摘要
慢性心力衰竭(CHF)是心血管常见危重症。内质网应激是内质网处于非正常状态下的一种机体内源性整合调控机制,具有促进心肌细胞生存或凋亡两方面作用,是CHF的病理生理基础。本文围绕正邪理论及内质网应激阐释CHF的病理机制。CHF病机以正虚为本,邪实为标,正邪相争贯穿疾病始终,而内质网应激乃机体正邪二气失衡、气血阴阳失和在细胞微观层面的体现。正气抗邪,适度内质网应激可促进心肌细胞生存、维持心功能正常;邪盛正负,内质网功能失代偿,过度内质网应激引起心肌细胞损伤,此时大量未折叠蛋白或异常折叠蛋白的堆积、心肌细胞凋亡、串扰炎症反应等可加重CHF病情。因此,靶向调控心肌细胞内质网应激、调整正邪关系是防治CHF的关键。本文基于正邪理论,探讨了内质网应激在CHF中的作用及其中医药干预。
Chronic heart failure(CHF)is a common cardiovascular critical illness.Endoplasmic reticulum stress is an endogenous regulation mechanism of endoplasmic reticulum in abnormal condition.It can promote the survival or apoptosis of cardiomyocytes and is the pathophysiological basis of CHF.This article explained the pathological mechanism of CHF through the theory of healthy Qi and pathogenic Qi and endoplasmic reticulum stress.The pathogenesis of CHF is based on the deficiency of healthy Qi and the stagnation of pathogenic Qi.The struggle between vital Qi and pathogen run through the disease.Endoplasmic reticulum stress is the manifestation of the imbalance between healthy Qi and pathogenic Qi,the disharmony of Qi and blood,Yin and Yang at the micro level of cells.Healthy Qi can defend pathogenic Qi,moderate endoplasmic reticulum stress can promote the survival of cardiomyocytes,and maintain normal cardiac function.Pathogenic Qi triumphs over healthy Qi,the endoplasmic reticulum function is decompensated,excessive endoplasmic reticulum stress causes myocardial cell damage,at this time,the accumulation of large amounts of unfolded or abnormally folded proteins,myocardial cell apoptosis,and cross-talk inflammatory reactions can exacerbate the condition of CHF.Therefore,targeted regulation of endoplasmic reticulum stress in myocardial cells and adjustment of the relationship between healthy Qi and pathogenic Qi are the key to the prevention and treatment of CHF.Based on the theory of healthy Qi and pathogenic Qi,this article explored the endoplasmic reticulum stress in CHF and its TCM intervention.
作者
黄爱思
魏佳明
曾清华
施敏
袁惠
郭志华
HUANG Aisi;WEI Jiaming;ZENG Qinghua;SHI Min;YUAN Hui;GUO Zhihua(School of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China;Department of Cardiovascular Medicine,the First Hospital of Hunan University of Chinese Medicine,Changsha 410021,China)
出处
《实用心脑肺血管病杂志》
2024年第10期105-109,113,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
国家自然科学基金资助项目(81673955)
湖南省自然科学基金资助项目(2021JJ30495)
2023年湖南中医药大学校级课题项目(2023CX178)。
关键词
心力衰竭
内质网应激
正邪相争
扶正祛邪
Heart failure
Endoplasmic reticulum stress
Struggle between vital Qi and pathogen
Strengthening body resistance to eliminate pathogenic factors
