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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 针灸推拿学院,成都 610075
[第一作者] 金硕果,博士,讲师,从事中西医结合治疗神经系统疾病的临床及基础研究,Tel:028-87783362,E-mail:jinshuoguo@cdutcm.edu.cn
*刘福友,教授,从事中西医结合治疗神经系统疾病的临床及基础研究,Tel:028-87783362,E-mail:liufuyou1952@163.com
收稿日期:2019-08-28,
网络出版日期:2020-03-02,
纸质出版日期:2020-05-20
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金硕果, 刘福友, 杨东东, 等. 基于胶质淋巴系统探讨“毒损脑络”[J]. 中国实验方剂学杂志, 2020,26(10):186-191.
Shuo-guo JIN, Fu-you LIU, Dong-dong YANG, et al. Correlation Analysis of " Toxin Damaging Brain Collaterals" from Glymphatic System[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(10): 186-191.
金硕果, 刘福友, 杨东东, 等. 基于胶质淋巴系统探讨“毒损脑络”[J]. 中国实验方剂学杂志, 2020,26(10):186-191. DOI: 10.13422/j.cnki.syfjx.20201025.
Shuo-guo JIN, Fu-you LIU, Dong-dong YANG, et al. Correlation Analysis of " Toxin Damaging Brain Collaterals" from Glymphatic System[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(10): 186-191. DOI: 10.13422/j.cnki.syfjx.20201025.
络脉是经脉系统的分支,具有沟通表里上下、联系脏腑的作用,在支持气血运行方面呈现双向流动的特性,具有物质交换和新陈代谢的功能。脑为诸阳之会,脑络纵横交错,脑络渗灌气血以充实脑髓并敷布阳气以温煦脑神,为“脑主神明”提供物质基础和源动力。病理情况下脑络不通,毒邪内生,而致“毒损脑络”。“毒损脑络”病机学说不仅应用于中风病机研究中,而且拓展到痴呆等其他脑病中,推动了中医脑病病机理论的发展。新近发现脑内存在“胶质淋巴系统”,是星形胶质细胞介导的脑脊液-脑间质液的交换流动系统。胶质淋巴系统把脑脊液中的葡萄糖、脂质、电解质和载脂蛋白E等营养物质和神经活性物质运送到脑组织,也能清除脑内代谢产物(如乳酸)、可溶性蛋白(如
β
-淀粉样蛋白和Tau蛋白)和异物,这是维持脑内环境稳态的重要液体流动系统。胶质淋巴系统的发现为神经系统疾病病理机制的研究提供了新视角,可能成为脑血管疾病、神经退行性疾病等神经精神系统疾病干预的新靶点。作为脑内广泛分布的代谢废物排出途径和物质运送系统的胶质淋巴系统可能是“脑络”病变的生物学基础,是中西医对“毒损脑络”认识的交叉点,从胶质淋巴系统探析“毒损脑络”,有可能为揭示“毒损脑络”的现代内涵提供新的靶点。
The collaterals are branches of the meridians and vessels system
and have the roles of connecting upper-lower and interior-exterior portions of the body
the characteristics of two-way flow in supporting the operation of Qi and blood
and the functions of material exchange and metabolism. The brain is the intersection of the Yang meridians. Crisscross brain collaterals permeate Qi and blood to enrich the brain
and spread Yang Qi
in order to warm the brain-mind
and provide material basis and source power to the " brain governing mind" . Under pathological conditions
cerebral collaterals are blocked
and toxic pathogens are endogenous
resulting in " toxin damaging brain collaterals" . This theory is not only applied to the study of stroke pathogenesis
but also extended to other encephalopathy
such as dementia
which promoted the development of the theory of pathogenesis in traditional Chinese medicine. Recently
a " glymphatic system" was discovered in the brain
which is an exchange flow system of cerebrospinal fluid-brain interstitial fluid mediated by astrocyte. The glymphatic system transports nutrients and neuroactive substances
such as glucose
lipids
electrolytes and apolipoprotein E in the cerebrospinal fluid
to brain tissue
and also removes metabolic products (such as lactic acid)
soluble proteins (such as
β
-amyloid protein and Tau protein) from the brain and foreign bodies
which are important liquid flow systems that maintain the homeostasis of the brain. The discovery of the glymphatic system provides a new perspective for the study of pathological mechanism of neurological diseases
and may become a new target for interventions in neurological diseases
such as cerebrovascular diseases and neurodegenerative diseases. As a widely distributed cerebral metabolic waste removal way and material delivery system
the lymphatic system may be the biological foundation of " brain collateral" disease
and a cross point of understanding on " toxin impairing brain collaterals" by Western and traditional Chinese medicine. The study based on the glymphatic system will give a more rational explanation on " toxic damage to brain collaterals" .
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