基于代谢模型对中医痰证生理学基础的理论探讨  

Probing the pathophysiology of phlegm syndrome in TCM according to novel metabolic models

作　　者：严冬[1] 鲁海峰[2] 方辉[1] 应佩君 肖党生[1] YAN Dong;LU Haifeng;FANG Hui;YING Peijun;XIAO Dangsheng

机构地区：[1]浙江大学医学院附属第一医院,浙江杭州310003 [2]浙江大学医学院附属第一医院传染病诊治国家重点实验室,浙江杭州310003

出　　处：《中医临床研究》2021年第33期80-83,共4页Clinical Journal Of Chinese Medicine

摘　　要：在中医理论体系中,痰是气机运行失常后的病理产物。现今将痰分为广义之痰和狭义之痰。在新型代谢模型中,能量物质氧化过程是气机运行的生理学基础,能量物质推动肾精化血濡养五脏六腑是机体内化血过程的生理学基础。这两个过程失常将导致痰证的形成。外感寒邪通过阻碍水热排泄,逆化气通路造成水液停聚,诱导痰证的形成。过量摄入的能量物质不仅促使人体和细胞内的氧化过程处于饱和状态后而促使能量物质的积聚,干扰机体内气机运行,诱导痰证的形成。干细胞分裂分化失常造成机体内免疫系统活化、体细胞更新下降而导致痰证形成。免疫系统活化是机体内气机运行失常的具体表现,是广义痰证和狭义痰证共同具有的病理过程。温阳散寒,减少能量物质摄取以及调整干细胞分裂分化(温补肾阳)是治疗痰证的基本原则。In TCM,phlegm is regarded as pathological product which is caused by the abnormality of Qi motion(气机).At present,all phlegm syndromes are divided into generalized phlegm syndromes and specialized phlegm syndromes.In novel metabolic models,oxidation of energy agents is defined as the physiology of Qi motion and energy agents can also drive kidney essence to be converted into bloodTCM so as to nourish all organs,which is defined as physiology of Yin(阴)or bloodTCM.The abnormalities of both pathways are the causality of phlegm syndromes.By block the expenditure of heat energy and dissipation of water,cold pathogen will lead to the accumulation of water in local tissues or organ on the reversed pathway of Qi motion,which is one of pathophysiology of phlegm syndromes.Over-intake of energy agents will not only saturate oxidation pathway in cells and in body but also drive energy agents to be accumulated in local tissue and organs so as to disturb the motion of Qi,which is another pathophysiology of phlegm syndromes.Abnormality of stem cell proliferation and differentiation will activate immune system and attenuate the update of somatic cells,which is also the pathophysiology of phlegm syndrome.Activated immune system is the result of abnormal Qi motion and can also be regarded as the common pathophysiology of generalized phlegm syndrome and specialized phlegm syndrome.Warming yang for dispelling cold pathogen,reducing the intake of energy agents and regulating the stem cell proliferation and differentiation are the general principle for therapy of phlegm syndromes.

关 键 词：痰证 气机 水湿停聚 能量代谢 干细胞 

分 类 号：R255.8[医药卫生—中医内科学]