从“益气养阴”角度探讨中医药调节线粒体能量代谢紊乱治疗冠心病研究进展

Research progress on traditional Chinese medicine regulating mitochondrial energy metabolism disorder for coronary heart disease from the perspective of “supplementing qi and nourishing yin”

关键词:  线粒体能量代谢  冠状动脉粥样硬化性心脏病  气阴两虚  中医药  综述

Key words:  mitochondrial energy metabolism  coronary heart disease  qi and yin deficiency  traditional Chinese medicine  review

摘要:

文章基于《中国心血管健康与疾病报告2023》数据，综述了线粒体能量代谢紊乱与冠状动脉粥样硬化性心脏病（简称冠心病，CHD）气阴两虚证的关系及中医药“益气养阴”干预机制。CHD属中医“胸痹”“心痛”范畴，气阴两虚是其常见证型。研究表明，线粒体能量代谢障碍导致三磷酸腺苷（ATP）合成不足、活性氧增多等，与CHD发生与发展密切相关。ATP不足所致心功能减退印证了“气虚”病机，而代谢底物蓄积等现象则与“阴虚”病机相关。目前研究发现，多种益气养阴中药及复方能够改善线粒体功能，促进ATP合成，抑制氧化应激与细胞凋亡，从而缓解心肌损伤。文章从“益气养阴”角度探讨中医药调节线粒体能量代谢治疗CHD的机制，为中西医结合防治CHD提供理论依据与研究思路。

Abstract:

Based on the data from the Report on Cardiovascular Health and Diseases in China 2023,the article reviews the relationship between mitochondrial energy metabolism disorder and the syndrome of qi and yin deficiency in coronary atherosclerotic heart disease(coronary heart disease,CHD),as well as the intervention mechanisms of traditional Chinese medicine(TCM) through the principle of "supplementing qi and nourishing yin". CHD belongs to the categories of "chest impediment" and "heart pain" in TCM,with qi and yin deficiency being a common syndrome pattern. Studies have shown that mitochondrial energy metabolism disorder,leading to insufficient adenosine triphosphate(ATP) synthesis and increased reactive oxygen species,is closely related to the occurrence and progression of CHD. The resulting decline in cardiac function corroborates the TCM pathogenesis of "qi deficiency",while phenomena such as metabolic substrate accumulation are related to the pathogenesis of "yin deficiency". Current research has found that various Chinese medicinal herbs and compound formulas for supplementing qi and nourishing yin can improve mitochondrial function,promote ATP synthesis,inhibit oxidative stress and cell apoptosis,thereby alleviating myocardial injury. The article discusses the mechanisms by which TCM regulates mitochondrial energy metabolism to treat CHD from the perspective of "supplementing qi and nourishing yin",providing a theoretical basis and research direction for the integrated Chinese and Western medicine prevention and treatment of CHD.