基于免疫炎症探析心血管疾病中医证候特点及临床意义  

Exploring the syndromes characteristics and clinical significance of cardiovascular disease in Traditional Chinese Medicine based on immune inflammation

作　　者：何佳玲 余润佳 关卓骥 单伟 王陵军 冼绍祥[2,4] HE Jialing;YU Runjia;GUAN Zhuoji;SHAN Wei;WANG Lingjun;XIAN Shaoxiang(The First School of Clinical Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第一临床医学院,510405 [2]广州中医药大学第一附属医院岭南心血管病研究所 [3]广州中医药大学第一附属医院岭南医学研究中心 [4]广东省中医临床研究院

出　　处：《环球中医药》2024年第7期1274-1280,共7页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(82174316);广州市科技计划重点研发计划项目(202206080015);深圳市“医疗卫生三名工程项目”(SZZYSM202106006);岐黄学者冼绍祥工作室(国中医药人教函〔2021〕203号)。

摘　　要：免疫炎症是心血管疾病的基本病理机制,本质是由于机体炎症免疫相关细胞受内外刺激因素作用下所表现出的异常系统反应,包括免疫紊乱与过度炎症反应。中医认为,心血管疾病根本病机为本虚标实,本虚以气虚、阳虚为主,标实包括气滞、血瘀、痰湿、热毒等。免疫功能与正气密切相关,机体免疫功能紊乱,正气虚弱,不可抵御邪气,致使气虚、气滞,进而阳虚、火郁。免疫紊乱进一步加剧炎症反应,火热之邪渐盛,蓄积成毒,毒损心脉,造成局部组织变性坏死,类似变质性炎症;气阳亏虚,形成水湿痰饮之邪,积久化浊,阻碍津液代谢,水液不循常道,大量外渗,类似渗出性炎症;正虚日久成瘀,痰瘀互结,结久成积,阴盛成形,心肌纤维化进展加快,类似增生性炎症。因此,益气扶正、疏肝理气、清热解毒、化痰除湿、活血化瘀等中医治法可以有效调节心血管疾病炎症免疫反应。本文从中医角度集中探索免疫炎症与心血管疾病证候的内在联系,以期为临床治疗心血管疾病提供新的治疗思路。Immune inflammation is the basic pathological mechanism of kinds of cardiovascular diseases(CVD),which is essential due to the body’s inflammatory immune-related cells by the role of internal and external stimuli showing an abnormal systemic response,including immune disorders and excessive inflammatory.According to Traditional Chinese Medicine(TCM),the underlying pathology of CVD belongs to deficiency in origin and excess in superficiality.The deficiency in origin often dominated by qi and yang deficiency,and the excess in superficiality includes qi impediment,blood stasis,phlegm-dampness,heat-toxicity and so on.The immune function is often closely related to the healthy qi.Immune dysfunction and the weakness of healthy qi,inability to resist the invasion of pathogen factors,it leads to qi deficiency and qi impediment,then transforming into yang deficiency and fire.Immune disorders further exacerbate the inflammatory response.Fire and heat evil gradually flourish,accumulate into toxic,toxic damage to the heart and vessels,causing local tissue degeneration and necrosis,similar to metamorphic inflammation.Qi and yang deficiency leads to the formation of dampness,phlegm and retained fluid,these water can exude the vessel and become turbid after a long period of accumulation,similar to exudative inflammation.The healthy qi deficiencies leads to blood stasis after a long time,then blood stasis and phlegm intermingle,the yin constituting form,the myocardial fibrosis is accelerated,similar to proliferative inflammation.Based on this,treatments in TCM such as benefiting and correcting qi,disperse the liver and rectify qi,clearing heat and removing toxins,transform phlegm and remove dampness and activating blood circulation and removing blood stasis can effectively regulate the inflammatory immune response of CVD and reduce the inflammatory damage.This paper concentrates on exploring the intrinsic connection between immune inflammation and CVD syndromes in Chinese medicine,which provides new therapeutic ideas for clini

关 键 词：免疫炎症 心血管疾病 中医证候 相关性 机制 

分 类 号：R259[医药卫生—中西医结合]