中国中药杂志2026，Vol.51Issue(14)：3972-3980,9.DOI:10.19540/j.cnki.cjcmm.20260331.901
基于"虚痰瘀毒"探讨"肠肺轴-NETs"在慢性阻塞性肺疾病中的作用
Role of"gut lung axis-NETs"pathway in chronic obstructive pulmonary disease based on theory of"deficiency,phlegm,stasis,and toxin"
摘要
Abstract
Chronic obstructive pulmonary disease(COPD)is a systemic disease characterized by persistent airflow limitation and airway inflammation,with a consistently high incidence and a lack of effective clinical interventions to reverse disease progression.Based on the core TCM pathogenesis theory of"deficiency,phlegm,stasis,and toxin",this paper systematically explores the critical role of the"gut lung axis-neutrophil extracellular traps(NETs)"pathway in the occurrence and development of COPD,as well as its intrinsic association with TCM pathogenesis.Specifically,dysbiosis of the intestinal microecology and dysregulation of pulmonary NETs persist throughout the disease course.Among these,"deficiency of healthy Qi"serves as the initiating factor;disruption of the gut microbiota and deficiency of metabolic products lead to decreased pulmonary defensive function and immunometabolic imbalance.Furthermore,impairment of the intestinal barrier results in the translocation of lipopolysaccharide(LPS)into the bloodstream.As an"endogenous toxin",LPS activates pulmonary neutrophils,triggers oxidative stress,and promotes the formation of NETs.Moreover,the explosive release of pulmonary NETs represents the microscopic entity of the pathological products of"phlegm,stasis,and toxin".The highly viscous DNA backbone of NETs contributes to the formation of"tenacious phlegm"that obstructs the airways;NETs-induced immunothrombosis leads to"stasis obstructing lung collaterals";and the cytotoxic proteins carried by NETs act as"virulent toxins"that directly damage the lung parenchyma.These pathological processes are the microscopic manifestations of the core pathogenesis of COPD,namely"deficiency leading to excess","intertwining of phlegm and stasis",and"toxin damaging lung collaterals".In this context,spleen Qi deficiency drives dysregulation of the gut-lung microecology;the influx of endogenous toxins induces NETs activation;and the accumulation of phlegm,stasis,and toxin aggravates lung tissue remodeling.Accordingly,this paper proposes the application of the"consolidating the foundation and clearing the source"method to reconstruct intestinal microecology and block the origin of endogenous toxins,as well as the"removing toxins and dredging collaterals"method to target NETs regulation for resolving phlegm and removing stasis.Through dual"gut-lung"targeting to restore systemic homeostasis,this study provides a theoretical basis and new insights for the integrated TCM and western medicine prevention and treatment of COPD.关键词
慢性阻塞性肺疾病/虚痰瘀毒/肠肺轴/中性粒细胞外诱捕网/中医药Key words
chronic obstructive pulmonary disease/deficiency,phlegm,stasis,and toxin/gut-lung axis/neutrophil extracellular traps/TCM引用本文复制引用
于方媛,陈雨菲,赵翰韬,洪政,汪睿韬,钟晓曼,吴建军..基于"虚痰瘀毒"探讨"肠肺轴-NETs"在慢性阻塞性肺疾病中的作用[J].中国中药杂志,2026,51(14):3972-3980,9.基金项目
国家自然科学基金项目(82274462,82575036) （82274462,82575036）
北京市自然科学基金项目(7232284) （7232284）
国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号) （国中医药人教函[2022]1号）
北京市中医药管理局北京中医药新时代125工程项目(京中医药科字[2025]2号) （京中医药科字[2025]2号）
北京中医药大学第三附属医院精诚人才计划项目(京中三院人[2025]14号) （京中三院人[2025]14号）
