首页|基于"动则生阳"理论探讨鸢尾素与慢性心力衰竭心阳虚证本质的联系

基于"动则生阳"理论探讨鸢尾素与慢性心力衰竭心阳虚证本质的联系

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慢性心力衰竭(chronic heart failure,CHF)是各种原因导致的心脏疾病终末阶段,心阳不足是导致CHF恶化的关键病因.鸢尾素是一种肌动蛋白糖基化蛋白激素,是纤维连接蛋白Ⅲ型结构域 5(fibronectin type Ⅲ domain containing 5,FNDC5)的多肽切割产物,同时也是一种依赖于过氧化物酶体增殖物激活受体γ共激活物-1α(peroxisome proliferator-activated receptor γ coacti-vator-1α,PGC-1α)的肌细胞因子.在肌肉运动时,PGC-1α通过刺激FNDC5 表达,增加鸢尾素释放并介导运动相关的效应.在这一过程中产生的鸢尾素可以增加线粒体产能和脂肪褐变产热,促进葡萄糖代谢和脂肪酸氧化."动则生阳"理论源于《易经》,其指出"动"是化生阴阳万物的起源.对于CHF心阳虚证患者,运动可振奋其心阳,促进人体气血通畅,改善CHF症状,促进疾病向愈."动则生阳"的本质可能是运动改善了CHF心阳虚证患者的"气虚"和"寒象"状态,可能与机体运动时产生的鸢尾素调控了能量代谢及线粒体产能有关.因此,推测缺乏鸢尾素可能是CHF心阳虚证的生物学内涵.
The relationship between irisin and the essence of heart yang deficiency pattern of chronic heart failure based on the theory of"movement generating yang"
Chronic heart failure(CHF)is the end stage of heart disease caused by various factors,with heart yang deficiency being a key factor leading to its worsening.Irisin,an actin-glycosylated protein hormone,is a peptide cleavage product of fibronectin type Ⅲ domain containing 5(FNDC5)and is dependent on peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α),which presents in myocytes.During muscular movement,PGC-1α stimulates the expression of FNDC5,leading to increased release of irisin,which mediates the movement-related effects.The irisin produced in this process boosts mitochondrial capacity and promotes thermogenesis through adipose browning,thereby enhancing glucose metabolism and fatty acid oxidation.The theory of"movement generating yang"originates from the Yi Jing(Book of Changes),suggesting that"movement"is the source of the generation of yin and yang and thus of all things.For patients with heart yang deficiency pattern of CHF,exercise can revitalize their heart yang,promote the smooth circulation of qi and blood,alleviate CHF symptoms,and facilitate recovery.The essence of"movement generating yang"may be attributed to exercise mitigating the"qi deficiency"and"cold symptoms"in CHF patients with heart yang deficiency pattern,possibly through the regulation of energy metabolism and mitochondrial capacity by irisin produced during physical activity.Therefore,it is speculated that a deficiency of irisin may represent the biological essence of heart yang deficiency pattern of CHF.

movement generating yangirisinchronic heart failureheart yang deficiency patternenergy metabolism

李欣春、王菲、李琳、胡思远、胡志希

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湖南中医药大学中医诊断研究所,湖南 长沙 410208

湖南中医药大学体育艺术学院,湖南 长沙 410208

动则生阳 鸢尾素 慢性心力衰竭 心阳虚证 能量代谢

国家自然科学基金湖南省教育厅项目湖南省教育厅项目湖南省学位与研究生教育教学改革项目广东省重点领域研发计划湖南中医药大学研究生创新课题

8227441221A023021B03612020JGZX0122020B11111000012023CX01

2024

10.3969/j.issn.1674-070X.2024.05.018

湖南中医药大学学报
湖南中医药大学

湖南中医药大学学报

CSTPCD
影响因子：1.098
ISSN：1674-070X
年,卷(期)：2024.44(5)
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