基于“气化理论”探讨细胞自噬在骨髓增生异常综合征中的作用  

Exploring the Role of Cellular Autophagy in Myelodysplastic Syndrome Based on“Qi Transformation Theory”

作　　者：朱义文 谌海燕[2] 王文儒 丁晓庆[2] ZHU Yiwen;CHEN Haiyan;WANG Wenru;DING Xiaoqing(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing Univsity of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《中医药学报》2024年第8期1-6,共6页Acta Chinese Medicine and Pharmacology

基　　金：北京市科技计划项目(Z161100000516059);北京中医药大学新教师启动基金项目(2023-JYB-XJSJJ044);中华中医药学会委托课题(202169-004)。

摘　　要：气化理论是中医基础理论之一,气机是气化的基础,气化是气机的根本,二者的协调作用是维持脏腑功能正常的关键,气机、气化失常是导致疾病发生的重要因素。细胞自噬通过机体降解大分子物质、蛋白质及细胞器以防御外邪入侵,作为一种机体防御机制在代谢、免疫方面与中医“气”的功能类似。骨髓增生异常综合征(MDS)在中医中属于“髓毒劳”“虚劳”,以本虚标实为特点,肾虚为本,阳虚无以温煦推动,气化失常,水液代谢障碍,痰浊、瘀血、邪毒形成,久居骨髓而发病。本文通过气化理论分析MDS的自噬机制,将中医“气化理论”与MDS中细胞自噬相结合,寻找其中的关系及内在联系,认为气化失常是MDS发病的主要病机,提出以补虚扶正、化痰解毒、填精益髓、温阳化气为治则,调畅气机,协调阴阳,延缓MDS进程,改善MDS患者临床症状,为MDS的临床诊疗提供新思路。Qi transformation theory is one of the fundamental theories of traditional Chinese medicine(TCM).Qi movement is the foundation of qi transformation,and qi transformation is the basis of qi movement.The coordination between the two is the key to maintaining the normal function of the viscera and bowels.Abnormalities in qi movement and qi transformation are important factors leading to the occurrence of diseases.Autophagy defies the invasion of external pathogen by degrading macromolecules,proteins and organelles.As a defense mechanism,autophagy is similar to the function of qi in TCM in terms of metabolism and immunity.Myelodysplastic syndrome(MDS)in TCM belongs to the categories of“marrow toxin fatigue”or“deficiency fatigue”.It is characterized by deficiency in root and excess in superficiality.Kidney deficiency is the root problem in this case.Because,in this case,yang is in deficiency and fails to warm and propel,leading to failure in qi transformation,water metabolism disorders,phlegm turbidity formation,blood stasis,and pathogenic toxin formation.If pathogenic toxin resides in the bone marrow for a long time,myelodysplastic syndrome will arise.This article analyzes the autophagy mechanism of MDS through the theory of qi transformation,combines qi transformation with cellular autophagy in MDS,in order to explore the relationship between the two.We believe that qi transformation abnormality is the main pathogenesis in the occurrence of MDS.Therefore,we put forward the treatment principles of tonifying deficiency and reinforcing the healthy qi,resolving phlegm and relieving toxin,filling essence and benefiting the marrow,and warming yang and transforming qi.This way,we can regulate qi movement,coordinate yin and yang,in order to delay the process of MDS,improving the clinical symptoms,and providing new ideas for the clinical diagnosis and treatment of MDS.

关 键 词：气化理论 细胞自噬 骨髓增生异常综合征 

分 类 号：R22[医药卫生—中医基础理论]