基于氧化应激学说探讨从痰论治冠心病合并抑郁

Discussion on the Treatment of Coronary Heart Disease and Depression from Phlegm Based on the Theory of“Oxidative Stress”

随着“生物-心理-社会”医学模式的确立,冠心病合并抑郁症的“双心疾病”已逐渐在国内外医学界受到重视。抑郁症作为临床上常见的一种精神障碍类疾病,常与冠状动脉粥样硬化性心脏病兼而并见、互为影响。有研究表明,氧化应激在冠心病、抑郁症的发生发展中具有重要的作用,调节氧化应激水平可能是治疗双心疾病的潜在靶点之一。冠心病、抑郁症归属于中医学“胸痹”“郁证”等范畴,痰浊是冠心病与抑郁症发病机制的关键枢纽。该文拟从氧化应激学说出发,立足于中医痰浊理论及现代研究,通过阐明痰浊的演变形成与氧化应激致病特点等方面的相似性,以及在冠心病与抑郁症中的调节作用,对中医从痰论治冠心病合并抑郁进行理论探析,以期为中医治疗双心疾病提供新思路。

With the establishment of the“bio-psycho-social”model of medicine,the“psycho-cardiology”of coronary heart disease(CHD)combined with depressive disorder has gradually gained attention in the medical community at home and abroad.Depressive disorder,as a common clinical mental disease often coexist with and mutually influence coronary heart disease.Studies have shown that oxidative stress(OS)plays an important role in the occurrence and development of CHD and depression disorder.Regulation of oxidative stress may be a potential target for the treatment of the disease.CHD and depressive order belongs to the category of“chest paralysis”and“depressive syndrome”in traditional Chinese medicine(TCM).Phlegm is a key pivot in the pathogenesis of CHD and depressive disorder.Based on the doctrine of OS and the theory of phlegm in TCM and modern studies,this paper aims to clarify the similarities between the evolutionary formation of phlegm and the pathogenic characteristics of OS,as well as its regulatory role in CHD and depressive disorder.To explore the theory of the treatment of CHD combined with depressive disorder from phlegm theory in TCM,in order to provide a new idea for the treatment of psycho-cardiology disease in TCM.