从"膏-浊-热毒"病机演变浅析高甘油三酯血症相关性急性胰腺炎重症化的机制

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国家科技期刊平台
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中文摘要：高甘油三酯血症相关性急性胰腺炎是由富含甘油三酯的脂蛋白代谢紊乱引发的胰腺外分泌器官急性炎症。目前，高甘油三酯血症相关性急性胰腺炎的发病率逐年上升，其病情易重症化，目前无特异性治疗药物。中医治疗本病有着独特的优势，然而，其基础理论体系有待完善。高甘油三酯血症相关性急性胰腺炎为热病，平人饮食失节、脏腑功能失调可引起膏浊异常堆积，膏浊停聚日久则化为浊邪，浊满则热，是疾病发生的重要病机;在疾病发展过程中，热邪灼化膏浊，热浊相煎成毒，是疾病重症化的重要机制。基于此，本文提出，防膏化浊、扭转热毒是本病的治疗原则。本文梳理了中医典籍中高甘油三酯血症相关性急性胰腺炎所涉及的 2 个关键理论，即高甘油三酯血症相关的膏浊理论和急性胰腺炎相关的热病理论，结合高甘油三酯血症相关性急性胰腺炎重症化机制及相应中医药作用靶点的现代研究，提出"膏-浊-热毒"病机演变是导致高甘油三酯血症相关性急性胰腺炎重症化的中医学理论基础，以期为临床治疗提供新的启发。

外文标题：Mechanism of aggravated severity in hypertriglyceridemia-associated acute pancreatitis:insights from the pathogenesis of"fat-turbidity-toxic heat"

外文摘要：Hypertriglyceridemia-associated acute pancreatitis is an inflammatory disorder of exocrine pancreas caused by metabolism disturbances of triglyceride-rich lipoproteins.Currently,hypertriglyceridemia-associated acute pancreatitis is characterized by an escalating incidence rate,a tendency for more severe cases,and a lack of therapeutic drugs.Traditional Chinese medicine has distinct advantages in treating this disease,but its theoretical framework has not yet been established.Hypertriglyceridemia-associated acute pancreatitis manifests itself as a febrile disease,aberrant accumulation of fat and turbidity may stem from dietary imbalances and visceral dysfunction in ordinary individuals.The prolonged accumulation of fat and turbidity can transform into turbid pathogen,subsequently engendering heat,constituting a pivotal pathogenic factor.Throughout the progression of the disease,the fiery pathogen consumes the fat and turbidity,resulting in the generation of toxic heat,which is a crucial mechanism in the exacerbation of the disease severity.Thus,this article posits therapeutic principles aimed at averting the transformation of fat and turbidity into turbid pathogen and counteracting toxic heat in this disease.This article reviews two key theories from traditional Chinese medicine classics relevant to hypertriglyceridemia-associated acute pancreatitis:the theory of fat-turbidity associated with hypertriglyceridemia and the febrile disease related to acute pancreatitis.Combining these traditional theories with modern research on the mechanisms that intensify hypertriglyceridemia-associated acute pancreatitis and the corresponding targets of traditional Chinese medicine,it suggests that the pathogenesis of"fat-turbidity-toxic heat"serves as the theoretical basis of traditional Chinese medicine for the aggravated severity of hypertriglyceridemia-associated acute pancreatitis.The article aims to offer new insights for the treatment of hypertriglyceridemia-associated acute pancreatitis.

外文关键词：

hypertriglyceridemia-associated acute pancreatitisfat-turbidity-toxic heatfree fatty acidsmultiple organ dysfunction syndrome

作者：

李玉莹、杨鑫敏、钟少琦、冷玉琳、姚林波、刘婷婷、金涛、夏庆、黄伟

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作者单位：

四川大学华西医院中西医结合中心,华西胰腺炎卓越中心成都 610041

四川大学华西医院生物样本库

成都中医药大学附属医院

关键词：

高甘油三酯血症相关性急性胰腺炎膏-浊-热毒游离脂肪酸多器官功能不全综合征

基金：

国家自然科学基金国家自然科学基金四川省科技计划重点研发项目(高新区)(第二批)(2021)

项目编号：

822706728197363272

出版年：

2024

DOI：

10.3969/j.issn.1006-2157.2024.05.011

北京中医药大学学报

北京中医药大学

北京中医药大学学报

CSTPCD北大核心

影响因子：1.568

ISSN：1006-2157

年,卷(期)：2024.47(5)