摘要
慢性心力衰竭是多种心血管疾病的终末期阶段,心肌损伤后,免疫介导的Th17、Treg细胞在心衰的发病机制具有关键作用,通过分泌炎症因子,导致心肌纤维化、心室重塑。中医正邪理论内涵丰富,对于认识Th17/Treg细胞与心衰的发展及相互作用具有指导意义,隶属于正邪理论范畴,即Th17/Treg细胞平衡,有利于维持机体的免疫平衡,属于“正气”范畴;Th17/Treg细胞失衡可能破坏机体内环境的稳定,导致免疫异常,促进疾病的发生,属于“邪气”范畴。基于此,作者以正邪理论为切入点,从宏观、微观角度来阐述Th17/Treg细胞在慢性心力衰竭发展中的作用,提出心衰早期,正虚为主,邪实为辅;心衰中期,正虚邪实;心衰晚期,邪实为主,正虚为辅;心衰终末期,正虚为主。临床通过扶正祛邪,调整机体正邪平衡,恢复机体Th17/Treg细胞的动态平衡,以期为中医理论阐述Th17/Treg在心衰的发展作用的现代研究奠定基础,为心衰的诊治提供新的理论依据。
Chronic heart failure is the end-stage of many cardiovascular diseases.After myocardial injury,immune-mediated Th17 and Treg cells have a key role in the pathogenesis of heart failure,which can lead to myocardial fibrosis and ventricular remodelling through the secretion of inflammatory factors.Theory of healthy Qi and pathogenic Qi in TCM is rich in connotations and which is a strong guide to understanding the development and interaction between Th17/Treg cells and heart failure.The imbalance of Th17/Treg cells may destabilise the body's internal environment,leading to immune abnormalities and promoting the occurrence of disease,which belongs to the category of“evil Qi”.Based on this,the author intends to use the theory of positive and evil as the entry point to elaborate the role of Th17/Treg cells in the development of chronic heart failure from both macroscopic and microscopic perspectives,proposing that in the early stage of heart failure,positive deficiency is dominant and evil is complementary;in the middle stage of heart failure,positive deficiency and evil are real;in the late stage of heart failure,evil is dominant and positive deficiency is complementary;and in the end stage of heart failure,positive deficiency is dominant.The clinical approach is to restore the dynamic balance of Th17/Treg cells in the body by supporting the balance of positive and evil,with a view to laying the foundation for modern research on the role of Th17/Treg in the development of heart failure as elaborated by TCM theory,and providing a new theoretical basis for the diagnosis and treatment of heart failure.
作者
杨梦
胡思远
李琳
王梓仪
胡志希
YANG Meng;HU Siyuan;LI Lin;WANG Ziyi;HU Zhixi(Hunan University of Chinese Medicine,Changsha 410208,Hunan,China;Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)
出处
《辽宁中医药大学学报》
CAS
2024年第4期153-158,共6页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家自然科学基金项目(82274412)
湖南中医药大学校级课题(Z2023XYJB13)。
关键词
慢性心力衰竭
TH17/TREG细胞
正邪理论
中药干预
chronic heart failure
Th17/Treg cells
theory of healthy Qi and pathogenic Qi
herbal intervention
