从“心脾相关,营卫和合”探析幽门螺杆菌诱导心房颤动的病机与治疗思路

Exploring the pathogenesis and treatment of atrial fibrillation resulting from Helicobacter pylori from the“heart-spleen correlation,ying-wei harmony”perspective

心脾相关理论起源于《黄帝内经》,是中医学五脏一体观的组成部分。近年来,多项研究显示,幽门螺杆菌(Hp)可通过诱导异常炎症-免疫反应、破坏肠道菌群而影响脑-肠互动、增加血液黏度等多种机制影响心房颤动的发生与进展。本文从心脾相关理论入手,认为“营卫失充、菌邪外袭”“营卫失谐、心神异常”“营卫失行、气血失和”“营卫失制、心脾互伤”是Hp诱导心房颤动发病与进展的病机基础及演变过程,而营卫的“失充”“失谐”“失行”“失制”均归属于“营卫失和”的范畴,“营卫失和”作为核心病机贯穿始终。本文从“心脾同调,营卫和合”视角,探析自Hp感染之始,至其诱导心房颤动发生发展不同阶段的辨证论治,以期为心房颤动的预防与治疗提供新思路。

The heart-spleen correlation theory originated from Huangdi Neijing,a part of the holism of the five zang organs in traditional Chinese medicine.Numerous recent studies have shown that Helicobacter pylori(Hp)is potentially associated with the occurrence and development of atrial fibrillation through inducing abnormal inflammatory and immunology response,destroying intestinal flora,affecting brain-gut interaction,and increasing blood viscosity.This study begins with the heart-spleen correlation theory and indicates that“ying-wei insufficiency,bacterial pathogen invasion”,“ying-wei disordered regulation,abnormal mind”,“ying-wei abnormal operation,qi and blood disharmony”,“ying-wei loss of constraints,heart and spleen mutual injury”are the traditional Chinese medicine pathogenesis and evolution processes of atrial fibrillation resulting from Hp.And the“insufficiency”,“disordered regulation”,“abnormal operation”and“loss of constraints”of ying-wei are all under the category of“ying-wei disharmony”.“Nutrient-defense disharmony”is the core pathogenesis throughout.From the perspective of“heart-spleen correlation,ying-wei harmony”,this paper analyzes the syndrome differentiation and treatment of different stages of the process from the beginning of Hp infection to the development of Hp-induced atrial fibrillation,with a view to providing new ideas for the prevention and treatment of atrial fibrillation patients.