[1]郭伶俐,武玉泽,谢龙,等.从“气血”辨析心肌缺血再灌注损伤中性粒细胞胞外诱捕网[J].陕西中医,2025,46(7):934-939.[doi:DOI:10.3969/j.issn.1000-7369.2025.07.014]
　GUO Lingli,WU Yuze,XIE Long,et al.Analysis of neutrophil extracellular traps in myocardial ischemia-reperfusion injury based on the theory of Qi-blood[J].,2025,46(7):934-939.[doi:DOI:10.3969/j.issn.1000-7369.2025.07.014]
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从“气血”辨析心肌缺血再灌注损伤中性粒细胞胞外诱捕网

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年7期
页码:
934-939
栏目:
学术探讨
出版日期:
2025-07-05

文章信息/Info

Title:
Analysis of neutrophil extracellular traps in myocardial ischemia-reperfusion injury based on the theory of Qi-blood
作者:
郭伶俐1; 武玉泽1; 谢龙2; 汪吴娇2; 杨志飞1; 齐葭1; 林谦2; 万洁1; SINZALIA Almeida Gomes3（东帝汶民主共和国）
（1.北京中医药大学东方医院，北京 100078；2.北京中医药大学东直门医院，北京 100700；3.北京中医药大学，北京 100029）
Author(s):
GUO Lingli1; WU Yuze1; XIE Long2; WANG Wujiao2; YANG Zhifei1; QI Jia1; LIN Qian2; WAN Jie1; SINZALIA Almeida Gomes3
（1.Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China；2.Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China；3.Beijing University of Chinese Medicine,Beijing 100029,China）
关键词:
心肌缺血再灌注损伤; 气血理论; 气虚血瘀; 中性粒细胞胞外诱捕网; 炎症反应; 微血管阻塞
Keywords:
Myocardial ischaemia-reperfusion injury; Theory of Qi-blood; Qi deficiency and blood stasis; Neutrophil extracellular trap; Inflammatory reaction; Microvascular obstruction
分类号:
R 542.2
DOI:
DOI:10.3969/j.issn.1000-7369.2025.07.014
文献标志码:
A
摘要:
急性心肌梗死（AMI）心肌缺血再灌注损伤（MIRI）常因急性心肌梗死冠脉突然再通发展而来，具有恶性心律失常、猝死等严重并发症，临床尚无特效药物。中医药通过辨证论治，采用多靶点、多环节干预MIRI，具有一定优势。将“气血”理论与MIRI的病理变化相结合，提出中性粒细胞胞外诱捕网（NETs）是导致MIRI的重要原因，其病理特点与气血失和相似。NETs驱动炎症级联反应造成心肌细胞损伤，促进血栓形成，导致微血管阻塞（MVO）病理变化，这与中医“气虚血瘀”状态下心气亏虚推动无力、血行滞涩瘀阻脉络、津液输布代谢失常的病理改变具有相关性。本研究以“气血”理论为总纲，阐述NETs在MIRI中的治则治法，结合 “气虚-血瘀-痰饮-毒邪”的病机变化，辨证论治。治病之则，调气为先，气虚为本，务在补益心气、温阳化气；兼顾痰瘀，痰瘀并治，行气活血、破痰逐瘀；正虚邪亢，多因胶结不解，易败为毒邪，宜清热解毒。基于此，可丰富中医药防治心血管疾病的现代科学内涵，为临床实践提供新的思路及参考。
Abstract:
Myocardial ischemia-reperfusion injury (MIRI) often develops due to sudden reperfusion of the coronary artery during acute myocardial infarction (AMI) and associated with severe complications such as malignant arrhythmias and sudden death.There were no specific drugs available for its treatment in clinical practice.Traditional Chinese medicine (TCM),through syndrome differentiation and treatment,intervenes in MIRI using a multi-target and multi-link approach,offering certain advantages.By integrating the theory of Qi-blood with the pathological changes of MIRI.It was proposed that neutrophil extracellular traps (NETs) an important cause of MIRI.The pathological features of NETs were similar to those of Qi-blood disharmony.NETs drive an inflammatory cascade reaction,resulting in myocardial cell damage,promoting thrombus formation and leading to pathological changes of microvascular obstruction (MVO).It was related to the pathological changes in the state of Qi deficiency and blood stasis in TCM,where the deficiency of heart-Qi leads to insufficient propulsion,sluggish blood circulation and obstruction of the meridians,and abnormal distribution and metabolism of body fluids.This study takes the theory of Qi-blood as the general principle to expound the therapeutic principles and methods of NETs inMIRI.Combining with the pathogenesis changes of Qi deficiency-blood stasis-phlegm-toxin,it adopts syndrome differentiation and treatment.The principle of treating diseases was to regulate Qi first,as Qi deficiency was the root cause.It was essential to tonify heart-Qi and warm Yang to transform Qi.Meanwhile,both phlegm and blood stasis should be considered.A combined treatment of phlegm and blood stasis was advisable,including promoting Qi circulation and activating blood circulation,breaking up phlegm and removing blood stasis.When the body’s Zheng-Qi (healthy Qi) was deficient and the pathogenic factors were excessive,they often combine and were difficult to resolve,easily transforming into toxic pathogens.Therefore,it was necessary to clear heat and remove toxins.Based on this,the modern scientific connotation of TCM in the prevention and treatment of cardiovascular diseases can be enriched,providing new ideas and references for clinical practice.

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备注/Memo

备注/Memo:
国家自然科学基金资助面上项目（82074252）；北京中医药大学东方医院高水平能力建设项目“国自然培育计划”——国家级人才培育项目（DFG2RB2024GJR013）；第六批北京市级中医药专家学术经验继承工作项目
更新日期/Last Update: 2025-07-09