基于胶质淋巴系统探讨“毒损脑络”  

Correlation Analysis of"Toxin Damaging Brain Collaterals"from Glymphatic System

作　　者：金硕果[1] 刘福友[1] 杨东东[1] 尹海燕[2] 刘美君[1] 杨芳[1] 孙鸿辉[1] 陈卫银[1] JIN Shuo-guo;LIU Fu-you;YANG Dong-dong;YIN Hai-yan;LIU Mei-jun;YANG Fang;SUN Hong-hui;CHEN Wei-yin(Hospital of Chengdu University of Traditional Chinese Medicine(TCM),Chengdu 610072,China;School of Acupuncture and Message,Chengdu University of TCM,Chengdu 610075,China)

机构地区：[1]成都中医药大学附属医院,成都610072 [2]成都中医药大学针灸推拿学院,成都610075

出　　处：《中国实验方剂学杂志》2020年第10期186-191,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划专项(2018YFC1705604);成都中医药大学附属医院科研项目(189508)。

摘　　要：络脉是经脉系统的分支,具有沟通表里上下、联系脏腑的作用,在支持气血运行方面呈现双向流动的特性,具有物质交换和新陈代谢的功能。脑为诸阳之会,脑络纵横交错,脑络渗灌气血以充实脑髓并敷布阳气以温煦脑神,为"脑主神明"提供物质基础和源动力。病理情况下脑络不通,毒邪内生,而致"毒损脑络"。"毒损脑络"病机学说不仅应用于中风病机研究中,而且拓展到痴呆等其他脑病中,推动了中医脑病病机理论的发展。新近发现脑内存在"胶质淋巴系统",是星形胶质细胞介导的脑脊液-脑间质液的交换流动系统。胶质淋巴系统把脑脊液中的葡萄糖、脂质、电解质和载脂蛋白E等营养物质和神经活性物质运送到脑组织,也能清除脑内代谢产物(如乳酸)、可溶性蛋白(如β-淀粉样蛋白和Tau蛋白)和异物,这是维持脑内环境稳态的重要液体流动系统。胶质淋巴系统的发现为神经系统疾病病理机制的研究提供了新视角,可能成为脑血管疾病、神经退行性疾病等神经精神系统疾病干预的新靶点。作为脑内广泛分布的代谢废物排出途径和物质运送系统的胶质淋巴系统可能是"脑络"病变的生物学基础,是中西医对"毒损脑络"认识的交叉点,从胶质淋巴系统探析"毒损脑络",有可能为揭示"毒损脑络"的现代内涵提供新的靶点。The collaterals are branches of the meridians and vessels system,and have the roles of connecting upper-lower and interior-exterior portions of the body,the characteristics of two-way flow in supporting the operation of Qi and blood,and the functions of material exchange and metabolism.The brain is the intersection of the Yang meridians.Crisscross brain collaterals permeate Qi and blood to enrich the brain,and spread Yang Qi,in order to warm the brain-mind,and provide material basis and source power to the"brain governing mind".Under pathological conditions,cerebral collaterals are blocked,and toxic pathogens are endogenous,resulting in"toxin damaging brain collaterals".This theory is not only applied to the study of stroke pathogenesis,but also extended to other encephalopathy,such as dementia,which promoted the development of the theory of pathogenesis in traditional Chinese medicine.Recently,a"glymphatic system"was discovered in the brain,which is an exchange flow system of cerebrospinal fluid-brain interstitial fluid mediated by astrocyte.The glymphatic system transports nutrients and neuroactive substances,such as glucose,lipids,electrolytes and apolipoprotein E in the cerebrospinal fluid,to brain tissue,and also removes metabolic products(such as lactic acid),soluble proteins(such asβ-amyloid protein and Tau protein)from the brain and foreign bodies,which are important liquid flow systems that maintain the homeostasis of the brain.The discovery of the glymphatic system provides a new perspective for the study of pathological mechanism of neurological diseases,and may become a new target for interventions in neurological diseases,such as cerebrovascular diseases and neurodegenerative diseases.As a widely distributed cerebral metabolic waste removal way and material delivery system,the lymphatic system may be the biological foundation of"brain collateral"disease,and a cross point of understanding on"toxin impairing brain collaterals"by Western and traditional Chinese medicine.The study based on the glymphati

关 键 词：络脉 毒损脑络 胶质淋巴系统 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]