基于神经元凋亡与自噬探讨从肾论治阿尔茨海默病的现代生物学机制  

Discussion on the modern biological mechanism of treating Alzheimer’s disease from kidney based on neuron apoptosis and autophagy

作　　者：崔远武[1] 王凯[2] 徐家淳 孙伟明[2] 于臻[3] CUI Yuan-wu;WANG Kai;XU Jia-chun;SUN Wei-ming;YU Zhen(Second Affiliated Hospital of Tianjin University of TCM,Tianjin 300250,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学第二附属医院治未病科,天津300250 [2]天津中医药大学第二附属医院,天津300250 [3]天津中医药大学,天津301617

出　　处：《中华中医药杂志》2020年第7期3584-3587,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81673752);天津市中医治未病建设项目。

摘　　要：现代医学中发现β-淀粉样蛋白(Aβ)生成增多聚集成毒导致神经元凋亡是阿尔茨海默病(AD)的重要发病机制,神经元自噬功能具有清除Aβ减轻神经元损伤的作用。中医学认为肾虚髓亏、脑失充养是AD形成的基本病理基础,痰湿和瘀血阻窍是其发病的重要病理环节,治疗上须兼顾补肾益精与蠲除浊邪两个相辅相成的方面。研究发现Aβ与中医的痰瘀具有相似的特征;近年来已有研究表明补肾祛邪的方药可通过调节神经元凋亡和自噬功能发挥减轻神经元缺失、改善AD学习记忆能力减退的作用,提示中医从肾论治AD的有效性。文章拟从Aβ病理作用下,神经元凋亡和自噬变化入手,进一步探讨其与AD中医肾虚痰瘀病机的关系,从细胞层次揭示从肾论治AD的现代生物学机制,为AD和衰老相关疾病的临床诊疗和科学研究提供新思路。It has been found in modern medicine that increased production and accumulation into toxicity of betaamyloid protein(Aβ)leads to neuronal apoptosis,which is an important pathogenesis of Alzheimer's disease(AD).Neuronal autophagy can clear Aβto reduce neuronal damage.The failure of nourishment and filling of brain due to kidney deficiency and marrow depletion is considered the basic pathology of AD in traditional Chinese medicine(TCM),while stagnation of phlegm and blood stasis in orifice are the key pathological links.Therefore,tonifying kidney and essence as well as eliminating turbid pathogenic factors should be taken into consideration to treat AD.Based on this and the similar characteristics of Aβand phlegm and blood stasis in TCM was found,recent studies have shown that prescriptions of tonifying kidney and eliminating pathogenic factors can improve the learning and memory impairment of AD by regulating he neuronal apoptosis and autophagy to reduce the loss of neurons,suggesting that the treatment of AD from kidney in TCM is effective.This article discusses Aβand pathogenesis of AD in TCM from neuronal apoptosis and autophagy to reveal the modern biological mechanism of treating AD from kidney on the cellular level,which provides novel insight into the clinical diagnosis,treatment and scientific researches of AD and agingrelated diseases.

关 键 词：阿尔茨海默病 神经元 凋亡 自噬 肾虚痰瘀 从肾论治 

分 类 号：R277.7[医药卫生—中医学]