[1]闫冀含,张敬华.基于阴阳气化理论探讨缺血性脑卒中线粒体损伤机制[J].陕西中医,2026,(8):1079-1084.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.012]
　YAN Jihan,ZHANG Jinghua.Exploring mitochondrial damage mechanism of ischemic stroke based on Yinyang Qi transformation theory[J].,2026,(8):1079-1084.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.012]
点击复制

基于阴阳气化理论探讨缺血性脑卒中线粒体损伤机制

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年8期
页码:
1079-1084
栏目:
学术探讨
出版日期:
2026-08-05

文章信息/Info

Title:
Exploring mitochondrial damage mechanism of ischemic stroke based on Yinyang Qi transformation theory
作者:
闫冀含1; 张敬华2
(1.南京中医药大学养老服务与管理学院，江苏 南京 210023；2.南京中医药大学附属南京市中医院，江苏 南京210022)
Author(s):
YAN Jihan1; ZHANG Jinghua2
(1.School of Elderly Care Services and Management，Nanjing University of Chinese Medicine,Nanjing 210023，China;2.Nanjing Hospital of Traditional Chinese Medicine Affiliated with Nanjing University of Chinese Medicine,Nanjing 210022，China)
关键词:
缺血型脑卒中; 阳化气; 阴成形; 线粒体质量控制; 线粒体自噬; 线粒体动力学; 线粒体生物合成
Keywords:
Ischemic stroke; Yang transforming Qi; Yin forming substance; Mitochondrial quality control; Mitochondrial autophagy; Mitochondrial dynamics; Mitochondrial biogenesis
分类号:
R 255.2
DOI:
DOI:10.3969/j.issn.1000-7369.2026.08.012
文献标志码:
A
摘要:
缺血性脑卒中（IS）是由脑组织急性缺血缺氧引发的以能量代谢崩溃、神经元死亡为核心病理机制的急性脑血管疾病。线粒体质量控制（MQC）是维持线粒体结构与功能稳定的重要调节机制，能直接参与调控脑内能量代谢、维持神经元正常生理功能，与IS发生发展密切相关。中医“阳化气，阴成形”理论高度概括生命活动中功能代谢与形态结构的对立统一规律，为阐释IS病机与干预策略提供整体视角。IS核心病机以阳化气不足为发病之本，阴成形失调为疾病核心。亚细胞层面MQC稳态对应阴阳气化相济的生理状态，IS病理状态下MQC失衡则是阳化气亏虚、阴成形太过与不及的微观具象，三者恶性循环加重脑神经元损伤。临床可确立复阳化气、抑阴散浊、分期论治的治疗原则，多类中药单体及复方可多靶点调控线粒体分裂、融合、自噬、生物发生等MQC环节，改善能量代谢、减轻氧化应激与炎症损伤，发挥神经保护作用。本文构建IS中西医病机对应体系，阐明中医药调控MQC防治疾病的科学内涵，提出从线粒体微观化、复方网络药理二方面开展研究，为IS中西医结合精准防治提供理论参考。
Abstract:
Ischemic stroke (IS) was an acute cerebrovascular disease caused by acute cerebral ischemia and hypoxia.Its core pathological mechanisms involve energy metabolism failure and neuronal death.Mitochondrial quality control (MQC) was a key regulatory system that sustains the structural and functional integrity of mitochondria.It directly modulates cerebral energy metabolism and neuronal physiological function,and was tightly linked to onset and progression of IS.Traditional Chinese medicine (TCM) theory of Yang transforming Qi,Yin forming substance highly generalizes the unity of opposites between functional metabolism and morphological structure in life activities,offering a holistic perspective for interpreting the pathogenesis and intervention strategies of IS.Studies have demonstrated that the fundamental pathogenesis of IS lies in deficient Yang transforming Qi,while disordered Yin forming substance serves as the core driver of disease progression.At the subcellular level,steady-state MQC corresponds to physiological state of balanced Yinyang Qi transformation.In the pathological state of IS,MQC imbalance manifests as deficient Yang transforming Qi together with excessive or inadequate Yin forming substance.The interplay of these pathological changes creates a vicious cycle that exacerbates neuronal injury.Accordingly,clinical therapeutic principles formulated，replenishing yang to transform Qi,restraining Yin to eliminate turbidity,and stage-based treatment.Multiple TCM monomers and compound prescriptions could multi-targetedly regulate MQC processes including mitochondrial dynamics (mitochondrial fission and fusion),mitochondrial autophagy,and mitochondrial biogenesis.Thereby improve energy metabolism,alleviate oxidative stress and inflammatory damage,and exert neuroprotective effects.This paper establishes an integrated TCM-Western medicine pathogenesis framework for IS and clarifies scientific mechanism underlying TCM-mediated MQC regulation in the prevention and treatment of IS.Future research directions proposed,including in-depth exploration of mitochondrial mechanisms and network pharmacology analysis of TCM compounds.This study provided theoretical basis for the precise integrated management of ischemic stroke.

参考文献/References:

[1]LEI W,ZHUANG H,HUANG W,et al.Neuroinflammation and energy metabolism：A dual perspective on ischemic stroke[J].Journal of Translational Medicine,2025,23(1)：413.
[2]SONG N,MEI S,WANG X,et al.Focusing on mitochondria in the brain：From biology to therapeutics[J].Translational Neurodegeneration,2024,13(1)：23.
[3]MA Y,SONG R,DUAN C.Mitochondrial quality control and transfer communication in neurological disorders and neuroinflammation[J].Frontiers in Immunology,2025,16：1542369.
[4]宋清江,白晓莉,刘红燕.“阳化气,阴成形”与现代医学的代谢观[J].中国中医基础医学杂志,2007,132(8)：572,607.
[5]毕珊榕,古文霞,关冰河,等.从阳化气阴成形角度探讨阴阳二气与能量代谢的内在联系[J].中国中医药现代远程教育,2024,22(14)：85-88.
[6]王浩源,祝昌昊,黄伟,等.基于“阳化气,阴成形”理论从脏腑辨证论治糖尿病肾病[J].陕西中医,2025,46(9)：1228-1231.
[7]张伟,唐农.基于“阳化气、阴成形”探讨中风的中医证治[J].中医杂志,2020,61(8)：721-723.
[8]张诗嘉,孙许涛,姜德友.阳虚邪中理论在中风病中的应用[J].中医杂志,2023,64(11)：1112-1116.
[9]周胜强,刘芳,邓奕辉,等.国医大师刘祖贻运用“气阳主用”思想辨治髓病经验[J].湖南中医药大学学报,2019,39(9)：1064-1067.
[10]崔志洁,高铸烨,姜众会,等.基于“脾主肌肉”理论探讨线粒体质量控制在心力衰竭合并肌少症中医药治疗中的价值[J].陕西中医,2025,46(6)：795-799.
[11]LIU M,YIN Z,LI B,et al.Targeting Drp1 in cerebral ischemia-reperfusion injury：Mechanisms and therapeutic implications[J].Cns Neuroscience & Therapeutics,2025，31(8)：e70590.
[12]LI C,CHEN C,QIN H,et al.The role of mitochondrial dynamin in stroke[J].Oxidative Medicine and Cellular Longevity,2022(1)：2504798.
[13]YUAN Y,TIAN Y,JIANG H,et al.Mechanism of PGC-1α-mediated mitochondrial biogenesis in cerebral ischemia-reperfusion injury[J].Frontiers in Molecular Neuroscience,2023,16：1224964.
[14]WU Y,LI Z,DING T,et al.Bidirectional regulation of neuronal autophagy in ischemic stroke：Mechanisms and therapeutic potential[J].Ageing Research Reviews,2025,111：102842.
[15]欧昌泽,陈彬彬,刘新利,等.缺血性脑卒中线粒体损伤的关键靶点及中医药干预机制研究进展[J].中国中药杂志,2025,50(18)：5098-5110.
[16]安瑞舒,秦文秀,杨建,等.线粒体跨细胞转移在脑缺血/再灌注损伤中的作用机制[J].生理学报,2026,78(2)：295-305.
[17]YUAN Y,CHEN T,YANG Y,et al.E2F1/CDK5/DRP1 axis mediates microglial mitochondrial division and autophagy in the pathogenesis of cerebral ischemia-reperfusion injury[J].Clinical and Translational Medicine,2025,15(2)：e70197.
[18]LU D.MFN2 and BAG6 synergistically protect against cerebral reperfusion injury by regulating ROS levels and autophagic flux[J].Stroke,2025,56(12)：3468-3483.
[19]CHEN H,LIU J,CHEN M,et al.SIRT3 facilitates mitochondrial structural repair and functional recovery in rats after ischemic stroke by promoting OPA1 expression and activity[J].Clinical Nutrition,2024,43：1816-1831.
[20]TANG T,HU L,DING C,et al.Src inhibition rescues FUNDC1-mediated neuronal mitophagy in ischaemic stroke[J].Stroke and Vascular Neurology,2024,9：367-379.
[21]LI Y,GAO Y,YU G,et al.G6PD protects against cerebral ischemia-reperfusion injury by inhibiting excessive mitophagy[J].Life Sciences,2025,362：123367.
[22]LAN X,ZHANG C,REN Z,et al.Astrocytic mitochondrial transfer：A new horizon for metabolic rescue and precision therapy in ischemic stroke[J].Journal of Translational Medicine,2026,24(1)：182.
[23]张怡,代传朕,高维娟.靶向线粒体质量控制防治缺血性脑卒中及其中医药治疗进展[J].中国药理学通报,2025,41(8)：1424-1431.
[24]张泽华,刘汉宇,朱泳江,等.基于“阳化气,阴成形”理论探讨线粒体质量控制对糖尿病肾病的影响及中医药的干预策略[J].中药药理与临床,2025,41(11)：103-110.
[25]刘竹暄,曾珊珊,谭惠中,等.线粒体功能障碍在慢性脑低灌注介导的血管性认知障碍中的作用[J].生命科学,2025,37(2)：109-117.
[26]马莉,赵俊杰,王鹏,等.黄芪甲苷通过PINK1/parkin通路介导的线粒体自噬途径减轻大鼠脑缺血再灌注损伤[J].中国病理生理杂志,2025,41(3)：501-508.
[27]CHEN D,DUAN H,ZOU C,et al.20(R)-ginsenoside Rg3 attenuates cerebral ischemia-reperfusion injury by mitigating mitochondrial oxidative stress via the Nrf2/HO-1 signaling pathway[J].Phytotherapy Research,2024,38：1462-1477.
[28]TAO D,LI F,ZHANG X,et al.20(R)-ginsenoside Rg3 protects against focal cerebral ischemia-reperfusion injury by suppressing autophagy via PI3K/Akt/mTOR signaling pathway[J].Neuropharmacology,2025,263：110226.
[29]王明洋,孙争宇,张丽,等.山茱萸环烯醚萜苷对脑缺血再灌注大鼠线粒体损伤的影响[J].首都医科大学学报,2020,41(3)：385-390.
[30]曾红雨,谭开媚,邱峰,等.基于PINK1/LETM1信号通路探讨何首乌苷减轻脑缺血再灌注损伤的作用机制[J].中国实验方剂学杂志,2025,31(11)：145-154.
[31]刘穗琦,明淑萍,董欢欢,等.从脾论治缺血性中风恢复期及验案举隅[J].中医药临床杂志,2024,36(3)：467-470.
[32]张雪茹,申伟,梁晓,等.运用角药治疗缺血性脑卒中经验[J].中医杂志,2025,66(4)：407-410.
[33]李慧敏,胡瑞学,王正中,等.基于复杂网络分析方法探索中医药治疗急性脑梗死的专家医案和经验方处方用药规律[J].现代中医临床,2024,31(5)：92-96.
[34]何曼曼,王岱,李智申,等.化痰通腑法治疗中风急性期痰热腑实证疗效及对患者神经功能的影响[J].陕西中医,2024,45(6)：789-793.
[35]罗苑,陈普,杨丽萍,等.天麻醇提物对脑缺血再灌注损伤中线粒体功能障碍的影响[J].中国中药杂志,2022,47(20)：5564-5573.
[36]唐标.线粒体自噬-NLRP3炎症小体途径在脑缺血再灌注损伤中的作用及三七总皂苷和黄芪甲苷干预的研究[D].长沙：湖南中医药大学,2019.
[37]吴倩,刘娇,田丽宇,等.藁本内酯介导的线粒体自噬减轻HT22细胞的缺糖缺氧/复氧损伤[J].中国中药杂志,2022,47(7)：1897-1903.
[38]周新华,王亮,张在军,等.川芎嗪对缺氧缺糖损伤大脑皮层神经元的保护作用及初步机制研究[J].暨南大学学报(自然科学与医学版),2014,35(6)：532-537.
[39]王连辉,米国青,薛满中.基于PINK1/Parkin通路探讨小续命汤调控急性脑缺血再灌注后线粒体自噬的分子机制及神经细胞凋亡的影响[J].中医药导报,2022,28(1)：36-40,44.
[40]丁慧敏,李彦杰,秦合伟,等.基于HIF-1α/BNIP3信号通路探讨小续命汤对脑缺血-再灌注损伤大鼠线粒体自噬的调控机制[J].中药材,2024,47(4)：1004-1010.

相似文献/References:

[1]王浩源,祝昌昊,黄伟,等.基于“阳化气，阴成形”理论从脏腑辨证论治糖尿病肾病[J].陕西中医,2025,46(9):1228.[doi:DOI:10.3969/j.issn.1000-7369.2025.09.015]
　WANG Haoyuan,ZHU Changhao,HUANG Wei,et al.Treating diabetic nephropathy based on the theory of “Yang transformmg qi and Yin formmg shape” and the syndrome differentiation and treatment according to the viscera and bowels[J].,2025,46(8):1228.[doi:DOI:10.3969/j.issn.1000-7369.2025.09.015]
[2]麻蒙凡,刘冰阳,卜献忠,等.基于“阳化气，阴成形”理论探讨儿童激素性股骨头坏死的辨治策略[J].陕西中医,2026,(6):792.[doi:DOI:10.3969/j.issn.1000-7369.2026.06.013]
　MA Mengfan,LIU Bingyang,BU Xianzhong,et al.Discussion on identification and treatment strategies of hormonal femoral head necrosis in children based on the theory of “yang transforming into qi,while yin constituting form”[J].,2026,(8):792.[doi:DOI:10.3969/j.issn.1000-7369.2026.06.013]
[3]薛建鑫,赵亚男,刘明,等.基于“阳化气，阴成形”探讨五苓散论治慢性下肢静脉性水肿[J].陕西中医,2026,(8):1090.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.014]
　XUE Jianxin,ZHAO Yanan,LIU Ming,et al.Based on Yang transforms into Qi Yin forms shape discusses treatment of chronic lower extremity venous edema with Wuling San[J].,2026,(8):1090.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.014]
[4]刘慧慧,唐路军,胡国恒,等.名中医王行宽基于“阳化气，阴成形”治疗冠心病经验[J].陕西中医,2026,(8):1104.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.017]
　LIU Huihui,TANG Lujun,HU Guoheng,et al.Experience of renowned traditional Chinese medicine practitioner WANG Xingkuan in treating coronary heart disease based on principle of Yang Huaqi，Yin Chengxing[J].,2026,(8):1104.[doi:DOI:10.3969/j.issn.1000-7369.2026.08.017]

备注/Memo

备注/Memo:
国家自然科学基金资助项目（82371360）；江苏省中医药科技发展计划项目（MS2024044）；江苏省中医药学会振兴发展项目（ZXFZ2024020）；南京市中医药青年人才培养计划项目（ZYQ20004）
更新日期/Last Update: 2026-08-13