冠心病是动脉粥样硬化斑块积聚和循环功能改变的一种慢性动态疾病，增龄衰老贯穿其病程，具有阶段性、时程性 特点，呈“稳定-不稳定-再稳定”演变。现代医学治疗冠心病在降脂、抗炎、支架材料技术方面取得了突破性进展，但仍 存在一定程度的残余风险。该文基于中医整体思维提出以“血-脉-心-神”一体观辨治冠心病，认为肾虚致衰贯穿冠心病的 始末，因衰而瘀，血脉心神共受累；防治冠心病应实施提升心脉气化、神司统筹的多维度、全周期干预，而补肾法是针对 其血浊则滞、脉坚则腐、心积则衰、神乱则怍的治本之法。补肾生精可净血濡脉，补肾促通可散结畅脉，补肾助化可育心 宁神。通过补肾可促进心脉的再生力、自净力、自适应力的构建，实现“正气存内，邪不可干”的健康稳态，补肾之法可 落实到冠心病的未病、稳病、病瘥等各病理阶段。

Coronary heart disease（CHD）is a chronic and dynamic disease resulting from atherosclerotic plaque accumulation and disordered circulatory function. For aging and senescence have an effect through the course of the disease，periodic and time-related manifestations of CHD are presented，characterized by the "stable-unstablestable" process. Modern medicine has made breakthroughs in lipid-lowering and anti-inflammatory agents，and scaffold material technologies for CHD，but it still has certain residual risk. Inspired by the holistic concept of traditional Chinese medicine（TCM），this paper proposed the treatment of CHD from the view of “blood-vesselsheart-spirit” integration，and holds that kidney-deficiency induced aging has an effect on the progression of CHD through the course of disease. Aging results into blood stasis，and then the blood，vessels，heart and spirit are all affected. The prevention and treatment of CHD should be performed by multi-dimensional， whole-process intervention with therapies for promoting the qi transformation of heart-vessels， and recovering the function of spirit governing the whole body. Nourishing kidney to treat the root cause aims at vessel stagnation due to blood turbidity，atherosclerosis caused by vessel stagnation，heart failure due to atherosclerosis，and spirit disturbance due to heart failure. Nourishing kidney to generate essence is helpful for purifying blood and moistening vessels， nourishing kidney to unblock the vessels is beneficial for dissipating mass and smoothing vessels，and nourishing kidney to promote transformation dis helpful for nourishing heart and tranquilizing spirit. By nourishing kidney，the regenerative，self-purifying and self-adaptive function of the heart-vessels will be promoted，thus to achieve the healthy homeostasis of“pathogenic factors being impossible to invade the body if healthy qi being sufficient inside”. Therapy of nourishing kidney can be used in various pathological stages for preventing， controlling and curing CHD.

R259.414

国家自然科学基金项目（编号：81774232）；国家中医药管理局岐黄学者支持项目（国中医药人教涵[2022]6号）；国家中医药管理 局第二批国医大师传承工作室建设项目（编号：20150815）；天津市卫生健康委名中医项目（津卫中 [2020] 732号）；第二批国家“万人计划” 百千万工程领军人才项目（津党通 [2016] 77号）