| 引用本文: |
王琳舒, 张明雪.基于“火郁发之”理论探讨易损斑块炎症消退障碍的辨治思路[J].湖南中医药大学学报,2026,46(9):1879-1887[点击复制] |
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| 基于“火郁发之”理论探讨易损斑块炎症消退障碍的辨治思路 |
| 王琳舒,张明雪 |
| (辽宁中医药大学, 辽宁 沈阳 110847;辽宁中医药大学附属医院, 辽宁 沈阳 110032) |
| 摘要: |
| 易损斑块破裂是急性冠脉综合征的主要病理基础之一。炎症消退障碍与巨噬细胞胞葬功能受损密切相关，凋亡细胞堆积和炎症迁延是其核心环节。本文从“火郁发之”理论出发，对此病理过程的中医病机进行理论阐释，认为“痰瘀互结，郁而化火，火郁不发”是炎症迁延的重要病机，其病机演变可概括为气郁化火、痰火瘀结、毒损心络3个阶段，胞葬功能障碍可视为该病机在细胞层面的关键环节。基于此病机，确立调畅气机、清除痰瘀、化解毒邪三层治法，使郁火得以外达，炎症得以消退。以“火郁发之”为理论切入点，探讨易损斑块炎症消退障碍的病机演变及分期辨治思路。 |
| 关键词: 易损斑块|炎症消退障碍|火郁发之|冠心病|胞葬作用|病机 |
| DOI：10.3969/j.issn.1674-070X.2026.09.018 |
| 投稿时间：2026-03-25 |
| 基金项目:国家重点研发计划项目(2017YFC1700401);全国名老中医药专家传承工作室项目(国中医药人教函[2022]75号);辽宁省特聘教授滚动支持项目(辽教函[2018]35号)。 |
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| Differentiation and treatment approach for impaired inflammation resolution in vulnerable plaques based on the theory of “dispersing fire stagnation” |
| WANG Linshu, ZHANG Mingxue |
| (Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110847, China;The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning 110032, China) |
| Abstract: |
| Rupture of vulnerable plaques is one of the main pathological bases of acute coronary syndrome (ACS). Impaired inflammation resolution is closely associated with defective macrophage efferocytosis, characterized by the accumulation of apoptotic cells and persistent inflammation. Drawing on the theory of "dispersing fire stagnation", this paper offers a theoretical interpretation of the TCM pathogenesis of this process. It proposes that "intertwined phlegm and blood stasis, qi stagnation transforming into fire, and fire stagnation failing to disperse" is an important pathogenesis of persistent inflammation. Its pathogenesis evolution can be summarized into three stages: qi stagnation transforming into fire, binding of phlegm, fire and blood stasis, and toxin damaging the heart collaterals. Defective efferocytosis represents a key cellular component of this pathogenesis. Based on this pathogenesis, a three-tier therapeutic approach is established: regulating qi movement, clearing phlegm and blood stasis, and resolving toxic pathogens, so that stagnated fire can disperse outward and inflammation can resolve. Taking "dispersing fire stagnation" as the theoretical entry point, this paper explores the pathogenesis evolution and staged differentiation and treatment approach for impaired inflammation resolution in vulnerable plaques. |
| Key words: vulnerable plaque|impaired inflammation resolution|dispersing fire stagnation|coronary heart disease|efferocytosis|pathogenesis |
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