山西中医药大学学报2025，Vol.26Issue(12)：1322-1328,7.DOI:10.19763/j.cnki.2096-7403.2025.12.04
基于"气络理论"与"肺血管内皮间质转化"论治慢性阻塞性肺疾病相关性肺动脉高压
Based on the"theory of qi collaterals"and"pulmonary vascular endothelial-mesenchymal transition"in the treatment of COPD-associated pulmonary arterial hypertension
摘要
Abstract
Chronic obstructive pulmonary disease(COPD)is a chronic condition characterized by persistent airflow limitation.In some patients,progression to COPD-associated pulmonary arterial hypertension(COPD-PAH)occurs due to fibrosis and vascular occlusion driven by pulmonary vascular endothelial-mesenchymal transition(EndMT).COPD-PAH can be categorized under the traditional Chinese medicine(TCM)concept of"lung distension",whose progression is closely associated with"impaired qi collaterals".The theory of qi collaterals emphasizes the movement of qi and the patency of collateral vessels,elucidating the patterns of meridian qi circulation and distribution within the collaterals.Based on this theory,and using the pulmonary microvascular network and neuro-immune microenvironment as structural foundations,this study explores the dynamic correspondence between EndMT evolution and the imbalance of"qi-blood-collaterals"dur-ing disease progression.It proposes that"deficiency and stagnation of qi collaterals"is the root cause of COPD-PAH patho-genesis,"obstruction of collaterals by phlegm and stasis"is key to disease progression,and"stagnation of toxic pathogens in the collaterals"is the pivotal mechanism leading to irreversibility.Ultimately,these factors result in lung lobe distension with failure to contract,and qi dynamic congestion that is difficult to descend,forming a severe pattern of lung distension characterized by root deficiency(qi deficiency of the lung,spleen,and kidney)and manifest excess(intertwined phlegm,stasis,and toxin).Therefore,clinical treatment should focus on unblocking qi collaterals as the core strategy.According to the pathological bias,early-stage intervention should tonify collateral qi to consolidate the root;mid-stage treatment should dredge qi collaterals to curb progression;and late-stage management should resolve toxin and unblock collaterals,applying both attack and tonification to break the stagnation.This approach harmonizes the ascending,descending,exiting,and en-tering of qi dynamics,promoting mutual transformation of essence and blood to replenish the collaterals,thereby resolving all symptoms.This perspective offers a unique"dynamic evolution and holistic regulation"framework for interpreting COPD-PAH as a systemic pathological process,providing new theoretical insights and potential interventional strategies for integrated Chinese and Western medicine in preventing and treating COPD-PAH.关键词
气络学说/慢性阻塞性肺疾病/肺动脉高压/内皮间质转化Key words
theory of qi collaterals/chronic obstructive pulmonary disease/pulmonary arterial hypertension/endothelial-mesenchymal transition分类
医药卫生引用本文复制引用
吴好雨,童佳兵,张琳煜,周昀,于航,李泽庚..基于"气络理论"与"肺血管内皮间质转化"论治慢性阻塞性肺疾病相关性肺动脉高压[J].山西中医药大学学报,2025,26(12):1322-1328,7.基金项目
国家自然科学基金(82374399) （82374399）
国家自然科学基金区域创新重点项目(U20A20398) （U20A20398）
安徽省教育厅重大项目(KJ2021ZD0063) （KJ2021ZD0063）
合肥综合性国家科学中心大健康研究院新安医学与中医药现代化研究所"揭榜挂帅"重大突破项目(2023CXMMTCM005) （2023CXMMTCM005）
