从“毒瘀蚀心,肺失百脉”探讨细胞焦亡与肺动脉高压右心衰竭的关系  

Relationship Between Pyroptosis and Right Heart Failure in Pulmonary Hypertension from Perspective of "Du Yu Shi Xin and Fei Shi Bai Mai"

作　　者：周瑞玲 张雯 崔力心 唐雅伦 张新宇 张琼[2] ZHOU Ruiling;ZHANG Wen;CUI Lixin;TANG Yalun;ZHANG Xinyu;ZHANG Qiong(Beijing University of Chinese Medicine,Beijing China 100029;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing China 100091)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院西苑医院,北京100091

出　　处：《中医学报》2023年第2期227-232,共6页Acta Chinese Medicine

基　　金：中国中医科学院科技创新工程项目(CI2021A 01106)。

摘　　要：肺动脉高压(pulmonary hypertension,PH)被称为心血管系统的“恶性肿瘤”,右心衰竭是其最终结局,目前PH治疗难度已成为临床棘手问题。研究发现炎症是导致PH右心衰竭的重要病机,NLRP3炎症小体介导的细胞焦亡产生炎症级联反应,加速PH右心衰竭恶化。基于中医基础理论,认为PH右心衰竭的根本病机为“毒瘀蚀心,肺失百脉”,以PH始发环节炎症为切入点,以心肌细胞焦亡为落脚点,炎症反应乃“浊毒”,肺血管重塑为“血瘀”,与细胞焦亡通过调控NLRP3炎症小体促进PH右心衰竭的病理机制相契合。故从“毒瘀蚀心,肺失百脉”病机探讨细胞焦亡在PH右心衰竭中的发病机制,以期为PH右心衰竭的治疗提供新的思路。Pulmonary hypertension(PH) is known as a "malignant tumor" of the cardiovascular system,and right heart failure is its final outcome.At present,the difficulty of PH treatment has become a difficult clinical problem.It is found that inflammation is an important pathogenesis leading to right heart failure in PH,and pyroptosis mediated by NLRP3 inflammasomes produces an inflammatory cascade reaction that accelerates the deterioration of right heart failure in PH.Based on the basic theory of traditional Chinese medicine,it is believed that the fundamental pathogenesis of PH right heart failure is "Du Yu Shi Xin and Fei Shi Bai Mai".Taking inflammation as the initial link of PH as the entry point and myocardial pyroptosis as the foothold,the inflammatory response is "Zhuo Du",and the pulmonary blood vessels are remodeled as "Xue Yu",which is con sistent with the pathological mechanism that pyroptosis promotes PH right heart failure by regulating NLRP3 inflammasome.Therefore,the pathogenesis of pyroptosis in PH right heart failure is explored from the pathogenesis of "Du Yu Shi Xin and Fei Shi Bai Mai",in order to provide new ideas for the treatment of PH right heart failure.

关 键 词：肺动脉高压 右心衰竭 细胞焦亡 “毒瘀蚀心 肺失百脉” 肺朝百脉 活血解毒法 

分 类 号：R256.2[医药卫生—中医内科学]