从“亢则害,承乃制”论动脉粥样硬化的免疫炎症机制

Exploring the Immune Inflammatory Mechanism of Atherosclerosis from "Hyperactivity Being Harmful, and Commitment Being a Control"

"亢则害,承乃制"即亢害承制论,若邪气过盛则为亢,物为亢邪所损则为害。动脉粥样硬化为病之因有二:一为体质,二为宿邪。现代医学将可能导致动脉粥样硬化的物质但未形成真正病灶时称之为"盛";"盛"的日积月累导致"害"的结果时,"盛"转变为"亢"。低密度脂蛋白的升高即为"盛",此时由于饮食、情志、体质等因素导致血液中出现痰湿之邪。而动脉粥样硬化的关键病变为巨噬细胞转化为泡沫细胞,并分泌更多的炎症因子以诱发更严重的免疫反应。最后泡沫细胞和相关免疫细胞在内膜中堆积并死亡形成粥样斑块("害");由于痰("盛")使血液运行受阻而导致血瘀或痰瘀互阻为"亢"。

"Hyperactivity is harmful, and commitment is a control",that is, the theory of hyperactivity leads to harm.If the pathogenic qi is excessive, it will be hyperactivity, and if the object is damaged by hyperactivity and pathogen, it will do harm.There are two causes of atherosclerosis: one is physique and the other is persistent pathogen.Modern medicine calls it "prosperity" when substances that may cause atherosclerosis but do not form real lesions;When the accumulation of "prosperity" leads to the result of "harm",the "prosperity" turns into "hyperactivity".The increase of Low density lipoprotein is called "prosperity".At this time, the pathogen of phlegm and dampness appears in the blood due to diet, emotion, physique and other factors.The key pathological changes of atherosclerosis are macrophages transformed into foam cells and secreting more inflammatory factors to induce more severe immune responses.Finally, foam cells and related immune cells accumulate in the intima and die to form atheromatous plaques( "harm"). "Hyperactivity" refers to blood stasis or mutual obstruction of phlegm and blood stasis due to the obstruction of blood circulation caused by phlegm( "prosperity").