基于“虚气留滞”与线粒体自噬探讨慢性心力衰竭的病机与治疗  

Pathogenesis and Treatment of Chronic Heart Failure Based on"Qi Deficiency and Stagnation"and Mitochondrial Autophagy

作　　者：任甜甜 刘如秀[1] 李翠芝 刘金凤[1] 关宣可 常兴 吴巧敏 汪艳丽[1] REN Tiantian;LIU Ruxiu;LI Cuizhi;LIU Jinfeng;GUAN Xuanke;CHANG Xing;WU Qiaomin;WANG Yanli(Guang′anmen Hospital,Chinese Academy of Chinese medical Sciences,Beijing China 100053)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中医学报》2025年第4期728-734,共7页Acta Chinese Medicine

基　　金：中央高水平中医医院临床研究和成果转化能力提升项目(HLCMHPP20230118);中央高水平中医医院临床科研业务费资助项目(HLCMHPP2023053);北京中医药薪火传承“新3+3”工程刘志明门人(刘如秀)传承工作站项目(2023-SZ-G-02);北京中医药薪火传承“新3+3”工程刘志明“三名”传承工作室项目(2023-SZ-F-06);中国中医科学院学部委员学术传承与传播专项项目(CI2022E012XB);中国中医科学院优秀青年科技人才专项项目(ZZ14-YQ-014)。

摘　　要：慢性心力衰竭为本虚标实之证,其核心病机可概括为“虚气留滞”,呈因虚而滞,滞而成虚的动态病机变化。线粒体自噬为线粒体质量控制系统的重要组成部分,在维持细胞内环境稳态中起着至关重要的作用,其功能失调是慢性心力衰竭的重要病理机制。气为化生宇宙万物的源能量,线粒体通过氧化磷酸化过程为细胞提供能量,二者功能相似。线粒体自噬是气化的微观体现,“虚气”是线粒体自噬状态发生改变的关键因素,自噬障碍所致病理性产物积聚与“虚气”引起“留滞”使体内水湿、痰饮、瘀血等邪毒蓄积十分相似。基于“虚气留滞”理论,以补虚通滞为法,中医药可以通过多途径、多靶点调控线粒体自噬,对于慢性心力衰竭的防治具有重要意义。Chronic heart failure is deficiency in root and excess in syndrome and its core pathogenesis can be summarized as"Qi deficiency and stagnation",which is a dynamic pathogenesis of Qi stagnation due to Qi deficiency and Qi stagnation inducing Qi deficiency.Mitochondrial autophagy is an important part of the mitochondrial quality control system,which plays a crucial role in maintaining the homeostasis of the intracellular environment,and its dysfunction is an important pathological mechanism of chronic heart failure.Qi is the source energy that generates everything in the universe,and mitochondria provide energy to cells through the process of oxidative phosphorylation,which is similar in function.Mitochondrial autophagy is the microcosmic embodiment of qi,and"Qi deficiency"is the key factor for the change of mitochondrial autophagy status,and the accumulation of pathologic products due to autophagy obstacles and the"Qi stagnation"caused by"Qi deficiency"is like the evil factor and Toxin accumulation of Water and Dampness,blood stasis and stagnation within the body.Based on the theory of"Qi stagnation and deficiency",with tonifying method and stagnation dredging method,Chinese medicine can regulate mitochondrial autophagy through multiple pathways and targets,which is of great significance for the prevention and treatment of chronic heart failure.

关 键 词：慢性心力衰竭 虚气留滞 线粒体自噬 补虚通滞法 

分 类 号：R256.29[医药卫生—中医内科学]