeb;14(1):98-108.e8. doi: 10.1016/j.jacl.2019.10.015.

[39]Ray KK, Troquay RPT, Visseren FLJ, Leiter LA,

Scott Wright R, Vikarunnessa S, Talloczy Z, Zang X, Maheux

P, Lesogor A, Landmesser U. Long-term efficacy and safety of

inclisiran in patients with high cardiovascular risk and elevated

LDL cholesterol (ORION-3): results from the 4-year open-label

extension of the ORION-1 trial[J]. Lancet Diabetes Endocrinol.

2023 Feb;11(2):109-119. doi: 10.1016/S2213-8587(22)00353-9.


(13 摘要 Views, 36 PDF Downloads)

Refbacks

  • 当前没有refback。