基于“内质网-线粒体”互通论心肌梗死后抑郁“瘀虚痰热”之机  

Mechanism of“Stasis,Deficiency,Phlegm,and Heat”in Depression after Myocardial Infarction Based on“Endoplasmic Reticulum-mitochondria”Interconnection

作　　者：刘祥 侯季秋 赵海滨[2] 孙治琪 赵维哲 郜亚茹 LIU Xiang;HOU Jiqiu;ZHAO Haibin;SUN Zhiqi;ZHAO Weizhe;GAO Yaru(Beijing University of Chinese Medicine,Beijing 100000,China;Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100071,China)

机构地区：[1]北京中医药大学,北京100000 [2]北京中医药大学东方医院,北京100071

出　　处：《世界中医药》2024年第18期2840-2845,共6页World Chinese Medicine

基　　金：国家自然科学基金项目(82174332);北京市自然科学基金项目(7202126)。

摘　　要：双心疾病主要指心脏和心理同病,心肌梗死后抑郁是常见的双心疾病。心肌梗死后,患者容易出现抑郁等不良情绪,而抑郁情绪又是诱发不良心血管事件的重要危险因素。瘀、虚、痰、热作为心肌梗死后抑郁的重要病因,可单独或相兼致病,故临床上常用活血养血、化痰清心之法以达到瘀、虚、痰、热共治的目的。同时,现代医学认为内质网应激引起线粒体相关内质网膜(MAM)钙稳态失衡是导致线粒体钙超载损伤的内在机制,本文从该角度阐释心肌梗死后抑郁的内在机制,为临床治疗提供新的参考。Psycho-cardiological disease primarily refers to the co-occurrence of cardiac and psychological disorders,with post-myocardial infarction(MI)depression being a common example.After an MI,patients often experience adverse emotions like depression,which significantly increases the risk of negative cardiovascular events.Stasis,deficiency,phlegm,and heat are key pathological factors contributing to post-MI depression,and they can act independently or synergistically.Clinically,therapies such as activating and nourishing blood,resolving phlegm,and clearing heat are commonly used to address stasis,deficiency,phlegm,and heat collectively.Moreover,modern medicine suggests that endoplasmic reticulum(ER)stress leading to imbalances in calcium homeostasis at the mitochondria-associated ER membranes(MAM)is an intrinsic mechanism causing mitochondrial calcium overload and damage.This study elucidates the underlying mechanisms of post-MI depression from this perspective and offers new insights for clinical treatment strategies.

关 键 词：心肌梗死后抑郁 机制 内质网应激 线粒体钙超载 钙稳态 瘀虚痰热 活血养血 化痰清心 

分 类 号：R256.2[医药卫生—中医内科学]