| 引用本文: |
刘溪源, 寻馨, 吕怡, 周派, 彭清华.气阴两虚与铁死亡在糖尿病视网膜病变发病机制中的相关性探讨[J].湖南中医药大学学报,2025,45(8):1585-1590[点击复制] |
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| 气阴两虚与铁死亡在糖尿病视网膜病变发病机制中的相关性探讨 |
| 刘溪源,寻馨,吕怡,周派,彭清华 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 糖尿病视网膜病变（DR）是糖尿病常见的微血管并发症，也是导致糖尿病患者失明的主要原因之一。现代研究表明，铁死亡与DR的发病机制密切相关，其核心机制涉及铁离子代谢紊乱、脂质过氧化及抗氧化系统失衡。中医学认为，气阴两虚是消渴及其并发症消渴内障的核心病机。消渴日久，气耗阴伤，气虚推动无力，阴虚濡润失职，导致气血水运行输布失常，即气血水失调，是DR发生发展的关键病理环节。“气血水失调”理论与铁死亡机制在物质基础和病理过程上存在深刻关联。本文立足气阴两虚核心病机，探讨其导致气血水失调的病理过程，并以此为桥梁，阐释铁死亡在DR中的作用机制，揭示气阴两虚-气血水失调-铁死亡的内在联系，总结调节DR铁死亡的关键因子，以及靶向抑制铁死亡防治DR的中药活性成分及中药复方，为中医药防治DR提供理论参考。 |
| 关键词: 糖尿病视网膜病变 气阴两虚 气血水失调 铁死亡发病机制 |
| DOI：10.3969/j.issn.1674-070X.2025.08.029 |
| 投稿时间：2025-04-08 |
| 基金项目:国家自然科学基金项目(82274588,81904260);国家中医药管理局高水平重点学科《中医眼科学》建设项目(ZK1801YK015);中医药防治五官科疾病湖南省重点实验室建设项目(2017TP1018);湖南中医药大学研究生创新课题项目(CX20240745) |
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| Correlation between dual deficiency of qi and yin and ferroptosis in the pathogenesis of diabetic retinopathy |
| LIU Xiyuan, XUN Xin, LYU Yi, ZHOU Pai, PENG Qinghua |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Diabetic retinopathy（DR） is a common microvascular complication of diabetes and one of the leading causes of blindness in diabetic patients. Modern research indicates that ferroptosis is closely associated with the pathogenesis of DR,with its core mechanisms involving iron metabolism disorder, lipid peroxidation, and antioxidant system imbalance. In Chinese medicine（CM）, dual deficiency of qi and yin is recognized as the core pathogenesis of wasting and thirst disorder and its complication of eye disorders. Prolonged wasting and thirst disorder comsumes qi and damages yin. Qi deficiency results in insufficient propelling power, while yin deficiency causes a failure in nourishing and moistening functions. Consequently, the normal circulation and distribution of qi, blood, and body fluids become disrupted, which is referred to as qi-blood-fluid dysregulation, constituting a critical pathological process in the occurence and progression of DR. The theory of "qi-bloodfluid dysregulation" exhibits substantial material and pathological overlap with ferroptosis mechanisms. Grounded in the core pathogenesis of dual deficiency of qi and yin, the paper explores its role in triggering qi-blood-fluid dysregulation and uses this relationship as a bridge to elucidate the mechanism of action of ferroptosis in DR. It also reveals the intrinsic connection among dual deficiency of qi and yin, qi-blood-fluid dysregulation, and ferroptosis, summarizes key factors involved in regulating ferroptosis in DR, and identifies active ingredients of Chinese medicines and CM formulas targeting ferroptosis,aiming to provide a theoretical framework for CM-based prevention and treatment of DR. |
| Key words: diabetic retinopathy dual deficiency of qi and yin qi-blood-fluid dysregulation ferroptosis pathogenesis |
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