摘要
动脉粥样硬化(Atherosclerosis,AS)是一种严重威胁人类健康的慢性炎症性疾病,是心脑血管事件发生的病理基础,因其高发病率和高致残率而成为全球性的重大公共卫生问题。研究表明,内质网应激(Endoplasmic Reticulum Stress,ERS)作为细胞应对内外环境紊乱的重要机制,在AS的发生与发展中扮演了关键角色。持续存在的ERS会打破未折叠蛋白反应(Unfolded Protein Reaction,UPR)的平衡,进而诱导内皮细胞与巨噬细胞凋亡,促进脂质沉积与炎性反应,最终导致斑块形成与不稳定。这一生物学过程与中医学“浊气归心,淫精于脉”的理论核心具有高度的内在一致性。过食肥甘厚味损伤脾胃,运化失司则水谷精微化为病理性浊气,此浊气归之于心,浸淫于脉,演变为痰浊、瘀血等病理产物,相互搏结,壅塞脉道,此乃AS的核心病机。其与现代医学中氧化型低密度脂蛋白(Oxidized Low Density Lipoprotein,ox-LDL)的产生、游离胆固醇的异常蓄积所触发的ERS及其介导的细胞凋亡共同加速AS进展,二者在病机层面上有异曲同工之妙。因此,文章基于“浊气归心,淫精于脉”理论,从中西医结合的视角系统阐述ERS与AS之间的内在联系,并进一步论证以“化痰祛瘀、通脉活络”为治则的中医药疗法可通过干预ERS途径为防治该病提供新的思路与策略,为中医药的现代化研究和临床应用提供有益借鉴。
Atherosclerosis is a chronic inflammatory disease that poses a serious threat to human health.As a common pathological basis for various cardiovascular and cerebrovascular events,its high incidence and disability rates have made it a major global public health concern.Recent studies have shown that endoplasmic reticulum stress(ERS),as a critical signaling pathway activated in response to internal and external environmental disturbances,plays a central role in the initiation,progression,and plaque destabilization of atherosclerosis.Persistent ERS can disrupt the homeostasis of the unfolded protein response,trigger apoptosis in endothelial cells and macrophages,exacerbate lipid accumulation and local inflammatory responses,thereby promoting the formation and development of atherosclerotic plaques.This mechanism exhibits remarkable consistency with the pathological process described in the classical theory of traditional Chinese medicine,which states that“turbid Qi(气)returns to heart,and superfluous nutritious substances accumulates in channels”.Dietary irregularities and overconsumption of rich foods impair the spleen and stomach’s transforming and transporting functions,causing turbid Qi to be abnormally retained and transformed into pathogenic turbidity.This turbid Qi ascends to the heart,overflows in the vessels,and further transforms into phlegm-turbidity and blood stasis,which combine to block and congest the vessels,forming the core TCM pathogenesis of atherosclerosis.This pathological evolution complements the mechanism of ERS and apoptosis induced by oxidized low-density lipoprotein and free cholesterol accumulation in modern medicine,collectively driving disease progression and reflecting the convergence of Chinese and Western medical theories in explaining the same pathological phenomenon.Based on this,guided by the theory of“turbid Qi returns to heart,and superfluous nutritious substances accumulates in channels”,this paper systematically explores the relationship between ERS and the development of atherosclerosis,and proposes a TCM treatment strategy centered on“resolving phlegm,eliminating stasis,and unblocking the vessels”.By targeting the ERS signaling pathway,it offers new ideas for the prevention and treatment of atherosclerosis,while also providing a theoretical basis and practical reference for advancing the modernization and clinical application of TCM.
出处
《中医临床研究》
2025年第30期72-77,共6页
Clinical Journal Of Chinese Medicine
关键词
内质网应激
细胞凋亡
浊气归心
淫精于脉
动脉粥样硬化
Endoplasmic reticulum stress
Apoptosis
Turbid Qi returns to heart,and superfluous nutritious substances accumulate in channels
Atherosclerosis
