基于血浊理论探讨氧化应激与心肌纤维化的关系及中医辨治  

Exploration on the relationship between oxidative stress and myocardial fibrosis based on the theory of turbid blood and the traditional Chinese medicine differentiation and treatment

作　　者：贾思涵 连妍洁 尚菊菊[1] 刘红旭[1] 李思耐[1,3] JIA Sihan;LIAN Yanjie;SHANG Juju;LIU Hongxu;LI Sinai(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;Capital Medical University,Beijing 100069,China;Beijing Institute of Traditional Chinese Medicine,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]首都医科大学 [3]北京市中医药研究所

出　　处：《北京中医药大学学报》2024年第6期741-746,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(No.82174106);国家中医药管理局中医药循证能力建设项目-专科专病循证能力提升(No.2019XZZX-XXG001);首都医科大学附属北京中医医院科技发展基金资助项目(No.LYYB202303)。

摘　　要：心肌纤维化以细胞外基质病理性重构为主要特征,是多种心血管疾病发展至一定阶段的共同病理改变。脏腑气化失常,精微积聚停滞,血浊内生,导致疾病发生,血浊理论被广泛用于解释疾病的病理变化,并指导疾病的预防与治疗。血浊作为特殊的致病因素与病理产物,在心肌纤维化氧化应激过程中发挥了关键作用。心脾气虚,血浊伏脉,心血不畅,无力维持心肌细胞氧化还原系统平衡,为病起之本。血浊蓄积,痰瘀互结,心脉壅塞,代谢产物积累为病进之渐。浊久蕴毒,心体胀大,心神涣散,细胞外基质重构为病重之势。治疗早期以扶正运脾、降浊复清为主,中期以化痰逐瘀、祛浊留清为要,晚期以解毒化浊、和脉复清为重。遵循病机特点运用中药干预,可以抑制氧化应激,避免细胞外基质病理性重构,改善心肌纤维化。Myocardial fibrosis is characterized by pathological remodeling of extracellular matrix,which is a common pathological change during the development of various cardiovascular diseases.Qi transformation dysfunction in the zang-fu organs,subtle substance accumulation,and endogenous turbid evil production lead to the occurrence of diseases.The theory of turbid blood is widely used to elucidate the pathological changes of diseases and guide the prevention and treatment.Turbid blood,as a special pathogenic factor and pathological product,plays a crucial role in the oxidative stress process of myocardial fibrosis.Qi deficiency of the heart and spleen,stagnation of turbid blood,impaired blood circulation in the heart,and the inability to maintain the oxidative-reductive system balance of myocardial cells are the root causes of disease onset.Accumulation of turbid blood,intermingled phlegm and blood stasis,blockage of heart vessels,and accumulation of metabolic waste products contribute to disease progression.Prolonged turbidity accumulation leads to cardiac enlargement,scattered mental state,and pathological remodeling of the extracellular matrix,indicating a severe disease stage.Early treatment focuses on strengthening the vital qi and spleen,reducing turbidity and recovering clarity.In the middle stage,the key is to resolve phlegm,eliminate stasis,and promote clarity while removing turbidity.In the late stage,detoxification,turbidity elimination,and restoring clarity are emphasized.By adhering to the characteristics of the pathological mechanism and using traditional Chinese medicine intervention,it is possible to suppress oxidative stress,prevent pathological remodeling of the extracellular matrix,and improve myocardial fibrosis.

关 键 词：血浊理论 心肌纤维化 氧化应激 辨证论治 

分 类 号：R256.29[医药卫生—中医内科学]