从脉络学说角度探讨通络治疗脉络-血管系统病规律
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摘要
脉络学说是指导脉络-血管系统病变治疗的重要理论,该理论以脉为独立脏腑组织为立足点,探讨多种现代血管系统疾病的共性病理机制微血管病变,并提出该类疾病的共性干预策略"孙络-微血管"保护,而通心络作为"孙络-微血管"保护的代表性通络中药复方,通过多种途径的内皮细胞保护作用实现对微血管的保护,进而有效治疗心肌梗死后无再流、脑梗死以及糖尿病并发症等多系统脉络疾病的作用特点,体现脉络学说从脉为单独研究对象对血管系统疾病治疗的指导价值。
Vessels-collateral theory is constructed by regards Vessels as an independent organ and modern vascular system research inclusive,which is an important guidance theory in the treatment of vascular disease. The theory of veins is an important theory of vegan-vascular disease treatment. The theory aims to explore the common pathogenesis of multi-system disease-microvascular injury,and put forward the common disease Intervention strategy-" minute collateramicrovascular" protection,and Tongxinluo as representative " minute collatera-microvascular " protection of Chinese medicine compound,which through a variety of ways of endothelial cell protection to achieve the protection of capillaries,and thus effective treatment of myocardial infarction no reflow,cerebral infarction and diabetic complications and other multi-system disease characteristics of the disease. The function of Tongxinluo reflects the guiding value of the Vessels-collateral in the treatment of vascular system.
Vessels-collateral theory is constructed by regards Vessels as an independent organ and modern vascular system research inclusive,which is an important guidance theory in the treatment of vascular disease. The theory of veins is an important theory of vegan-vascular disease treatment. The theory aims to explore the common pathogenesis of multi-system disease-microvascular injury,and put forward the common disease Intervention strategy-" minute collateramicrovascular" protection,and Tongxinluo as representative " minute collatera-microvascular " protection of Chinese medicine compound,which through a variety of ways of endothelial cell protection to achieve the protection of capillaries,and thus effective treatment of myocardial infarction no reflow,cerebral infarction and diabetic complications and other multi-system disease characteristics of the disease. The function of Tongxinluo reflects the guiding value of the Vessels-collateral in the treatment of vascular system.
引文
[1]吴以岭.“脉络—血管系统病”新概念及其治疗探讨[J].疑难病杂志,2005,4(5):285-287.
[2]吴以岭.“脉络-血管系统”相关性探讨[J].中医杂志,2007,48(1):5-8.
[3]吴以岭,袁国强,贾振华,等.脉络学说的学术地位及其应用价值[J].中医杂志,2012,53(1):3-7.
[4]常成成,魏聪,吴以岭.脉络学说“孙络-微血管”概念及其临床指导意义[J].中医杂志,2016,57(1):7-11.
[5]吴以岭.脉络论[M].北京:中国科学技术出版社,2010:54.
[6]张鑫月.高危因素致颈动脉粥样硬化患者甲襞微循环病变特征及通络干预研究[D].石家庄:河北医科大学,2014.
[7]刘秀华,郭渝成.微血管病——转化医学的范例[J].微循环学杂志,2012,22(1):1-5.
[8]田牛.循环学[M].北京:北京原子能出版社,2004:33.
[9]ZHANG HT,JIA ZH,ZHANG J,et al. No-reflow protection and long-term efficacy for acute myocardial infarction with Tongxinluo:a randomized double-blind placebo-controlled multicenter clinical trial(ENLEAT Trial)[J]. Chin Med J(Engl),2010,123(20):2858-2864.
[10]LI XD, YANG YJ, GENG YJ, et al. Tongxinluo reduces myocardial no-reflow and ischemia-reperfusion injury by stimulating the phosphorylation of e NOS via the PKA pathway[J]. Am J Physiol Heart Circ Physiol,2010,299(4):H1255-1261.
[11]CUI H,LI X,LI N,et al. Induction of autophagy by Tongxinluo through the MEK/ERK pathway protects human cardiac microvascular endothelial cells from hypoxia/reoxygenation injury[J]. J Cardiovasc Pharmacol,2014,64(2):180-190.
[12]LI YN, WANG XJ, LI B, et al. Tongxinluo inhibits cyclooxygenase-2, inducible nitric oxide synthase, hypoxiainducible factor-2alpha/vascular endothelial growth factor to antagonize injury in hypoxia-stimulated cardiac microvascular endothelial cells[J]. Chin Med J(Engl),2015,128(8):1114-1120.
[13]LIANG JQ,WU K,JIA ZH,et al. Chinese medicine Tongxinluo modulates vascular endothelial function by inducing e NOS expression via the PI-3K/Akt/HIF-dependent signaling pathway[J]. J Ethnopharmacol,2011,133(2):517-523.
[14]LI LM,ZHENG B,ZHANG RN,et al. Chinese medicine Tongxinluo increases tight junction protein levels by inducing KLF5 expression in microvascular endothelial cells[J]. Cell biochemistry and function,2015,33(4):226-234.
[15]吴以岭.血管保护——脑梗死治疗的新靶点[J].疑难病杂志,2006,5(5):356-358.
[16]常丽萍,魏聪,贾振华,等.通心络对缺血性脑卒中大鼠微血管新生及血流灌注状态的影响[J].中国中西医结合杂志,2012,32(12):1667-1670.
[17]吴以岭,吴正国,袁国强,等.通心络对实验性大脑中动脉闭塞大鼠脑缺血微血管的保护作用[J].中华神经科杂志,2007,40(1):54-58.
[18]丁素菊,黎佳思,毕晓莹,等.通心络对局灶性脑缺血再灌注损伤大鼠保护作用及机制研究[J].中华脑血管病杂志:电子版,2010,4(1):3-10.
[19]LIU S,WEI C,KANG N,et al. Chinese medicine Tongxinluo capsule alleviates cerebral microcirculatory disturbances in ischemic stroke by modulating vascular endothelial function and inhibiting leukocyte-endothelial cell interactions in mice:A twophoton laser scanning microscopy study[J]. Microcirculation,2018,25(2).
[20]李敏州,高彦彬,马鸣飞,等.糖尿病肾病发病机制研究进展[J].中国实验方剂学杂志,2012,18(22):344-349.
[21]WANG JY,GAO YB,ZHANG N,et al. Tongxinluo ameliorates renal structure and function by regulating miR-21-induced epithelial-to-mesenchymal transition in diabetic nephropathy[J].Am J Physiol Renal Physiol,2014,306(5):F486-495.
[22]周盛楠,高彦彬,李娇阳,等.通心络对早期糖尿病肾病大鼠肾功能及肾组织NO/e NOS表达的影响[J].环球中医药,2014,7(11):821-825.
[23]李娇阳,高彦彬,周盛楠,等.通心络对早期糖尿病肾病大鼠血管内皮生长因子表达的影响[J].环球中医药,2015,8(1):29-32.
[24]李娇阳,高彦彬,周盛楠,等.通心络对2型糖尿病大鼠肾脏血管紧张素Ⅱ表达的影响[J].世界中医药,2015,10(8):1222-1226.
[25]周盛楠,高彦彬,耿建国,等.通心络对糖尿病肾病大鼠肾组织NO和ET-1的影响[J].世界中西医结合杂志,2016,11(2):181-184.
[26]卢姗,沈捷,马向华.糖尿病足微循环改变的基础和研究进展[J].医学研究生学报,2010,23(11):1213-1216.
[27]仲炜,倪林,范晓萍.通心络胶囊治疗糖尿病足临床观察[J].辽宁中医杂志,2014,41(7):1436-1437.
[28]高怀林,贺会仙,孔青,等.通心络对糖尿病足大鼠内皮功能的影响[J].疑难病杂志,2015,14(9):888-890.
[29]郭勇英,位庚,李红蓉,等.通心络联合外周血间充质干细胞移植对糖尿病足大鼠血管新生磷脂酰肌醇3-激酶/蛋白激酶B信号通路的影响研究[J].中国全科医学,2016,19(13):1602-1606.
[2]吴以岭.“脉络-血管系统”相关性探讨[J].中医杂志,2007,48(1):5-8.
[3]吴以岭,袁国强,贾振华,等.脉络学说的学术地位及其应用价值[J].中医杂志,2012,53(1):3-7.
[4]常成成,魏聪,吴以岭.脉络学说“孙络-微血管”概念及其临床指导意义[J].中医杂志,2016,57(1):7-11.
[5]吴以岭.脉络论[M].北京:中国科学技术出版社,2010:54.
[6]张鑫月.高危因素致颈动脉粥样硬化患者甲襞微循环病变特征及通络干预研究[D].石家庄:河北医科大学,2014.
[7]刘秀华,郭渝成.微血管病——转化医学的范例[J].微循环学杂志,2012,22(1):1-5.
[8]田牛.循环学[M].北京:北京原子能出版社,2004:33.
[9]ZHANG HT,JIA ZH,ZHANG J,et al. No-reflow protection and long-term efficacy for acute myocardial infarction with Tongxinluo:a randomized double-blind placebo-controlled multicenter clinical trial(ENLEAT Trial)[J]. Chin Med J(Engl),2010,123(20):2858-2864.
[10]LI XD, YANG YJ, GENG YJ, et al. Tongxinluo reduces myocardial no-reflow and ischemia-reperfusion injury by stimulating the phosphorylation of e NOS via the PKA pathway[J]. Am J Physiol Heart Circ Physiol,2010,299(4):H1255-1261.
[11]CUI H,LI X,LI N,et al. Induction of autophagy by Tongxinluo through the MEK/ERK pathway protects human cardiac microvascular endothelial cells from hypoxia/reoxygenation injury[J]. J Cardiovasc Pharmacol,2014,64(2):180-190.
[12]LI YN, WANG XJ, LI B, et al. Tongxinluo inhibits cyclooxygenase-2, inducible nitric oxide synthase, hypoxiainducible factor-2alpha/vascular endothelial growth factor to antagonize injury in hypoxia-stimulated cardiac microvascular endothelial cells[J]. Chin Med J(Engl),2015,128(8):1114-1120.
[13]LIANG JQ,WU K,JIA ZH,et al. Chinese medicine Tongxinluo modulates vascular endothelial function by inducing e NOS expression via the PI-3K/Akt/HIF-dependent signaling pathway[J]. J Ethnopharmacol,2011,133(2):517-523.
[14]LI LM,ZHENG B,ZHANG RN,et al. Chinese medicine Tongxinluo increases tight junction protein levels by inducing KLF5 expression in microvascular endothelial cells[J]. Cell biochemistry and function,2015,33(4):226-234.
[15]吴以岭.血管保护——脑梗死治疗的新靶点[J].疑难病杂志,2006,5(5):356-358.
[16]常丽萍,魏聪,贾振华,等.通心络对缺血性脑卒中大鼠微血管新生及血流灌注状态的影响[J].中国中西医结合杂志,2012,32(12):1667-1670.
[17]吴以岭,吴正国,袁国强,等.通心络对实验性大脑中动脉闭塞大鼠脑缺血微血管的保护作用[J].中华神经科杂志,2007,40(1):54-58.
[18]丁素菊,黎佳思,毕晓莹,等.通心络对局灶性脑缺血再灌注损伤大鼠保护作用及机制研究[J].中华脑血管病杂志:电子版,2010,4(1):3-10.
[19]LIU S,WEI C,KANG N,et al. Chinese medicine Tongxinluo capsule alleviates cerebral microcirculatory disturbances in ischemic stroke by modulating vascular endothelial function and inhibiting leukocyte-endothelial cell interactions in mice:A twophoton laser scanning microscopy study[J]. Microcirculation,2018,25(2).
[20]李敏州,高彦彬,马鸣飞,等.糖尿病肾病发病机制研究进展[J].中国实验方剂学杂志,2012,18(22):344-349.
[21]WANG JY,GAO YB,ZHANG N,et al. Tongxinluo ameliorates renal structure and function by regulating miR-21-induced epithelial-to-mesenchymal transition in diabetic nephropathy[J].Am J Physiol Renal Physiol,2014,306(5):F486-495.
[22]周盛楠,高彦彬,李娇阳,等.通心络对早期糖尿病肾病大鼠肾功能及肾组织NO/e NOS表达的影响[J].环球中医药,2014,7(11):821-825.
[23]李娇阳,高彦彬,周盛楠,等.通心络对早期糖尿病肾病大鼠血管内皮生长因子表达的影响[J].环球中医药,2015,8(1):29-32.
[24]李娇阳,高彦彬,周盛楠,等.通心络对2型糖尿病大鼠肾脏血管紧张素Ⅱ表达的影响[J].世界中医药,2015,10(8):1222-1226.
[25]周盛楠,高彦彬,耿建国,等.通心络对糖尿病肾病大鼠肾组织NO和ET-1的影响[J].世界中西医结合杂志,2016,11(2):181-184.
[26]卢姗,沈捷,马向华.糖尿病足微循环改变的基础和研究进展[J].医学研究生学报,2010,23(11):1213-1216.
[27]仲炜,倪林,范晓萍.通心络胶囊治疗糖尿病足临床观察[J].辽宁中医杂志,2014,41(7):1436-1437.
[28]高怀林,贺会仙,孔青,等.通心络对糖尿病足大鼠内皮功能的影响[J].疑难病杂志,2015,14(9):888-890.
[29]郭勇英,位庚,李红蓉,等.通心络联合外周血间充质干细胞移植对糖尿病足大鼠血管新生磷脂酰肌醇3-激酶/蛋白激酶B信号通路的影响研究[J].中国全科医学,2016,19(13):1602-1606.