基于“肝受气于心,传之于脾”探讨血流剪切力调控冠心病的相关机制

Exploring Relevant Mechanisms of Blood Flow Shear Force Regulation in Coronary Heart Disease Based on Principle of "Liver Receiving Qi from Heart and Transmitting to Spleen"

“肝受气于心,传之于脾”包括肝脾同治的理念。肝脾居中焦,调节各脏腑之气机升降出入,正所谓“气有余,则制己所胜而侮所不胜”,肝脾功能失衡,可祸及于心。研究发现疏肝健脾祛痰法能够调节miR-155水平,上调胆固醇跨血管内皮转运主要受体ABCA1,减少胆固醇沉积,改善冠脉血流量,但具体机制尚不明确。新近研究表明,血流剪切应力感受器Integrin激活可致miR-155核内启动下游基因转录。基于前期基础结合国内外研究进展,关注环境因素和生活方式对冠心病形成的作用,提出“肝郁脾虚,痰浊内生”乃AS重要病机,揭示《内经》藏象理论心病防治新策略的科学内涵,为中医从肝脾防治冠心病提供科学依据。

The theory of "the liver receiving Qi from heart and transmitting to spleen" includes the concept of treating liver and spleen together. Liver and spleen are in the middle Jiao, and can regulate the Qi movement of Zang-Fu organs, which is so-called "the Zang-Fu organs with Qi excess can restrict the corresponding organs and counter-restrict the organs which it can not restrict in the normal state",liver and spleen function imbalance can affect heart. Studies have shown that soothing liver, strengthening spleen and eliminating phlegm method can regulate the level of miR-155,up-regulate ABCA1 which is the main receptor of cholesterol transvascular endothelial transport, reduce cholesterol deposition and improve coronary blood flow, but the specific mechanism is still unclear. Recent studies have shown that integrin activation of the blood flow shear stress receptor initiates downstream gene transcription in the nucleus of miR-155. Based on the previous foundation and the research progress at home and abroad, it pays attention to the role of environmental factors and lifestyle on the formation of coronary heart disease, and puts forward that "liver depression and spleen deficiency, internal turbid phlegm" is an important pathogenesis of atherosclerosis, revealing the scientific connotation of the new strategy of heart disease prevention and treatment in the theory of storing image in the Internal Classic,and providing scientific basis for the prevention and treatment of coronary heart disease by traditional Chinese medicine from liver and spleen.