| 引用本文: |
王梦雪, 栾玉洁, 丁炫烨, 李嘉琦, 张雯静, 胡元会.基于“营卫倾移”理论探讨免疫代谢紊乱在下肢动脉粥样硬化中的病机及辨治[J].湖南中医药大学学报,2026,46(5):1046-1053[点击复制] |
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| 基于“营卫倾移”理论探讨免疫代谢紊乱在下肢动脉粥样硬化中的病机及辨治 |
| 王梦雪,栾玉洁,丁炫烨,李嘉琦,张雯静,胡元会 |
| (中国中医科学院广安门医院, 北京 100053;中国中医科学院广安门医院南区, 北京 102600;北京中医药大学研究生院, 北京 100029;山东第一医科大学, 山东 济南 250117) |
| 摘要: |
| 下肢动脉粥样硬化是动脉粥样硬化病变累及下肢大中动脉的慢性炎症性疾病，其临床主要表现为下肢麻木、发凉、疼痛、间歇性跛行等，严重者可发生溃疡甚至坏疽，具有发病率高、迁延难愈等特点。本文立足于中医学“营卫倾移”理论，并结合免疫代谢紊乱这一关键病理环节，认为下肢动脉粥样硬化病机演变始于内外合邪而致“营卫相倾”，进展为“营卫倾移”而痰瘀内生，终致毒痹营卫而神机失用。治疗上以调和营卫为总纲，初期首当调补营卫、祛邪防痹，方用桂枝汤加减；进展期重在祛痰化瘀、交通营卫，方用赤麒麟散加减；末期则通络调神、宣通营卫，方用芍药甘草汤合四妙勇安汤加减，以期为丰富中医学营卫理论，推动中医药防治下肢动脉粥样硬化的临床应用提供理论支撑。 |
| 关键词: 下肢动脉粥样硬化|营卫理论|免疫代谢|巨噬细胞 |
| DOI：10.3969/j.issn.1674-070X.2026.05.025 |
| 投稿时间：2025-11-27 |
| 基金项目:中国中医科学院广安门医院（南区）所级科研基金课题（Y2023-21）。 |
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| Pathogenesis and pattern identification-based treatment of immune-metabolic dysregulation in lower extremity artery disease based on the theory of "tipping and shifting of Ying-nutrients and Wei-defence" |
| WANG Mengxue, LUAN Yujie, DING Xuanye, LI Jiaqi, ZHANG Wenjing, HU Yuanhui |
| (Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China;South District of Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 102600, China;Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China;Shandong First Medical University, Jinan, Shandong 250117, China) |
| Abstract: |
| Lower extremity artery disease (LEAD) is a chronic inflammatory disease characterized by atherosclerotic lesions affecting the medium and large arteries of the lower limbs. Its main clinical manifestations include numbness, cold sensation, pain, and intermittent claudication of the lower extremities; severe cases may progress to ulceration or even gangrene. The disease has a high incidence rate and tends to be protracted and difficult to cure. Based on the TCM theory of "tipping and shifting of Ying-nutrients and Wei-defence" and considering immune-metabolic dysregulation as a key pathological link, this paper proposes that the pathogenesis of LEAD evolves from the initial stage where external and internal pathogenic factors combine to cause "tipping of Ying-nutrients and Wei-defence", progresses to "shifting of Ying-nutrients and Wei-defence" with generation of phlegm and blood stasis internally, and finally leads to toxin obstructing the Ying-nutrients and Wei-defence, resulting in dysfunction of the spirit. In terms of treatment, harmonizing Ying-nutrients and Wei-defence is regarded as the general principle. At the initial stage, the priority is to tonify and harmonize Ying-nutrients and Wei-defence, dispel pathogenic factors, and prevent bi-impediment, using modified Guizhi Decoction. At the progressive stage, the focus is on resolving phlegm and removing blood stasis and reconnecting Ying-nutrients and Wei-defence, using modified Chiqilin Powder. At the advanced stage, the treatment aims to unblock the collaterals, regulate the spirit, and unblock Ying-nutrients and Wei-defence, using modified Shaoyao Gancao Decoction combined with Simiao Yong'an Decoction. This paper aims to enrich the TCM theory of "Ying-nutrients and Wei-defence" and to provide theoretical support for the clinical application of Chinese medicine in the prevention and treatment of LEAD. |
| Key words: lower extremity artery disease|theory of "Ying-Wei Imbalancet"|immune metabolism|macrophage |
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