摘要
中医学认为脾气散精功能失常是非酒精性脂肪性肝病(NAFLD)的关键病机之一,现代医学认为线粒体功能障碍是导致NAFLD发生发展的重要因素。线粒体是细胞能量代谢的重要场所,中医之脾通过升清功能将水谷精微和津液输送全身,二者在生理上都与机体的能量代谢相关;在病理上脾不散精产生的痰湿病理产物与线粒体障碍产生的氧化应激代谢产物存在契合之处。当痰湿堆积日久,久病化瘀,NAFLD会进展为非酒精性脂肪性肝炎(NASH)痰瘀互结证。核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)是导致NAFLD进展为NASH的重要因素,痰瘀互结的代谢产物与NLRP3炎症小体产生的炎症介质同样存在契合之处。因此,通过探究“脾气散精”与线粒体和NLRP3炎症小体的关系,可以为NAFLD/NASH的治疗提供一定的科学支撑。
Traditional Chinese medicine(TCM) considers the dysfunction of the spleen′s ability to disseminate essence as one of the key pathogenesis of non-alcoholic fatty liver disease(NAFLD).Modern medicine identifies mitochondrial dysfunction as a crucial factor in the onset and progression of NAFLD.Mitochondria are the primary sites for cellular energy metabolism,and the spleen in TCM plays a role in transporting the essence of food and fluids to the entire body through its ascending function.Both processes are physiologically related to the body′s energy metabolism.Pathologically,the phlegm and dampness produced by spleen dysfunction and the oxidative stress byproducts from mitochondrial impairment share similarities.Over time,the accumulation of phlegm and dampness can lead to blood stasis,progressing NAFLD into non-alcoholic steatohepatitis(NASH) with combined phlegm and stasis syndrome.The nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3(NLRP3) inflammasome is a key factor in the progression of NAFLD to NASH.The metabolic byproducts of phlegm and blood stasis overlap with the inflammatory mediators produced by the NLRP3 inflammasome.Therefore,exploring the relationship between the “spleen qi disseminating essence” function,mitochondria,and the NLRP3 inflammasome may provide scientific support for the treatment of NAFLD/NASH.
作者
刘彤
李善政
周铖
尚东方
刘素彤
赵文霞
LIU Tong;LI Shanzheng;ZHOU Cheng;SHANG Dongfang;LIU Sutong;ZHAO Wenxia(Department of Spleen,Stomach,Liver,and Gallbladder Diseases,First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China;The First Clinical School of Henan University of Chinese Medicine,Zhengzhou 450000,China)
出处
《世界中医药》
北大核心
2025年第6期1038-1042,共5页
World Chinese Medicine
基金
国家自然科学基金项目(82205086)——基于NOX4介导的线粒体氧化应激/铁死亡途径探讨化痰祛湿活血方改善NASH的作用机制
河南省中医学“双一流”创建科学研究专项(STG-ZYX02-202117)
河南省中医药科学研究专项重点课题(2022JDZX006)
河南省卫生健康委员会课题(2022JDZX114)
全国名中医传承工作室建设项目(国中医药办人教函[2022]245号)。
