基于“肺虚络瘀”病机观探讨血小板活化与特发性肺纤维化的作用机制  

Discussion on the mechanism of platelet activation and idiopathic pulmonary fibrosis based on the pathogenesis of lung deficiency and collateral blood stasis

作　　者：刘勇明[1] 吕晓东[1] 庞立健[2] 臧凝子[2] 王靖宇 梁元钰 王佳然 刘妍彤 邹吉宇 LIU Yongming;LYU Xiaodong;PANG Lijian;ZANG Ningzi;WANG Jingyu;LIANG Yuanyu;WANG Jiaran;LIU Yantong;ZOU Jiyu(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China;The First Hospital of China Medical University,Shengyang110001,China)

机构地区：[1]辽宁中医药大学,沈阳110847 [2]辽宁中医药大学附属医院,沈阳110032 [3]中国医科大学附属第一医院,沈阳110001

出　　处：《中华中医药杂志》2025年第2期569-574,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金青年科学基金项目(No.82204993,No.82204787);国家自然科学基金面上项目(No.82274440);国家中医药管理局中医络病重点学科项目(No.国中医药人教函[2023]85号);吕晓东辽宁省名中医传承工作室建设项目(No.辽中医药函[2021]1号);辽宁省自然科学基金联合基金(面上资助计划项目)(No.2023-MSLH-183);辽宁省教育厅青年科技人才“育苗”项目(No.L202029);辽宁中医药大学自然科学类重点项目(No.2021LZY040)。

摘　　要：以“肺虚络瘀”病机观为理论指导,对特发性肺纤维化(IPF)血小板活化发病机制加以阐述,提出IPF血小板活化能够通过成纤维细胞和肌成纤维细胞异常增殖、调控免疫细胞相互作用、激活上皮细胞间充质转化以及促进炎症因子分泌等多种途径参与IPF进程。IPF血小板活化与“肺虚络瘀”具有相同的病机演变格局,益气养阴活血通络法能够抑制血小板活化水平,延缓IPF进程。将传统病机观念与微观病理变化相互融合,基于“肺虚络瘀”病机观探讨IPF血小板活化作用机制,对于丰富中医络病理论科学内涵具有重要意义,同时为筛选以血小板活化效应为作用靶点的防治IPF药物发展提供新的研究策略及科学依据。Guided by the pathogenesis of lung deficiency and collateral blood stasis',this paper expounds the pathogenesis of platelet activation in idiopathic pulmonary fibrosis(IPF)and proposes that IPF platelet activation can participate in the IPF process through various ways,such as abnormal proliferation of fibroblasts and myofibroblasts,regulation of immune cell interaction,activation of epithelial-mesenchymal transformation,and promotion of inflammatory factor secretion.IPF platelet activation has the same pathological evolution pattern as'lung deficiency and collateral blood stasis',and the method of benefiting qi,nourishing yin,promoting blood circulation and dredging collateral can inhibit platelet activation levels and delay the progression of IPF.Integrating traditional pathogenesis concepts with microscopic pathological changes and exploring the mechanism of IPF platelet activation based on the pathogenesis of'lung deficiency and collateral blood stasis'are of great significance for enriching the scientific connotation of traditional Chinese medicine collateral disease theory.At the same time,it provides new research strategies and scientific basis for screening drugs targeting of platelet activation to prevent and treat IPF.

关 键 词：特发性肺纤维化 肺虚络瘀 血小板活化 微观辨证 

分 类 号：R259[医药卫生—中西医结合]