作者：李琳莉，刘富林，施敏，夏旭婷，葛俊，毛彩薇

单位：

410208湖南省长沙市，湖南中医药大学中医学院

Units：

School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha 410208, China

关键词：

心力衰竭；正邪相争；巨噬细胞；胞葬

Keywords：

Heart failure; Struggle between vital Qi and pathogen; Macrophages; Efferocytosis

CLC：

R 541.6

DOI：

10.12114/j.issn.1008-5971.2024.00.122

Funds：

湖南省自然科学基金面上项目（2022JJ30437）

摘要：

胞葬作为一种新型程序性凋亡细胞清除方式，指巨噬细胞将凋亡细胞吞噬、降解以防止细胞内自身抗 原引起的继发性坏死的过程，是机体生理过程中一种关键的稳态机制，在心力衰竭中起着关键作用。本文分析了中医 正邪理论，阐释心力衰竭乃本虚标实之证，正虚邪实构成其关键病机。并进一步探讨正邪理论在心力衰竭发生发展中 的作用机制，指出巨噬细胞胞葬乃“气”的微观表现，可能具有祛病维稳之功效。基于此，本文提出以正邪理论为指 导，通过扶正祛邪之法选方遣药，从而调控巨噬细胞胞葬，这可为心力衰竭的临床防治提供新的思路。

Abstract：

Efferocytosis was a novel programmed cell death clearance method, where macrophages phagocytize and degrade apoptotic cells to prevent secondary necrosis caused by intracellular autoantigens. It is a key homeostatic mechanism in the physiological processes of the body and plays a crucial role in heart failure. This article analyzes the traditional Chinese medicine theory of healthy Qi and pathogenic, elucidats that the heart failure is a syndrome of root deficiency and branch excess, and the key pathogenesis is composed of healthy Qi deficiency and pathogenic excess, and further explores the mechanism of theory of healthy Qi and pathogenic in the occurrence and development of heart failure, points out that macrophage efferocytosis is a microcosmic manifestation of "Qi" , and may have the effect of removing disease and maintaining stability. Based on this, this article proposes using the theory of healthy Qi and pathogenic as a guide, selecting appropriate treatments through the method of healthy Qi and eliminate pathogenic, in order to regulate macrophage efferocytosis, and this can provide new ideas for the clinical prevention and treatment of heart failure.

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