基于毒邪与络病学说探讨免疫炎症在慢性心力衰竭中作用  

Exploration of the Role of Immune Inflammation in Chronic Heart Failure Based on the Theory of Toxic Pathogens and Collateral Diseases

作　　者：杨梦[1] 苏丽清[1] 胡志希[1] YANG Meng;SU Liqing;HU Zhixi(Hunan University of Chinese Medicine,Changsha 410208,Hunan,China)

机构地区：[1]湖南中医药大学,湖南长沙410208

出　　处：《辽宁中医药大学学报》2024年第6期60-65,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82274412);湖南中医药大学校级课题(Z2023XYJB13)。

摘　　要：慢性心力衰竭(以下简称心衰),是各种心脏疾病的终末期阶段,其发病机制与免疫炎症密切相关。免疫细胞激活后,产生大量炎症因子,损伤心肌细胞,导致心肌纤维化、心室重构等病理改变。“毒损心络”是心衰发生、发展的主要病机,贯穿心衰发展的始终,以不同的形式影响心衰的发展及预后。该文通过查阅相关文献,基于毒邪与络病学说,从免疫炎症与心衰的关系及中药防治进行系统梳理,提出心衰早期,以心气虚为主,兼心气阴虚,尚未化毒、入络;心衰中期,心气亏虚为本,痰浊、瘀血、水饮留滞络脉,有化毒、入络趋势;心衰晚期,痰、瘀、水蕴结成毒,损伤心络。中药以复方治疗为主,多具有益气温阳、化瘀利水、解毒通络之功效,通过恢复M1/M2、Th1/Th2及Th17/Treg细胞之间的动态平衡,调节促炎/抗炎因子,从根本上祛除或缓解因毒邪产生的病理状态,减轻炎症,调整心之气血阴阳,达到扶正祛邪、保护心功能的作用,为临床防治心衰提供指导。Chronic heart failure(CHF)is the end stage of various heart diseases,and its pathogenesis is closely related to immune inflammation.After the activation of immune cells,a large number of inflammatory factors are produced,which damage myocardial cells,leading to pathological changes such as myocardial fibrosis and ventricular remodeling.“Toxic damages the heart collaterals”is the main pathogenesis of the occurrence and development of CHF.It runs through the development of CHF and affects the development and prognosis of CHF in different forms.Based on the theory of toxic pathogens and collateral diseases,this paper systematically sorts out the relationship between immune inflammation and heart failure and the prevention and treatment of traditional Chinese medicine(TCM)by referring to relevant literature,and proposes that in the early stage of CHF,heart Qi deficiency is the main factor,and heart Qi and Yin deficiency are combined.In the middle stage of heart failure,the deficiency of heart Qi is the foundation,phlegm turbidity,blood stasis,and water retention in the collaterals,there is a tendency to dissolve toxins and enter the collaterals;in the late stage of CHF,the accumulation of phlegm,blood stasis and water becomes poisonous,which damages the collaterals.TCM is mainly treated with compound prescriptions,which mostly have the effects of benefiting Qi and Yang,removing blood stasis and diverting water,detoxifying and dredging collaterals.By restoring the dynamic balance between M1/M2,Th1/Th2 and Th17/Treg cells,it regulates pro-inflammatory/anti-inflammatory factors.It can fundamentally eliminate or alleviate the pathological state caused by poisonous pathogens,reduce inflammation,adjust the Qi,blood,Yin and Yang of the heart,achieve the effect of strengthening the righteousness and removing the pathogens,and protecting the heart function,providing guidance for clinical prevention and treatment of CHF.

关 键 词：慢性心力衰竭 毒邪 络病学说 毒损心络 免疫炎症 

分 类 号：R256.2[医药卫生—中医内科学]