基于“木郁土壅”理论从“肝-肠轴学说”探析越鞠丸防治动脉粥样硬化的机制  

Analysis on Mechanism of Yueju Pill(越鞠丸) Preventing and Treating Atherosclerosis from Theory of "Liver-Gut Axis" Based on Theory of "Wood Stagnation and Earth Obstruction"

作　　者：段盈竹 张欢[1] 于游[1] 张颖[1] 于睿[1] DUAN Yingzhu;ZHANG Huan;YU You;ZHANG Ying;YU Rui(Liaoning University of traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847

出　　处：《中华中医药学刊》2022年第10期99-102,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金(81674078);国家中医药管理局中医药古籍文献和特色技术传承专项(GZY-KTS-2020-026);辽宁省科学技术计划项目工业重大专项(2020JH1/10100022);辽宁省教育厅科学技术研究项目(L201948)。

摘　　要：在生物-心理-社会医学模式下,由慢性应激与脂质代谢紊乱等多重因素协同作用而致的动脉粥样硬化的发生发展,始终是预防心脏病学关注热点问题。根据中医基于五行相生关系之母病及子理论及治未病的思想,提出动脉粥样硬化发病的病因是木郁土壅,在“木郁土壅”的病理状态下,脂质不能有效流通、过多的脂质堆积形成“膏浊”,导致高脂血症,膏浊沉积,阻塞脉道,则发为动脉粥样硬化。西医的研究动脉粥样硬化的发生与肠道菌群结构紊乱和胆汁酸代谢异常相关,故提出“肝-肠轴学说”是动脉粥样硬化发生的机制。治疗六郁之名方越鞠丸基于疏肝运脾法可通过“肝-肠轴学说”调控FXR/FGF15/SHP信号通路促进胆固醇排出,抑制肠道对胆固醇吸收,改善肠道菌群结构,维持胆固醇代谢稳态,可能是防治动脉粥样硬化预病状态的分子机制之一。Under the biological-psychological-social medicine model,the occurrence and development of atherosclerosis caused by the synergistic effect of multiple factors such as chronic stress and lipid metabolism disorders has always been a hot issue in preventive cardiology.Based on the mother-organ diseases involving child-organ theories of the five-element relationship,the research team proposed that the etiology of atherosclerosis is the stagnation of wood.In the pathological state of"wood stagnation",lipids cannot circulate effectively and excessive accumulation of lipids forms a"paste turbid",leading to hyperlipidemia,deposits of the cream,blocking the veins and atherosclerosis.Western medicine researches that the occurrence of atherosclerosis is related to the disorder of intestinal flora and abnormal bile acid metabolism.Therefore,this paper proposes that the"liver-gut axis theory"is the mechanism of atherosclerosis.The famous prescription for treating six depression syndromes which is Yueju Pill(越鞠丸),based on the method of soothing liver and activating spleen,can regulate the FXR/FGF15/SHP signaling pathway to promote cholesterol excretion,inhibit the intestinal absorption of cholesterol and improve the structure of the intestinal flora through the"liver-gut axis theory".Maintaining the steady state of cholesterol metabolism may be one of the molecular mechanisms to prevent and treat the pre-morbid state of atherosclerosis.

关 键 词：木郁土壅 越鞠丸 动脉粥样硬化 防治 机制 

分 类 号：R259.435[医药卫生—中西医结合]