基于线粒体自噬探讨扩张型心肌病“虚气留滞”的生物学内涵  

Biological Connotation of"Qi Deficiency Induced Phlegm Stagnation"of Dilated Cardiomyopathy Based on Mitochondrial Autophagy

作　　者：高晓宇 吉锋 李星星 陈学彬 GAO Xiaoyu;JI Feng;LI Xingxing;CHEN Xuebin(Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712046;The Affiliated Hospital to Shaanxi University of Chinese Medicine,Xianyang Shaanxi China 712000)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《中医学报》2024年第10期2035-2041,共7页Acta Chinese Medicine

基　　金：陕西省教育厅重点科学研究计划项目(重点实验室项目)(23JS012);陕西省自然科学基金项目(2021JM-481)。

摘　　要：线粒体主要通过选择性隔离和降解结构或功能不完整的线粒体的自噬方式参与维持细胞稳态,从而延缓扩张型心肌病损害。线粒体自噬是中医“气化”的微观体现,而线粒体自噬不足则更能阐释“虚气”的具体机制,线粒体自噬不足可生成诸多病理性产物,与“虚气”引起“留滞”而使体内蓄积大量痰浊、瘀血、水饮等实性病理要素的过程具有密切联系。故线粒体功能障碍诱发病理改变与中医“虚气留滞”的病理机制现象相仿。基于此,线粒体自噬程序可通过益气、养心、补脾、固肾等“补虚”之法与祛瘀、化痰、利湿、活络等“通滞”之法相结合,标本共治,以维持人体内环境稳态,增强心脏功能,延缓扩张型心肌病进程,提高生存质量,改善预后,预防并发症的出现。Mitochondria are mainly involved in maintaining cellular homeostasis by selectively sequestering and degrading structural or functional mitochondria in an autophagic manner,thereby delaying the damage of dilated cardiomyopathy.Mitophagy is the microscopic embodiment of"Qihua"in traditional Chinese medicine,and insufficient mitochondrial autophagy can better explain the specific mechanism of"deficiency of Qi",which can produce many pathological products.It is closely related to the process of accumulation of solid pathological elements such as Phlegm and Turbidity,blood stasis,and Water Phlegm in the body caused by"Qi stagnation"due to"deficiency of Qi".Therefore,the pathological changes induced by mitochondrial dysfunction are like the pathological mechanism phenomenon of"deficiency Qi induced Phlegm retention"in traditional Chinese medicine.Based on this,the mitochondrial autophagy program can operate with the methods of"replenishing the deficiency"such as invigorating Qi,nourishing the Heart,tonifying the Spleen and strengthening the Kidney combined with the methods of"dredging the stagnation"such as removing stasis,dissolving Phlegm,relieving dampness,and activating the meridians,so as to maintain the homeostasis of the human body,enhance cardiac function,delay the process of dilated cardiomyopathy,improve the quality of life,improve prognosis,and prevent the occurrence of complications.

关 键 词：扩张型心肌病 线粒体自噬 虚气留滞 补虚通滞法 

分 类 号：R259.41[医药卫生—中西医结合]