中医杂志2026，Vol.67Issue(15)：1592-1598,7.DOI:10.13288/j.11-2166/r.2026.15.002
从脑内液体交换与细胞外微环境调控探讨"无形之痰"的生物学内涵
Exploring the Biological Connotation of"Invisible Phlegm"from the Perspective of Brain Fluid Exchange and Extracellular Microenvironment Regulation
摘要
Abstract
Based on the traditional Chinese medicine(TCM)theories of body fluid metabolism and turbid phlegm obstructing the orifices,and drawing on recent advances in cerebrospinal fluid-interstitial fluid(CSF-ISF)exchange,glymphatic clearance,and extracellular matrix(ECM)regulation,this article discusses the possible scien-tific connotation of"invisible phlegm"from the perspectives of pathogenesis,clinical manifestations,and therapeutic implications.Impaired brain fluid exchange may lead to reduced clearance,the retention of metabolic wastes and pathological proteins.Abnormal ECM remodeling may further disrupt molecular diffusion and local microenvironmental homeostasis,resulting in a pathological process characterized by slowed fluid movement,reduced clearance,and abnormal retention.This process bears a certain functional resemblance to the TCM pathogenesis of impaired distribu-tion of body fluids,endogenous formation of turbid phlegm and obstruction of the brain orifices,and may also be asso-ciated with manifestations such as a clouded sensation in the head,cognitive abnormalities,and emotional disturbances.On this basis,the potential effects of certain phlegm-dissolving Chinese medicines in improving brain clearance func-tion and extracellular microenvironmental homeostasis warrant further investigation.We therefore propose that,the"invisible phlegm"of TCM in brain tissue may manifest as a pathological retention state characterized by restricted fluid exchange,impaired clearance function,and extracellular microenvironmental imbalance.This perspective may provide a new avenue for investigating TCM treatment of neurological and psychiatric disorders from the perspective of phlegm.关键词
脑细胞外间隙/类淋巴系统/细胞外基质/代谢废物清除/痰浊阻窍/无形之痰Key words
brain extracellular space/glymphatic system/extracellular matrix/metabolic waste clearance/turbid phlegm obstructing the orifices/invisible phlegm引用本文复制引用
任毅铭,陆悦阳,张国瑗,曹唯仪,于宗良,张颢龄,高蕊..从脑内液体交换与细胞外微环境调控探讨"无形之痰"的生物学内涵[J].中医杂志,2026,67(15):1592-1598,7.基金项目
中国中医科学院中药监管科学研究项目(ZYJG-KX202401) （ZYJG-KX202401）
西藏自治区科技计划(XZ202501JX0007) （XZ202501JX0007）
