基于“卫气内伐”理论探讨冠状动脉周围脂肪组织调节动脉粥样硬化发生发展的机制

Exploration of the mechanism of pericoronary adipose tissue regulating occurrence and development of atherosclerosis based on the theory of‘defensive qi internal logging'

冠状动脉周围脂肪组织(PCAT)是围绕于冠状动脉周围的一种特殊脂肪组织,在病理状态下能“由外到内”导致动脉粥样硬化(AS),引发冠心病(CHD)。中医视角下PCAT的生物学特征与“卫气”具有相似性。文章将中医理论与现代科学机制有机结合,从“卫气内伐”理论探讨PCAT在病理条件下促AS的过程,提出因饮食不节或年老久虚导致脾肾两虚,可引起膏脂沉积,卫气内伐,扰乱营气,痰瘀并生,最终引发胸痹的观点,有助于从中医的辨证论治及整体观念角度认识微观PCAT病理机制,为今后从“卫气内伐”角度治疗CHD提供理论支持。

Pericoronary adipose tissue(PCAT)is a special kind of adipose tissue around coronary artery,which can cause atherosclerosis‘out to inside’in pathological conditions,thus causing coronary heart disease(CHD).From the perspective of traditional Chinese medicine(TCM),the biological characteristics of PCAT are similar to‘defensive qi’.This paper combines the theory of TCM and modern scientific mechanism,from the theory of‘defensive qi internal logging’to explore PCAT in pathological conditions to promote atherosclerosis.We put forward the view that deficiency of spleen and kidney caused by improper diet or chronic deficiency of old age may lead to deposition of ointment and lipid,defensive qi internal logging,disturbance of nutrient qi,coexistence of phlegm and blood stasis,and finally lead to chest stuffiness and pains,help from the dialectical theory of TCM and the overall concept of micro PCAT pathological mechanism,to provide theoretical support for the treatment of CHD from the perspective of‘defensive qi internal logging’in the future.