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湖南中医药大学,长沙 410208
Received:11 March 2026,
Revised:2026-05-07,
Accepted:12 May 2026,
Online First:20 May 2026,
Published:20 October 2026
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张宇彬,廉坤,叶嘉豪等.基于“命门动气”理论探讨中药干预线粒体质量控制对慢性心衰的影响[J].中国实验方剂学杂志,2026,32(20):269-280.
ZHANG Yubin,LIAN Kun,YE Jiahao,et al.Exploring Effect of Traditional Chinese Medicine Interventions on Mitochondrial Quality Control in Chronic Heart Failure Based on Theory of "Mingmen Dongqi"[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(20):269-280.
张宇彬,廉坤,叶嘉豪等.基于“命门动气”理论探讨中药干预线粒体质量控制对慢性心衰的影响[J].中国实验方剂学杂志,2026,32(20):269-280. DOI: 10.13422/j.cnki.syfjx.20260617.
ZHANG Yubin,LIAN Kun,YE Jiahao,et al.Exploring Effect of Traditional Chinese Medicine Interventions on Mitochondrial Quality Control in Chronic Heart Failure Based on Theory of "Mingmen Dongqi"[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(20):269-280. DOI: 10.13422/j.cnki.syfjx.20260617.
慢性心力衰竭(CHF)作为各类心血管疾病的终末阶段,具有病程迁延、致死率高等特点,严重威胁人类生命健康。该文基于明代医家孙一奎“命门动气”学说,结合现代医学线粒体质量控制(MQC),系统探讨CHF的病机演变规律及其与微观结构稳态之间的内在联系,进一步提出中药干预策略。CHF初期多因心气受损,随病程迁延,“久病及肾”致命门动气衰微;动气衰微致“维系固摄”失职则形体离散,对应线粒体动力学紊乱;“原动力”匮乏则气化无力,对应线粒体自噬异常,形成“命门-线粒体”病理传导链,最终导致心肌结构崩解与能量代谢衰竭。现代研究表明,CHF患者存在显著的MQC失衡,线粒体动力学紊乱致网络碎片化、自噬障碍致代谢受阻,构成其心室重构与泵功能衰竭的关键微观环节。温补肾阳、益气扶正等各类中药可通过多靶点干预PTEN诱导激酶1/帕金蛋白(PINK1/Parkin)、腺苷酸活化蛋白激酶/动力相关蛋白1(AMPK/Drp1)等信号通路,调节线粒体动力学平衡与自噬活性,进而修复受损的MQC网络,改善心肌能量代谢微环境。该干预策略与中医“温补命门、益气活血”治法高度契合,体现了从肾论治、以线粒体为靶点的整体调节优势。该文通过整合“命门动气”理论与MQC机制,构建中西医结合防治CHF的理论框架,为临床实践与后续研究提供了新视角与思路。
Chronic heart failure (CHF), as the terminal stage of various cardiovascular diseases, is characterized by a prolonged course and a high mortality rate, posing a serious threat to human health and life. According to physician Sun Yikui's theory of "Mingmen Dongqi" (dynamic Qi of life gate) in the Ming Dynasty and the modern medicine concept of mitochondrial quality control (MQC), this paper systematically explores the pathogenic mechanisms and evolutionary patterns of CHF, as well as its intrinsic connection with microstructural homeostasis, and further proposes potential traditional Chinese medicine (TCM) intervention strategies. CHF is often caused by damage to the heart Qi at the early stage. As the disease progresses, prolonged illness affects the kidneys, leading to the dynamic Qi decline of life gate. Further, it results in the failure of the functions of sustaining and consolidating, causing the disintegration of the physical form, which corresponds to mitochondrial kinetic disorders. The deficiency in primary driving force results in impaired Qi transformation, corresponding to mitochondrial autophagy dysfunction, forming a pathological transmission chain of "life gate-mitochondrion" that ultimately leads to myocardial structural disintegration and energy metabolism failure. Modern research indicates that patients with CHF exhibit significant MQC imbalance. Disrupted mitochondrial dynamics lead to network fragmentation, and impaired autophagy causes metabolic blockage, constituting the key microscopic mechanisms underlying ventricular remodeling and pump failure. Chinese herbal medicines, such as those with the effects of warming and tonifying kidney Yang or reinforcing healthy Qi, can intervene in multiple signaling pathways-including PTEN-inducible kinase 1 (PINK1)/Parkin and AMP-activated protein kinase/dynamin-related protein 1 (AMPK/Drp1)-to regulate mitochondrial dynamics and autophagy activity. This repairs damaged MQC networks and improves the microenvironment of myocardial energy metabolism. These intervention strategies align closely with the TCM therapeutic principles of warming and tonifying life gate, replenishing Qi, and activating blood, demonstrating the advantages of holistic regulation based on kidney-centered treatment and mitochondrial-targeted approaches. By integrating the "Mingmen Dongqi" theory with the MQC mechanism, this paper establishes a theoretical framework for the integrated prevention and treatment of CHF, offering new perspectives and insights for clinical practice and future research.
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