| 引用本文: |
蔡智辉, 秦泽琳, 陈金亮, 刘蕊, 李欣, 段文慧.从“痰、瘀、毒”探讨血管周围脂肪组织对冠心病的影响[J].湖南中医药大学学报,2026,46(6):1204-1212[点击复制] |
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| 从“痰、瘀、毒”探讨血管周围脂肪组织对冠心病的影响 |
| 蔡智辉,秦泽琳,陈金亮,刘蕊,李欣,段文慧 |
| (北京中医药大学研究生院, 北京 100029;中国中医科学院西苑医院, 北京 100091;国家中医临床心血管病医学研究中心, 北京 100091) |
| 摘要: |
| 血管周围脂肪组织（PVAT）是包裹在人体大多数血管周围且具有特异性功能的脂肪组织，是影响冠心病发生发展的重要血管外微环境。本文从中医“痰、瘀、毒”理论阐释PVAT与冠心病病机演变的内在联系，中医“膏脂生痰-痰瘀互结-瘀毒致变”的病机演变过程与PVAT异常介导的“脂肪表型失衡-恶性环路放大-稳定斑块破坏”的病理机制高度契合，并提出以化痰活血解毒为核心、通过调控PVAT通路为切入点的治疗思路，为冠心病防治与高危事件预防提供新策略，同时为揭示“痰、瘀、毒”理论的微观生物学基础、筛选中药优势作用靶点及构建PVAT相关风险预警和疗效评价影像学生物标志物提供新方向。 |
| 关键词: “痰、瘀、毒”理论 血管周围脂肪组织 冠心病 中医药 |
| DOI：10.3969/j.issn.1674-070X.2026.06.016 |
| 投稿时间：2026-01-28 |
| 基金项目:北京市研究型病房卓越临床研究计划项目（BRWEP2024Z014170105）；中国中医科学院西苑医院中医药临床科研一体化平台建设专项（XYZX0405-03）。 |
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| Effects of perivascular adipose tissue on coronary heart disease from the perspective of “phlegm, blood stasis, and toxin” |
| CAI Zhihui, QIN Zelin, CHEN Jinliang, LIU Rui, LI Xin, DUAN Wenhui |
| (Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China;Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China;National Research Center for Clinical Cardiovascular Diseases, Beijing 100091, China) |
| Abstract: |
| Perivascular adipose tissue (PVAT), a specialized adipose tissue surrounding most blood vessels in the human body, constitutes an important extra-vascular microenvironment affecting the occurrence and development of coronary heart disease (CHD). This paper primarily elucidates the intrinsic association between PVAT and the pathogenetic evolution of CHD from the perspective of the Chinese medicine (TCM) theory of "phlegm, blood stasis, and toxin". It is proposed that the TCM pathogenetic process of "gaozhi (lipid accumulation) generating phlegm—intertwined phlegm and blood stasis—pathological transformation induced by blood stasis and toxin" is highly consistent with the PVAT-mediated pathological mechanism of "adipose phenotypic imbalance—vicious-cycle amplification—plaque stability disruption". Based on this understanding, a therapeutic approach centered on resolving phlegm, activating blood, and detoxifying, with modulation of the PVAT pathway as an entry point, is proposed. This may provide a new strategy for the prevention and treatment of CHD and the prevention of high-risk cardiovascular events, and may also offer new directions for elucidating the micro-biological basis of the theory of "phlegm, blood stasis, and toxin," identifying priority targets of Chinese medicines, and establishing PVAT-related imaging biomarkers for risk warning and efficacy evaluation. |
| Key words: phlegm,blood stasis,and toxin theory perivascular adipose tissue coronary heart disease Chinese medicine |
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