动脉粥样硬化（AS）在我国呈现高发病率与年轻化趋势，是导致心脑血管疾病致残致死的主要病理基础。尽管化学药治疗有效，但潜在的不良反应如肝肾损伤限制了其应用。《药治通义》强调“用药之妙，莫如加减”，药对以其精妙的配伍，在AS防治中发挥关键作用。系统梳理文献，将具有抗AS作用的中药药对依据功效归纳为活血化瘀、活血解毒、活血益气、祛痰化浊及其他五大类。其作用机制主要包括抗炎、调节脂蛋白代谢、保护血管内皮、抗氧化、抑制泡沫细胞形成、调控细胞凋亡与增殖、抑制斑块内新生血管、抑制平滑肌细胞异常增殖、抗血栓形成及调节肠道菌群结构等。旨在为抗AS新药研发及未来研究方向提供理论参考。

Atherosclerosis（AS） exhibits a high prevalence and a trend towards affecting younger individuals in China, serving as the primary pathological basis for disability and mortality in cardiovascular and cerebrovascular diseases. While Western pharmacological treatments are effective, potential adverse effects, such as hepatorenal toxicity, constrain their application. The classic text "YaoZhiTongYi" emphasizes the precision of drug selection through addition and subtraction. Medicinal pairs（drug pairs）, with their sophisticated compatibility, play a pivotal role in AS prevention and treatment. This review systematically categorizes AS-inhibiting TCM pairs based on their therapeutic effects into five major classes: blood-activating and stasis-resolving, blood-activating and detoxifying, blood-activating and qi-tonifying, phlegm-resolving and turbidity-eliminating, and others. Their mechanisms of action primarily encompass anti-inflammation, regulation of lipoprotein metabolism, vascular endothelial protection, anti-oxidation, inhibition of foam cell formation, modulation of apoptosis and proliferation, suppression of intraplaque neovascularization, inhibition of abnormal vascular smooth muscle cell proliferation, anti-thrombosis, and regulation of intestinal flora structure. This work aims to provide a theoretical foundation for the development of novel anti-AS drugs and future research directions.

R285.5

国家重点研发计划项目(2017YFC1700401); 全国名老中医药专家传承工作室项目(国中医药人教函[2022]75号); 辽宁省特聘教授滚动支持项目(辽教函[2018]35号); 辽宁中医药大学大学生创新创业训练计划项目(S202310162023)