以新型代谢模型为基础探讨湿证的病机及病理生理基础  

Probing the pathogenesis and pathophysiological basis of dampness syndrome according to novel metabolic models

作　　者：肖党生[1] 琚涛 鲁海峰[1] 杨介钻[1] 方辉[1] 严冬[1] XIAO Dangsheng;JU Tao;LU Haifeng;YANG Jiezuan;FANG Hui;YAN Dong

机构地区：[1]浙江大学医学院附属第一医院,浙江杭州310003

出　　处：《中医临床研究》2023年第27期76-80,共5页Clinical Journal Of Chinese Medicine

基　　金：科技部“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项:我国周边地区重要传染病防控及处置能力提升研究(2018ZX10101001-001)。

摘　　要：气血之间的平衡维持着人体内气机正常运行,气血之间的失衡将诱导湿证的形成。能量物质的氧化过程是生命体内气机运行的核心,几乎所有的有机物都将进入三羧酸循环和氧化磷酸通路氧化形成代谢终产物。三羧酸循环和氧化磷酸化是湿证形成的核心环节,这个环节可以将湿证划分为气分湿证和阴分湿证。气分湿证形成的病机是机体内释放出来的热能不足以推动水液及代谢终产物排泄,表现为水肿现象;阴分湿证形成的病机是能量物质不能完全被氧化后在生命体内积聚,并伴有微炎症。基因表达失常参与了气分湿证和阴分湿证的形成。总体而言,能量物质氧化通路受阻是湿证形成的核心,能量物质积聚和水及代谢终产物排泄障碍是湿证形成过程中的实象;氧气摄入和热能产生相对不足是湿证形成过程中的虚象;基因表达和干细胞分裂过程既有增强现象,也有减弱现象。Interactions of Qi(气)and blood in TCM are maintainable of the motion of Qi,and the imbalance of Qi and blood in TCM will induce dampness syndrome.The oxidation of energy agents is an essence in living organisms,and nearly all organic molecules will be oxidized into end metabolites in tricarboxylic acid cycle(TAC)and oxidative phosphorylation(OxPhos).TAC and OxPhos play a crucial role in the pathophysiology of dampness syndrome.All dampness syndromes can be divided into two classes:dampness syndrome induced by abnormal Qi motion and dampness syndrome induced by abnormal Yin(阴)motion.The pathogenesis of dampness syndrome induced by abnormal Qi motion is that no sufficient heat is produced to drive water and end metabolites off our body so that stagnated water dissipation will lead to edema.The pathogenesis of dampness syndrome induced by abnormal Yin motion is that unoxidized energy agents will be accumulated in body coupling with slight inflammation.Aberrant gene expression is involved in pathogenesis of both dampness syndromes.In general,the causality of dampness syndrome is stasis of oxidation of energy agents.Accumulation of energy agents and stagnated dissipation of water and end metabolites belonged to the excess syndromes in dampness syndrome.The deficiencies of oxygen uptake and heat releasing should be regarded as the deficiency syndromes in dampness syndrome.Moreover,in the pathogenesis of dampness syndromes,some gene expression and differentiation pathways of stem cells are facilitated coupling with another gene expression and differentiation pathways of stem cells being attenuated or inhibited.

关 键 词：能量代谢 基因表达 炎症 湿证 气机 

分 类 号：R25[医药卫生—中医内科学]