基于巨噬细胞泡沫化探讨脾病“脉道不利”的科学内涵理论研究  

Exploration of Spleen Diseases Leading to“Unsmooth Vessels”Based on Macrophage Foam

作　　者：张会永[1,2] 闵冬雨[1] 贾连群[2] 杨关林[1,2] 

机构地区：[1]辽宁中医药大学附属医院血脉病研究室,沈阳110032 [2]辽宁中医药大学中医脏象理论及应用教育部重点实验室,沈阳110847

出　　处：《世界中医药》2017年第5期1000-1003,共4页World Chinese Medicine

基　　金：国家重点基础研究发展计划(973计划)资助项目(编号:2013CB531700);辽宁省自然科学基金资助项目(编号:2015020385);辽宁中医药大学中医脏象理论及应用国家教育部重点实验室开放基金资质项目(编号:2016013)

摘　　要：脾主运化水谷,布散精微。血脂亦由水谷化生,并依赖脾气散精,经"脉道"布散周身。脾失健运脂质代谢异常时,痰浊内生,阻碍气血运行,导致"脉道不利"。脾失健运脂质代谢异常是导致早期动脉粥样硬化形成的主要因素。脾失健运脂质代谢异常,可影响内皮细胞结构及功能,促使异常代谢的脂质在血管内膜下沉积,形成脂质条纹,导致血管管腔变窄,结构异常,即"脉道不利"。巨噬细胞内胆固醇吸收与排泄障碍,稳态失衡,使得巨噬细胞内脂质蓄积形成泡沫细胞,这一病理过程的使动环节与脾失健运脂质代谢异常密切相关。从"泡沫细胞"形成机制入手,探讨脾失健运脂质代谢异常状态下,早期动脉粥样硬化形成机制,可为厘清"脾失健运"与"脉道不利"的关系提供科学依据,亦为中医临床"从脾论治"冠心病提供科学依据。Spleen governs transportation and transformation of water and food, spreads food essence.Lipid also originates from food and water, and relies on spleen qi distributing essence, and is spread to the whole body by ＆quot;vessels＆quot;.If abnormal lipid metabolism caused by spleen weakness happens, phlegm generates in the body which would obstruct of qi and blood running, leading to ＆quot;unsmoothness of vessels＆quot;.Therefore, abnormal lipid metabolism caused by spleen weakness is a major factor which results in early atherosclerosis formation of fatty streaks.Focusing on the pathological change of fatty streak during early atherogenesis, begin from foam cell formation mechanism, with the aid of in vivo and in vitro experiments, exploration in the effects of lipid metabolic disorder caused by dysfunction of spleen in transportation in macrophage ＆quot;foam cell formation＆quot; and to clarify the pathogenesis of ＆quot;dysfunction of spleen in transportation＆quot; to ＆quot;unsmoothness of vessels＆quot; by the influence of scavenger receptor on macrophages uptake of cholesterol in the blood vessels and the related gene expression of regulation of cholesterol metabolism in macrophages, which can reveal acting mechanism of invigorating spleen for eliminating phlegm Chinese medicine to protect vascular endothelial cells and inhibiting effect mechanism of macrophage ＆quot;foam cell formation＆quot;.To illustrate scientific connotation ＆quot;spleen disease syndrome, unsmoothness of vessels＆quot; in The Inner Cannon of Huangdi, and thus theoretical basis for clinical treated atherosclerosis from spleen could be provided.

关 键 词：血脂异常 高脂血症 高密度脂蛋白 痰浊血瘀 化瘀祛痰 血脉 

分 类 号：R214[医药卫生—中医学]