基于脂噬角度探讨“态靶辨治”理念下高血压病“病-期-态”的生物学内涵

Biological Connotation of Disease-stage-state of Hypertension in Concept of State-target Differentiation and Treatment From Perspective of Lipophagy

高血压病是一种常见的以动脉压升高为主要临床表现的慢性疾病,能够使心、脑、肾等重要器官发生病变,近几年,高血压病渐渐成为常见的流行病之一,其发病率也呈逐年增长的趋势。仝小林院士将中医理论及个人临床经验相结合,依据态靶理论,提出了高血压病“病-期-态”具体病机。脂噬可通过干预脂质代谢、动脉粥样硬化、动脉斑块形成、血管重塑、血管内皮损伤等高血压发病环节,在高血压病的发病机制中发挥重要作用。通过现代医学和生物学研究,一方面认为脂噬动态病理变化与高血压态靶辨治“期”的密切相关,其动态病理变化与高血压病3个阶段疾病发生发展的时间点互相对应,另一方面认为脂噬是高血压态靶辨治“态”的重要微观体现。基于脂噬探讨高血压病的态靶辨治“病-期-态”模式的生物学内涵,借鉴现代医学疾病认知来认识疾病发展规律,可使中医宏观辨治思路与现代医学微观理化指标精准对接,实现中医精准治疗,以期为高血压病及其并发症的早期防治拓展新思路。

Hypertension is a common chronic disease with elevated arterial pressure as the main clinical manifestation,which can cause lesions in important organs such as heart,brain and kidney.In recent years,the prevalence of hypertension has increased,and its incidence is also increasing year by year.Combining the theory of traditional Chinese medicine(TCM)with personal clinical experience,Academician TONG Xiaolin put forward the specific pathogenesis of"disease-stage-state"of hypertension based on the state-target theory.Lipophagy plays an important role in the pathogenesis of hypertension by interfering with lipid metabolism,atherosclerosis,arterial plaque formation,vascular remodeling,vascular endothelial injury and other aspects of hypertension.Through modern medical and biological research,on the one hand,it is believed that the dynamic pathological changes in lipophagy are closely related to the"stage"of hypertensive state-target differentiation and treatment,corresponding to the time points of disease occurrence and development in the three stages of hypertension.On the other hand,it is believed that lipophagy is an important microscopic manifestation of the"state"of hypertensive state-target differentiation and treatment.From the perspective of lipophagy,this paper discusses the biological connotation of the'disease-stage-state'model of state-target differentiation and treatment of hypertension and draws on the modern medicine to understand the law of disease development,matching the macro differentiation and treatment of TCM and the micro physico-chemical indicators of modern medicine to achieve precise TCM treatment.This study provides new ideas for the early prevention and treatment of hypertension and its complications.