摘要
轻度认知障碍作为一种具有潜在可逆性的神经认知功能障碍综合征,其临床定位为处于生理性衰老与各类痴呆症之间的过渡阶段,该阶段的个体向痴呆转化的风险显著高于认知正常的人群。近年来,全球轻度认知障碍的发病率呈现持续攀升态势,且流行病学数据显示其发病年龄呈现年轻化趋势。当前西医学对轻度认知障碍病理机制的阐释仍存在显著局限性,亦缺乏普适性的早期干预靶点。中医学认为,“肾精亏虚”是轻度认知障碍发生发展的核心病机,肾精是先天之本,肾精亏耗,髓海失养,脑神不荣;“起亟失司”是此病的根本原因,肾精充足是起亟的物质前提,肾虚精亏,起亟失司,髓海失稳,最终发为“神病”。前沿研究领域不断涌现的新证据表明,随着年龄增长,免疫系统功能进行性衰退,导致外周循环中持续存在的慢性低度炎症能够通过多重复杂的生物学途径共同驱动认知功能的进行性衰退与加速恶化。本研究立足于中医经典理论“肾藏精起亟”的核心思想,探讨衰老导致的外周慢性炎症与轻度认知障碍发生发展的内在关联性,并试图从中医学视角对西医学研究所揭示的免疫衰老与中医核心病机概念“起亟失司”之间可能存在的内在联系进行初步阐释与探讨,以期理解轻度认知障碍的复杂病理机制,为融合中西医视角提供新思路。
Mild cognitive impairment(MCI),as a neurocognitive dysfunction syndrome with potential reversibility,is clinically positioned as a transitional stage between physiological aging and various forms of dementia,and individuals in this stage exhibit a significantly higher risk of progressing to dementia than people with normal cognition.In recent years,the incidence of MCI has been on a continuous upward trend worldwide,and epidemiological data indicates that the age of onset is getting younger.Current Western medicine still shows significant limitations in elucidating the pathological mechanisms of MCI and lacks universal early intervention targets.In traditional Chinese medicine(TCM),it is believed that“deficiency of kidney essence”is the core pathogenesis of MCI.Specifically,kidney essence is the congenital origin,and depleted kidney essence failing to nourish the Marrow Sea can lead to lack of nourishment for the brain spirit.Additionally,“dysregulation of functional impetus”is identified as the fundamental cause of the disease.Sufficient kidney essence is the material prerequisite for functional impetus,while deficiency of kidney essence results in dysregulation of functional impetus,destabilizing the Marrow Sea,ultimately manifesting as“spiritual disorders”.Constantly emerging new evidences in the cutting-edge research field indicate that the immune system function deteriorates progressively with age,leading to persistent chronic low-grade inflammation in the peripheral circulation,which can jointly drives the progressive decline and accelerated deterioration of cognitive function by multiple complex biological pathways.This study is based on the core idea of the classic theory of TCM,“the kidney stores essence and governs energy transformation”,and to explore the intrinsic relationship between aging-induced peripheral chronic inflammation and the occurrence and development of MCI.It also attempts to preliminarily interpret and discuss the potential intrinsic connection between immunosenescence revealed by Western medicine research and the core TCM pathogenic concept of“dysregulation of functional impetus”from the perspective of TCM,in order to understand the complex pathological mechanism of MCI and offer new ideas for the integration of TCM and Western medicine.
出处
《中医临床研究》
2025年第26期77-82,共6页
Clinical Journal Of Chinese Medicine
基金
国家自然科学基金项目(82274665)
辽宁省特聘教授项目(辽教发〔2015〕153号)。
关键词
轻度认知障碍
藏精起亟
外周炎症
免疫衰老
Mild cognitive impairment
Storing essence and governing energy transformation
Peripheral inflammation
Immunosenescence
