[1]富雪婷,杜宝林,赵永刚,等.基于“脉道-气血-脾之大络”探讨促血管生成防治慢性心力衰竭[J].陕西中医,2026,(2):223-227.[doi:DOI:10.3969/j.issn.1000-7369.2026.02.014]
　FU Xueting,DU Baolin,ZHAO Yonggang,et al.Based on theory of great meridian of meridians-Qi and blood-spleen explores ideas of promoting angiogenesis for prevention and treatment of chronic heart failure[J].,2026,(2):223-227.[doi:DOI:10.3969/j.issn.1000-7369.2026.02.014]
点击复制

基于“脉道-气血-脾之大络”探讨促血管生成防治慢性心力衰竭

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年2期
页码:
223-227
栏目:
学术探讨
出版日期:
2026-02-05

文章信息/Info

Title:
Based on theory of great meridian of meridians-Qi and blood-spleen explores ideas of promoting angiogenesis for prevention and treatment of chronic heart failure
作者:
富雪婷1; 杜宝林2; 赵永刚2; 赵明芬3
（1.新疆医科大学第四临床医学院，新疆 乌鲁木齐 830054;2.新疆乌鲁木齐市米东区中医医院，新疆 乌鲁木齐 831400；3.新疆医科大学附属中医医院，新疆 乌鲁木齐 830054）
Author(s):
FU Xueting1; DU Baolin2; ZHAO Yonggang2; ZHAO Mingfen3
(1.The Fourth Clinical Medical College of Xinjiang Medical University,Urumqi 830054,China;2.Midong District Hospital of Traditional Chinese Medicine,Urumqi City,Urumqi 831400，China；3.Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University,Urumqi 830054，China)
关键词:
慢性心力衰竭; 脉道; 脾之大络; 气血; 血管生成; 微循环障碍
Keywords:
Chronic heart failure; Pulse channel; Great collateral of spleen; Qi and blood; Angiogenesis; Microcirculation disorders
分类号:
R 541.6
DOI:
DOI:10.3969/j.issn.1000-7369.2026.02.014
文献标志码:
A
摘要:
慢性心力衰竭以心室收缩功能减退、血流动力学紊乱及患病率高、住院率高、病死率高为特征。心力衰竭存在心肌能量匮乏，刺激血管新生以满足心脏能量需求至关重要。靶向调节联合促进血管新生是目前治疗的热点。脉道可运行气血以濡养全身，脾气亏虚是脉道不利的主要因素，脾之大络是机体气血汇聚、转输、分流的重要部位，由此提出“脉道-气血-脾之大络”理论。心力衰竭核心病机为“脾气虚损-脉道不利”与“络破-实邪留滞”，前者因脾虚致气血生化不足、脉道瘀阻，与现代医学中血管内皮功能障碍相似。后者因络脉损伤、实邪留滞，加剧微循环障碍与心室重塑，导致血管生成障碍，二者均与该理论密切相关。基于此，提出“健脾益气温阳”“活血化瘀通络”治法，通过靶向调控血管生成因子改善相关障碍，为中医药防治心力衰竭提供新思路。
Abstract:
Chronic heart failure was characterized by reduced ventricular systolic function,hemodynamic disorders,and high prevalence,hospitalization rate,and mortality.Heart failure was associated with myocardial energy deficiency,and stimulating angiogenesis to meet the energy demands of the heart was crucial.Targeted regulation combined with promoting angiogenesis was currently a research hotspot in treatment.Meridians can transport Qi and blood to nourish the whole body,and deficiency of spleen Qi was the main factor for meridian obstruction.The large collateral of the spleen was an important site for the convergence,transfer,and diversion of Qi and blood in the body.Based on this,the meridian-Qi and blood-spleen large collateral theory was proposed.The core pathogenesis of heart failure was spleen Qi deficiency-meridian obstruction and collateral rupture-real pathogen retention.The former was due to spleen deficiency leading to insufficient Qi and blood production and meridian obstruction,which was similar to vascular endothelial dysfunction in modern medicine.The latter was due to collateral damage and real pathogen retention,which aggravates microcirculation disorders and ventricular remodeling,leading to angiogenesis disorders.Both were closely related to this theory.Based on this,the therapeutic methods of tonifying spleen Qi and warming Yang and activating blood circulation,removing blood stasis and unblocking collaterals were proposed.By targeting the regulation of angiogenic factors,related disorders can be improved,providing a new idea for the prevention and treatment of heart failure with traditional Chinese medicine.

参考文献/References:

[1]蔡建平,田焕,杨巧芳.慢性心力衰竭患者症状群特征及其影响因素分析[J].中华现代护理杂志,2021,27(25):3410-3415.
[2]WANG H,CHAI K,DU M,et al.Prevalence and incidence of heart failure among urban patients in China:A national population-based analysis[J].Circ Heart Fail,2021,14(10):8406.
[3]WANG H,LI Y,CHAI K,et al.Mortality in patients admitted to hospital with heart failure in China:A nationwide cardiovascular association database-heart failure centre registry cohort study[J].Lancet Glob Health,2024,12(4):e611-e622.
[4]ZHOU N Q,FANG Z X,HUANG N,et al.aFGF targeted mediated by novel nanoparticles-microbubble complex combined with ultrasound-targeted microbubble destruction attenuates doxorubicin-induced heart failure via anti-apoptosis and promoting cardiac angiogenesis[J].Front Pharmacol,2021,12:607785.
[5]孙龙飞,安冬青,郭龙龙.心力衰竭的中医药治疗优势与特色[J].中国中医急症,2016,25(3):452-456.
[6]侯美琪,朱爱松.基于“脾气亏虚,脉道不利”理论探讨血管平滑肌细胞衰老与动脉粥样硬化关系[J].辽宁中医药大学学报,2021,23(4):108-111.
[7]冯婷,彭家玺,杨娇,等.从脾之大络与脾之络的关系浅析其临床运用[J].成都中医药大学学报,2017,40(4):89-91.
[8]索上喻,吴继昆,谢文皎,等.基于络病学说探讨“脾之大络-气血-络脉”血循轴构建及意义[J].四川中医,2021,39(8):15-18.
[9]王世文.“脾之大络”之管[J].中医函授通讯,1990,9(6):19-21.
[10]张会永,崔家鹏,杨关林.从《内经》脾病“脉道不利”探讨“从脾论治”冠心病[J].中国中医基础医学杂志,2013,19(11):1256-1258.
[11]韩烁,王大英,刘宗军.基于“浊毒伏络”理论探讨线粒体自噬在慢性心力衰竭中的作用[J].辽宁中医药大学学报,2025，27（9）：53-57.
[12]孙静,郑金刚.冠状动脉微循环功能障碍在心力衰竭中的作用机制及研究进展[J].微循环学杂志,2025,35(4):112-117.
[13]OKA T,AKAZAWA H,NAITO A T,et al.Angiogenesis and cardiac hypertrophy:Maintenance of cardiac function and causative roles in heart failure[J].Circ Res,2014,114(3):565-571.
[14]陈子豪,贺爽,赵芳哲,等.糖尿病心力衰竭中的血管新生作用-中医药治疗糖尿病心肌病的潜在靶点[J].天津中医药大学学报,2023,42(1):113-120.
[15]廉坤,刘可欣,王学琴,等.基于“络病理论”探讨芪苈强心胶囊治疗慢性心力衰竭的作用机制[J].中国实验方剂学杂志,2025,31(16):146-155.
[16]龚蕾,王治校.miR-92a在心力衰竭中的表达及与心肌血管生成相关因子的关系[J].中西医结合心脑血管病杂志,2024,22(13):2402-2405.
[17]蒋著椿,彭佩纯,李小梅,等.基于HIF-1α/VEGF信号通路探讨瑶药肿瘤藤对HepG2肝癌细胞的效应机制[J].陕西中医,2025,46(6):723-728.
[18]QIU Z L,WEI Y,SONG Q Q,et al.The role of myocardial mitochondrial quality control in heart failure[J].Frontiers in Pharmacology,2019,10:1404.
[19]张选明,甘霞,张虹霞,等.从“脾-痰-瘀”论治动脉粥样硬化[J].兵团医学,2023,21(1):59-61.
[20]唐林,黎宗宝,白瑞娜.半夏白术天麻汤对原发性高血压的作用机制研究[J].世界中医药,2020,15(16):2458-2461,2465.
[21]代海峰,季瑜,孙元鹏.略论《金匮要略》中的瘀血[J].中国中医基础医学杂志,2010,16(10):3.
[22]王飞龙,韩岚,樊玲,等.桃红四物汤对实验性脑缺血大鼠血清中ET-1、Ang-1、VEGF的影响[J].中国实验方剂学杂志,2017,23(1):101-106.
[23]桑子瑾,吴文婷,陈强,等.止血化瘀利水方对缺氧诱导ARPE-19细胞VEGF及HIF-1α表达的影响[J].中国中医眼科杂志,2020,30(1):11-15,31.
[24]连妍洁,李明轩,刘红旭,等.基于“玄府-气液-络脉”探讨心力衰竭的中医证治[J].中医杂志,2023,64(6):641-645.
[25]郭允,王学工.加味益气强心汤对心阳亏虚型心力衰竭患者心功能、血管内皮功能的影响[J].陕西中医,2021,42(4):456-458.

相似文献/References:

[1]杨自生,金 琪,简立国.参苓养心汤治疗慢性心衰的疗效及对心功能、活动耐力、 NTProBNP、hsCRP的影响*[J].陕西中医,2019,(2):167.
　YANG Zisheng,JIN Qi,JIAN Liguo..The effect of Shenling Yangxin decoction on chronic heart failure and its effect on cardiac function，activity endurance，NTProBNP and hsCRP[J].,2019,(2):167.
[2]孙 哲,杨 默,石宗华.丹参多酚酸盐与丹参酮治疗慢性心力衰竭临床研究[J].陕西中医,2019,(5):591.
　SUN Zhe,YANG Mo,SHI Zonghua..Clinical effect and mechanism of salvianolate and Tanshinone in the treatment of chronic heart failure[J].,2019,(2):591.
[3]向宗兴,拓 文,仇卫峰,等.黄芪保心汤配合西药治疗慢性心力衰竭临床研究*[J].陕西中医,2019,(8):1085.
　XIANG Zongxing,TUO Wen,QIU Weifeng,et al.Clinical value of Huangqi Baoxin decoction combined with western medicine in the treatment of chronic heart failure[J].,2019,(2):1085.
[4]尚加芬.参芪附仙饮联合盐酸曲美他嗪片辨治慢性心力衰竭心肾阳虚证临床研究[J].陕西中医,2020,(1):38.
[5]陈宗伟,沈志涛,郑振国,等.芪苈强心胶囊配合保元汤加减治疗慢性心力衰竭临床研究*[J].陕西中医,2020,(2):191.
　CHEN Zongwei,SHEN Zhitao,ZHENG Zhenguo,et al.Observation on the effect of Qili Qiangxin capsules assist Baoyuan decoction in the treatment of chronic heart failure[J].,2020,(2):191.
[6]凌 望,孙思明,王璐玲,等.温阳益气活血方改善慢性心力衰竭患者生活质量临床研究*[J].陕西中医,2020,(5):621.[doi:DOI:10.3969/j.issn.10007369.2020.05.019]
　LING Wang,SUN Siming,WANG Luling,et al.A Study on the quality of life about Wenyang Yiqi Huoxue therapy in the treatment of chronic heart failure[J].,2020,(2):621.[doi:DOI:10.3969/j.issn.10007369.2020.05.019]
[7]朱 杰,林兆奋△,胡 聃,等.中西医结合治疗慢性心力衰竭研究进展*[J].陕西中医,2020,(9):1342.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.046]
[8]刘 薇,张玉焕,李 争.芪参益气滴丸对老年气虚血瘀型心力衰竭患者心肌保护、炎症状态的影响[J].陕西中医,2021,(1):37.[doi:DOI:10.3969/j.issn.1000-7369.2020.01.008]
　LIU Wei,ZHANG Yuhuan,LI Zheng.Effects of Qishen Yiqi dropping pills on myocardial protection,inflammatory state and serum cell adhesion molecule level in elderly patients with heart failure caused by qi deficiency and blood stasis[J].,2021,(2):37.[doi:DOI:10.3969/j.issn.1000-7369.2020.01.008]
[9]黄光明.理中汤加减治疗慢性心力衰竭及对患者血清BNP、IL-10及NOS水平的影响研究[J].陕西中医,2021,(2):159.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.006]
　HUANG Guangming.Modified Lizhong decoction on clinical symptoms and levels of serum BNP,IL-10 and NOS in patients with chronic heart failure[J].,2021,(2):159.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.006]
[10]胡 芳,谭明娜,谭小娥,等.加味五苓散联合西药治疗慢性心力衰竭疗效及对患者心功能、纤维化指标、炎性因子水平的影响[J].陕西中医,2021,(2):167.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.008]
　HU Fang,TAN Mingna,TAN Xiao'e,et al.Effects of modified Wuling powder combined with western medicine on levels of cardiac function,fibrosis indicators and inflammatory factors in patients with chronic heart failure[J].,2021,(2):167.[doi:DOI:10.3969/j.issn.1000-7369.2020.02.008]

备注/Memo

备注/Memo:
新疆维吾尔自治区重大科技专项项目(2022A03019-1)；乌鲁木齐市中医药科技创新项目(ZYYMS-14)
更新日期/Last Update: 2026-02-09