基于“线粒体动力学”机制探讨糖尿病心肌病“壮火食气”的科学内涵

来源:用户上传      作者:陈丽娟　文颖娟　仝武宁

　　 〔摘要〕 基于典中医理论及现有科学研究发现，“壮火食气”不仅是糖尿病心肌病（diabetic cardiomyopathy， DCM）发病的原因，更是影响DCM病程发展的重要因素，贯穿DCM发展过程始终。作为影响DCM的“线粒体动力学”机制与“壮火食气”理论也存在广泛且深刻的联系。首先“心气”的推动调控与线粒体动力学的能量调控有异曲同工之妙。其次，饮食失宜、情志失常、劳欲失度等“壮火”，损耗心气，心气不足致浊邪凝滞，心脉痹阻，心搏无力的状态，与糖脂代谢紊乱及胰岛素抵抗造成线粒体动力学失衡，从而引起心肌损伤导致泵血功能障碍的现象如出一辙。还基于“壮火食气”提出“气火并治”对于治疗DCM的指导意义。有望为DCM临床的治疗提供新思路。同时，还提出以“壮火食气-代谢失衡-线粒体动力学”为理论框架，调控线粒体动力学以治疗DCM，发挥心脏保护作用的猜想。为深入探究DCM的发病与治疗机制的研究提供了新方向。
　　 〔关键词〕 糖尿病心肌病;壮火食气;线粒体动力学;气火并治;心气;心肌损伤;代谢失衡
　　 〔中图分类号〕R259 〔文献标志码〕A 〔文章编号〕doi：10.3969/j.issn.1674-070X.2022.05.021
　　Discussion on the scientific connotation of “vigorous fire consumes Qi” in diabetic
　　cardiomyopathy based on “mitochondrial dynamics” mechanism
　　CHEN Lijuan， WEN Yingjuan TONG Wuning
　　（Shaanxi University of Chinese Medicine， Xianyang， Shaanxi 712046， China）
　　〔Abstract〕 Based on classical traditional Chinese medicine theory and existing scientific research， "vigorous fire consumes Qi" is not only the cause of diabetic cardiomyopathy （DCM）， but also an important factor affecting the development of DCM， which runs through the advance of DCM. The mechanism of "mitochondrial dynamics" in DCM has a broad and profound relationship with the theory of "vigorous fire consumes Qi". Firstly， the promotion of "heart Qi" is similar to the energy regulation of mitochondrial dynamics. Secondly， under the "vigorous fire" caused by eating inappropriately， emotional disorders， loss of labor， resulting in the deficiency of heart Qi， which leads to the state of turbid evil stagnation， obstruction of cardiovascular and weakness of heart function， which is similar to the phenomenon of disorders of glucose and lipid metabolism and insulin resistance， resulting in imbalances in mitochondrial dynamics， which cause myocardial damage and lead to blood pumping dysfunction. Based on "vigorous fire consumes Qi"， the essay also puts forward the guiding significance of "treating both Qi and fire"， so that can be propitious to provide a new idea for the clinical treatment of DCM. At the same time， a conjecture about protecting the heart is proposed based on the theoretical framework of "vigorous fire consumes Qi-metabolic imbalance-mitochondrial dynamics" to regulate mitochondrial dynamics for the treatment of DCM. It provides a new direction for further study on the pathogenesis and treatment mechanism of DCM.
　　〔Keywords〕 diabetic cardiomyopathy; vigorous fire consumes Qi; mitochondrial dynamics; treating both Qi and fire; heart Qi; myocardium damage; metabolic imbalance

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