[Temporal and spatial pathogenesis of myocardial infarction and TCM treatment from perspective of "three-dimensional network system" of collateral disease theory].

Myocardial infarction(MI), a cardiovascular disease with persistently high global mortality and disability rates, has a complex pathological mechanism. Western medicine has limitations in intervening in the high-risk state before onset and in ventricular remodeling after onset. Based on the "three-dimensional network system" of collateral disease theory, this paper systematically elucidates the spatiotemporal dynamic correlation between modern pathological mechanisms of MI and the evolution of its pathogenesis in TCM. We propose that the pathogenesis of MI involves an interplay between "collateral network disorder" and "dysfunction of collateral flow". Spatially, lesions originate from stagnation of Qi and blood in the local tertiary collateral vessels, progressively develop into acute occlusion of regional collaterals characterized by intermingled phlegm and blood stasis, and eventually lead to systemic network disorder marked by deficiency of Yang Qi, collateral stasis, and water retention. Temporally, the pathogenesis evolves from accumulation of latent pathogens due to stagnation or deficiency of collateral Qi before onset, shifts abruptly to sudden blockage of collaterals and drastic exhaustion of Qi and blood during the acute attack, and further progresses to ventricular remodeling characterized by collateral accumulation after onset. This reflects a spatiotemporal dynamic evolution from local tertiary collateral vessels to the entire network, and from the pre-onset to post-onset stages. Guided by this spatiotemporal pathogenesis evolution within the "three-dimensional network system", treatment involves promoting Qi and blood flow and unblocking the tertiary collateral vessels in the pre-onset stage for disease prevention; resolving phlegm, dispelling stasis, and dredging the collaterals in the acute stage to address acute manifestations; and warming heart Yang and regulating the collateral network in the post-onset stage to tackle the root cause. By integrating collateral disease theory with modern pathological mechanisms, this approach provides a precise TCM strategy for comprehensive prevention and treatment of MI, considering both spatial and temporal dimensions.