张国胜

[摘要] 高脂血症是临床最常见的脂代谢紊乱性疾病，其发病率高、分布广，且有年轻化趋势。大量流行病学、临床和实验研究均证实高脂血症是动脉粥样硬化的主要危险因素之一，且与冠心病、脑血管病的发病率有直接的相关性。近年来，中医对高脂血症的治疗做了大量的研究并取得了较好的疗效，其药源广泛、药食同源的特点，加之从多角度、多环节、多靶点来实现对心脑血管疾病的控制，已受到医学界同仁的关注。本文就近十年来中医药对高脂血症的治疗及实验研究现状进行综述，为临床治疗提供一定的参考依据。

[关键词] 高脂血症；中医；临床治疗；综述

[中图分类号] R589.2[文献标识码] A[文章编号]1673-7210（2011）11（c）-121-03

Advances on clinical treatment of traditional Chinese medicine in hyperlipidemia

ZHANG Guosheng

Department of Nephrology, TCM Hospital of Zhengzhou City, He'nan Province, Zhengzhou 450000, China

[Abstract] Hyperlipidemia is a most common fat metabolism disorder disease in clinic, the incidence rate is high, and distribution is wide, and also the trends in youth. Hyperlipidemia is confirmed by the most evidences from epidemiology, clinic and experimental study, which is a most important dangerous factor to atherosclerosis, also it has a direct relevance to coronary disease and cerebrovascular disease. In recent years, traditional Chinese medicine has done massive researches to hyperlipidemia treatment and has obtained good curative effect; it has some characteristics such as widespread medicine source, dual-use medicine, with multi-channel, multi-link, multiple target point in controlling heart blood vessel of brain disease, so it has been received by medical profession colleague in the medical arena. The author summarizes the traditional Chinese medicine to Hyperlipidemia treatment and present situation of experimental study in last ten years, and provides certain references for clinical treatment.

[Key words] Hyperlipidemia; Traditional Chinese medicine; Clinical treatment; Summary

血脂异常是指血中致动脉粥样硬化（AS）的脂质总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B（ApoB）和（或）脂蛋白（α）[Lp（α）]增高，而抗AS的脂质高密度脂蛋白胆固醇（HDL-C）和（或）载脂蛋白A（ApoA）降低[1]。高脂血症（HLP）主要是指TC和（或）LDL-C和（或）TG增高，HLP是AS的主要危险因素[2]。目前具有降脂作用的西药主要是他汀类及贝特类，品种较多，其共同的缺点是肝损害，限制其长期的临床应用范围。因此，发掘祖国医学宝库，寻找价廉安全、疗效可靠的调脂中药的研究，方兴未艾。

1 古代文献对高脂血症的认识

1.1 生理性的膏脂

祖国医学虽无高血脂的概念，历代中医文献中也无高血脂的独立病名，但对人体膏脂已有所认识，认为血中膏脂在正常情况下是生理性的。

1.2 病理性的膏脂

《灵枢·血络论》曰：“血气俱盛而阴气多者，其血滑，刺之则射，阳气蓄积，久留而不泻者，其血黑以浊，故不能射。……