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1.中国中医科学院西苑医院,北京 100091
2.中国中医科学院西苑医院 国家中医心血管病临床医学研究中心,北京 100091
3.广东药科大学 研究生院,广州 510006
Received:27 April 2022,
Published Online:12 August 2022,
Published:05 November 2022
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徐仕晗,刘艳飞,刘凤岚等.基于“异病同治”探讨活血解毒法治疗冠心病和认知功能障碍的机制[J].中国实验方剂学杂志,2022,28(21):185-191.
XU Shihan,LIU Yanfei,LIU Fenglan,et al.Mechanism of Blood-activating and Toxin-removing Method in Treatment of Coronary Heart Disease and Cognitive Dysfunction Based on Treating Different Diseases with Same Method[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(21):185-191.
徐仕晗,刘艳飞,刘凤岚等.基于“异病同治”探讨活血解毒法治疗冠心病和认知功能障碍的机制[J].中国实验方剂学杂志,2022,28(21):185-191. DOI: 10.13422/j.cnki.syfjx.20222193.
XU Shihan,LIU Yanfei,LIU Fenglan,et al.Mechanism of Blood-activating and Toxin-removing Method in Treatment of Coronary Heart Disease and Cognitive Dysfunction Based on Treating Different Diseases with Same Method[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(21):185-191. DOI: 10.13422/j.cnki.syfjx.20222193.
我国即将进入深度老龄化社会,多病共存逐渐增加,冠心病与认知功能障碍的发病率也逐年升高,两者相互影响,互为因果,成为危害老年人健康的重大慢病,积极探索对其的中西医结合防治方法具有重大的临床意义。中医对冠心病和认知功能障碍关系的认知最早见于《黄帝内经》,而随着对冠心病和认知功能障碍认识的不断深化,“瘀”与“毒”对两者并病的影响越来越得到学界关注。中医对冠心病和认知功能障碍病因病机的认识具有共通性,“异病同治”理论为中医临床辨治病机相同的不同疾病提供了理论基础,同时也符合现代医学对多病共存整体性和个体化的防治原则。基于此,本文系统提出了“瘀毒互结”为冠心病和认知功能障碍的重要病因病机,探讨了活血解毒方药可能通过调节神经酰胺代谢,激活沉默信息调节因子2相关酶1(SIRT1),抑制细胞焦亡、调节丝裂原活化蛋白激酶/核转录因子-
κ
B(MAPK/NF-
κ
B)信号通路、抑制线粒体分裂和调节DNA甲基化等方面异病同治冠心病和认知功能障碍的作用机制,以期为未来中医药防治冠心病和认知障碍研究提供思路。
As China is about to enter an era of deep aging, the coexistence of multiple diseases is gradually increasing. Coronary heart disease (CHD) and cognitive dysfunction also show increasing incidence year by year. The two diseases affect and cause each other, becoming the major chronic diseases harmful to the health of the elderly. It is of great clinical significance to explore the methods integrating traditional Chinese and western medicine for the prevention and treatment of the two diseases. The relationship between CHD and cognitive dysfunction in traditional Chinese medicine (TCM) was first recorded in
Huangdi’s Internal Classic
(
Huang Di Nei Jing
). As the understanding of CHD and cognitive dysfunction is deepening, the influences of stasis and toxin on both diseases have attracted increasing attention. According to the theories of TCM, CHD and cognitive dysfunction have common points in the etiology and pathogenesis. Therefore, the theory of treating different diseases with same method provides a theoretical basis for the clinical treatment of different diseases with the same pathogenesis. Moreover, this theory conforms to the principle of integrated and individualized prevention and treatment of multi-disease coexistence in modern medicine. This paper systematically proposed that the coexistence of stasis and toxin is a major pathogenesis of CHD and cognitive dysfunction. We then explored the possible mechanisms of the blood-activating and toxin-removing method in the treatment of CHD and cognitive dysfunction based on the theory of treating different diseases with same method. The mechanisms include the regulation of ceramide metabolism, activation of silent mating-type information regulation 2 homolog 1 (SIRT1), inhibition of pyroptosis, regulation of mitogen-activated protein kinase/nuclear factor-
κ
B (MAPK/NF-
κ
B) signaling pathway, inhibition of mitochondrial division, and regulation of DNA methylation. We hope this paper will provide an idea for the future research on the prevention and treatment of CHD and cognitive dysfunction with TCM.
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