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1.成都中医药大学 附属医院,成都 610072
2.成都中医药大学 附属医院 针灸学校,成都 610097
3.重庆市涪陵区人民医院,重庆 408000
Received:06 September 2021,
Published Online:22 October 2021,
Published:20 December 2021
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冯皓月,李慧,刘天一等.从“阳明有余”理论探讨“肠道-宿主免疫”失衡在糖尿病大血管病变中的作用[J].中国实验方剂学杂志,2021,27(24):219-226.
FENG Hao-yue,LI Hui,LIU Tian-yi,et al.Role of Imbalance of "Gut-Host Immunity" in Diabetic Macroangiopathy: An Exploration Based on Theory of "Superabundance of Yangming"[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(24):219-226.
冯皓月,李慧,刘天一等.从“阳明有余”理论探讨“肠道-宿主免疫”失衡在糖尿病大血管病变中的作用[J].中国实验方剂学杂志,2021,27(24):219-226. DOI: 10.13422/j.cnki.syfjx.20212425.
FENG Hao-yue,LI Hui,LIU Tian-yi,et al.Role of Imbalance of "Gut-Host Immunity" in Diabetic Macroangiopathy: An Exploration Based on Theory of "Superabundance of Yangming"[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(24):219-226. DOI: 10.13422/j.cnki.syfjx.20212425.
糖尿病大血管病变是以大血管床内持续动脉粥样硬化(AS)为特点的糖尿病主要并发症之一。糖脂代谢紊乱诱发的大血管区域内皮损伤是糖尿病继发AS的始动因素,其与糖尿病和AS已知的共同病理基础——免疫炎症之间的相互作用是糖尿病大血管病变进程中的关键环节。人类饮食模式的转变,导致与能量稳态相关的糖尿病及其并发症发病率急剧增加。最近的研究表明,肠道微生物群的组成和功能及相关衍生分子的改变伴随着糖尿病继发AS,而“肠道-宿主免疫”失衡可能是诱发大血管并发症的重要途径。中医药对糖尿病及其并发症的研究已形成独特的理论和临床体系,其中“阳明”在分布及功能上与肠道微生态类似。糖尿病起于阳明炽盛,糖尿病大血管病变继发于糖尿病,始动之因亦在阳明,即肠道微生态系统。阳明失约,燥气亢盛,可能促使宿主免疫细胞增殖,释放大量炎症介质弥漫脉道,阻碍血流运行,化生瘀血与脉中留滞的糖脂浊邪交织,最终形成斑块附着脉壁。因此,以《黄帝内经》“阳明有余,病脉痹”理论为切入点,从宏观及微观角度剖析肠道微生态与免疫炎症交互作用对糖脂代谢的影响,将有助于揭示中医药通过调控“肠道-宿主免疫”治疗糖尿病大血管病变的科学内涵并指导临床组方思路。
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