| 引用本文: |
卢佳慧, 刘雪梅, 马承平, 张艺馨, 傅晨.从线粒体功能障碍视角解析“虚气留滞”理论在血管性痴呆中的内涵与辨治[J].湖南中医药大学学报,2026,46(3):548-554[点击复制] |
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| 从线粒体功能障碍视角解析“虚气留滞”理论在血管性痴呆中的内涵与辨治 |
| 卢佳慧,刘雪梅,马承平,张艺馨,傅晨 |
| (北京中医药大学, 北京 100029;北京中医药大学东方医院脑病二科, 北京 100078) |
| 摘要: |
| 血管性痴呆（VD）是由脑血管病变引起的常见认知功能障碍综合征，也是导致老年人失能的主要原因之一。线粒体功能障碍如动力学失衡、自噬异常等诱发的氧化应激、神经炎症等过程，与中医“痰湿化浊”“浊毒内生”损伤脑络的理论具有一定相关性。“虚气留滞”理论是指因元气亏虚，导致气血津液运行失畅，进而形成气滞、血瘀、痰凝等病理产物的病机过程，这与VD“本虚标实、虚实夹杂”的核心病机高度契合。VD以“虚气”（心、脾、肾元气亏虚）为本，以“留滞”（痰浊、瘀血阻窍）为标，二者互为因果，形成恶性循环。基于此，本文立足于“虚气留滞”理论，将“元气亏虚-ATP生成不足”与“痰瘀阻窍-ROS及炎症因子蓄积”结合进行阐释，提出以“补虚通滞”为原则的治法，旨在阐明多靶点调控线粒体功能干预VD的作用机制，并丰富其辨治思路，从而为构建一个融贯中医病机理论与现代病理机制于一体的VD防治框架提供理论参考。 |
| 关键词: 血管性痴呆 线粒体功能障碍 虚气留滞 补虚通滞 |
| DOI：10.3969/j.issn.1674-070X.2026.03.015 |
| 投稿时间：2025-11-13 |
| 基金项目:中央高水平中医医院临床科研业务费资助（DFGZRC-2024GJRC021）；国家自然科学基金青年科学基金项目（82104808）。 |
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| Connotation and pattern differentiation-based treatment of "deficient qi-induced stagnation" in vascular dementia from the perspective of mitochondrial dysfunction |
| LU Jiahui, LIU Xuemei, MA Chengping, ZHANG Yixin, FU Chen |
| (Beijing University of Chinese Medicine, Beijing 100029, China;The Second Department of Brain Disease, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China) |
| Abstract: |
| Vascular dementia (VD) is a common cognitive impairment syndrome caused by cerebrovascular lesions and represents a major cause of disability among the elderly. Processes such as oxidative stress and neuroinflammation induced by mitochondrial dysfunction—including kinetic imbalance and abnormal autophagy—show certain correlations with TCM theories of "phlegm dampness transforming into turbidity" and "internal generation of turbid toxins" that damage the cerebral collaterals. The theory of "deficient qi-induced stagnation" describes a pathological process in which deficiency of Yuan-primordial qi leads to impaired circulation of qi, blood, and body fluids, thereby forming pathological products such as qi stagnation, blood stasis, and phlegm accumulation. This aligns closely with the core pathogenesis of VD, which is characterized by "deficiency at the root and excess at the manifestation, along with combined deficiency and excess pattern." In VD, "deficient qi" (deficiency of Yuan-primordial qi in the heart, spleen, and kidneys) constitutes the root, whereas "stagnation"(obstruction of orifices by phlegm turbidity and blood stasis) represents the manifestation. These two aspects are mutually causative, forming a vicious cycle. Grounded in the theory of "deficient qi-induced stagnation", this paper integrates the concepts of "Yuan-primordial qi deficiency-ATP production insufficiency" with "phlegm-stasis obstruction of orifices-accumulation of ROS and inflammatory factors." A therapeutic strategy guided by the principle of "tonifying deficiency and resolving stagnation" is proposed. It aims to elucidate the mechanism of action by which multi-target regulation of mitochondrial function may intervene in VD, enrich the theoretical framework for pattern differentiation and treatment, and provide a theoretical reference for constructing an integrated prevention and treatment framework for VD that combines TCM pathogenesis theory with modern pathological mechanisms. |
| Key words: vascular dementia mitochondrial dysfunction deficient qi-induced stagnation tonify deficiency and reslove stagnation |
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