心肌淀粉样变性（CA）是一种罕见且严重的渐进性浸润性疾病，发病机制尚未完全明确，目前也仍缺乏特效的治疗措 施。该文结合中医络病学说中的“络息成积”理论，探讨其与CA 的潜在关联，并依据CA 的演变规律分为四期。初期因正 气亏虚，抗邪无力，邪气趁虚而入，留滞心络；中期多为本虚标实、虚实夹杂之候，邪气积聚致气血运行受阻，痰瘀互结， 络脉痹阻；晚期表现为脾肾阳虚，络虚积留；终末期随着脾肾阳虚日重，最终导致阴阳离决，络损积坚。治法围绕调络、 通络、荣络、固络以能正确把握疾病阶段，恢复人体气血经络通畅，改善预后。基于“络息成积”理论分期论治CA，可为 中医药治疗CA 提供新思路。

Cardiac amyloidosis（CA）is a rare and severe progressive infiltrative disease whose pathogenesis remains not fully elucidated，and effective therapeutic interventions are still lacking. This article integrates the theory of“Collateral Stagnation Evolving into Accumulation”from the traditional Chinese medicine collateral disease doctrine to explore its potential relevance to CA. Based on the evolutionary pattern of CA，the disease progression is categorized into four stages. In the initial stage，deficiency of healthy qi renders the body unable to resist pathogenic factors，allowing pathogens to take advantage and lodge in the cardiac collaterals. The intermediate stage is typically characterized by root deficiency and branch excess，deficiency interweaved with excess，where accumulated pathogens obstruct qi and blood circulation，leading to phlegm interweaved with stasis and subsequent collateral blockage. The advanced stage manifests as spleen-kidney yang deficiency with collateral depletion and mass formation. The end-stage，marked by progressive spleen-kidney yang deficiency，ultimately results in the dissociation of yin and yang，with collateral damage and solidification of the mass. Therapeutic principles focus on regulating，unblocking，nourishing，and consolidating the collaterals to accurately address the disease stage，restore the smooth flow of qi，blood，and meridians，and improve prognosis. Differentiating and treating CA based on the staged progression outlined in the“Collateral Stagnation Evolving into Accumulation” theory may offer novel insights for the management of CA with traditional Chinese medicine.

R246.9

广东省中医药局科研资助项目（编号：20221465）；广东省医学科学技术研究基金资助项目（编号：B2022219）