基于“心受气于脾”理论探讨心力衰竭线粒体生物合成障碍机制及中医药治疗  

Mechanism of Mitochondrial Biosynthesis Disorder in Heart Failure Based on Theory of"Heart Receiving Qi from Spleen"and TCM Treatment of Heart Failure

作　　者：张斐 刘承鑫 魏佳明 王子焱 俞赟丰 高翎薇 郭志华[2,3,4] ZHANG Fei;LIU Chengxin;WEI Jiaming;WANG Ziyan;YU Yunfeng;GAO Lingwei;GUO Zhihua(College of Chinese Medicine,Hunan University of Chinese Medicine,Changsha Hunan China 410208;The First Clinical College of Chinese Medicine,Hunan University of Chinese Medicine,Changsha Hunan China 410208;Hunan Key Laboratory of Colleges and Universities of Intelligent Traditional Chinese Medicine Diagnosis and Preventive Treatment of Chronic Diseases of Hunan Universities of Chinese Medicine,Changsha Hunan China 410208;Hunan Provincial Intelligent Research Platform for the Treatment and Health Care of Heart and Brain Chronic Diseases by Classical Chinese Medicine Formulas,Changsha Hunan China 410208)

机构地区：[1]湖南中医药大学中医学院,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410208 [3]湖南中医药大学慢病中医智能诊断与治未病湖南省普通高等学校重点实验室,湖南长沙410208 [4]湖南省心脑慢病中医经典名方证治与养生智能化研究平台,湖南长沙410208

出　　处：《中医学报》2025年第2期261-267,共7页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81673955);湖南省卫生健康委员会中医药科研基金项目(2021029)。

摘　　要：线粒体生物合成障碍时,心肌细胞的能量代谢会发生紊乱,导致心肌细胞的结构和功能紊乱,最终诱发心力衰竭(heart failure, HF)。“心受气于脾”理论揭示了心与脾在五行属性、经络关系和脏腑功能之间的相关性。基于“心受气于脾”理论认为,脾阳气虚、血瘀水停是HF线粒体生物合成障碍的基本病机,脾阳气虚直接导致了线粒体生物合成障碍,而血瘀水停通过氧化应激途径间接导致了线粒体生物合成障碍。因此,临证治疗HF当以温补脾气、化瘀利水为治则。补阳还五汤、暖心康、芪参益气方、心复康口服液、养心氏片、冠心舒通胶囊、强心方、强心康颗粒、参附益心方、温阳补心汤、参葵通脉颗粒等中药复方和黄芪多糖、人参皂苷、三七总皂苷、红景天苷、姜黄素等中药有效成分均有调控HF线粒体生物合成的作用。When mitochondrial biosynthesis is impaired,the energy metabolism of cardiomyocytes will be disturbed,leading to structural and functional dysfunction of cardiomyocytes,and eventually inducing heart failure(HF).The theory of"Heart receiving Qi from Spleen"reveals the correlation between the Heart and the Spleen in terms of the properties of the lineage,meridian relationship and the functions of the internal organs.Based on the theory of"Heart receiving Qi from Spleen",it is believed that Spleen Yang Qi deficiency and blood stasis and Water stagnation are the basic pathomechanisms of mitochondrial biosynthesis disorders in HF.Spleen Yang Qi deficiency directly leads to mitochondrial biosynthesis disorders,and blood stasis and Water stagnation indirectly lead to mitochondrial biosynthesis disorders through the pathway of oxidative stress.Therefore,the treatment of HF should be based on warming Spleen Qi,resolving blood stasis and inducing Water retention.Traditional Chinese medicinal compounds,such as Buyang Huanwu Decoction,Nuanxin Kang,Qishen Yiqi Formula,Xinfukang Oral Liquid,Yangxinshi Tablets,Guanxin Shutong Capsules,Qiangxin Formula,Qiangxinkang Granules,Shenfu Yixin Formula,Wenyang Buxin Decoction,and Shenkui Tongmai Granules,as well as active components of traditional Chinese medicines such as astragali polysaccharides,ginsenosides,panax ginseng saponins,rhodiola rosea glycosides,curcumin,etc.,have been shown to modulate the biosynthesis of mitochondria in HF.

关 键 词：“心受气于脾” 心力衰竭 线粒体生物合成 中医药 

分 类 号：R259[医药卫生—中西医结合]