从中医“阳气亏虚,痰瘀内阻”理论探讨中医药防治心肌缺血再灌注损伤的机制  

Discussion on the Mechanism of Myocardial Ischemia-Reperfusion Injury in Traditional Chinese Medicine from the Theory of“Deficiency of Yang Qi,Phlegm and Blood Stasis Blocking the Viscera”

作　　者：曹蛟 张杼惠 刘建和[2] Cao Jiao;Zhang Zhuhui;Liu Jianhe(Graduate School of Hunan University of Chinese Medicine,Changsha 410208,China;The First Affiliated Hospital of Hunan University of Chinese medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学研究生院,长沙410208 [2]湖南中医药大学第一附属医院,长沙410007

出　　处：《世界科学技术-中医药现代化》2021年第2期510-515,共6页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：湖南省科学技术厅自然科学基金委员会科卫联合项目(2018JJ6038);基于RyR2受体研究“和解定悸法”治疗缺血性心律失常的作用机制,负责人:刘建和;湖南省教育厅学位与研究生教育改革研究项目(2019JGYB163);基于“读经典、跟名师”思想整合名医工作室资源提高中医专业学位研究生住培质量的实践与探索研究,负责人:刘建和。

摘　　要：目的从文献探讨中医“阳气亏虚,痰瘀内阻”理论防治急性心肌梗死(Acute myocardial infarction,AMI)后心肌缺血再灌注损伤(Myocardial ischemia reperfusion injury,MIRI)的机制,为其科研及防治提供依据。方法检索中国知网数据库、万方数据库、NCBI数据库从建库到2020年6月14日有关MIRI的文献,总结MIRI的发病机制及中医证治的新观点,分析可信度较高的相关实验数据,对运用中医“阳气亏虚,痰瘀内阻”理论防治MIRI进行探讨。结果文献表明温阳化气、活血化瘀、祛痰化浊的中医方药可通过抑制细胞内Ca^(2+)超载,稳定线细胞膜,减少氧自由基的生成,改善细胞能量代谢等多条途径参与缺血心肌的保护作用。结论MIRI的发病机制文献表明,涉及多种病因,中医药可通过多靶点、多路径参与对MIRI的防治,且可能对MIRI的临床辨证论治提供理论依据。Objective To explore the mechanism of myocardial ischemia-reperfusion injury(MIRI)in the prevention and treatment of acute myocardial infarction(AMI)from the theory of“deficiency of yang qi,phlegm and blood stasis blocking the viscera”in traditional Chinese medicine(TCM).The mechanism of myocardial ischemia reperfusion injury(MIRI)after acute myocardial infarction(AMI)was studied to provide a basis for scientific research and prevention.Methods By searching CNKI database,Wanfang database and NCBI database about MIRI from the establishment of the database to June 14,2020,we summarized the pathogenesis of MIRI and the latest viewpoints of the TCM syndrome treatment,analyzed the relevant experimental data with high credibility,and demonstrated the prevention and treatment of MIRI by the theory of“deficiency of yang qi,phlegm and blood stasis blocking the viscera”.Results The literature suggested that TCM prescriptions that warm yang and transform qi,activate blood circulation and eliminate phlegm and turbidity could participate in the protective effects of ischemic myocardium through multiple pathways such as inhibiting intracellular Ca^(2+)overload,stabilizing the nematocyte membrane,reducing oxygen radical generation,and improving cellular energy metabolism.Conclusion The pathogenesis literature of MIRI shows that the TCM therapy can participate in the prevention and treatment of MIRI through multiple targets and multi-path,and may provide theoretical basis for the clinical differentiation and treatment of MIRI.

关 键 词：气虚 痰瘀 中医药 心肌缺血 再灌注损伤 

分 类 号：R2-03[医药卫生—中医学]