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从气虚血瘀与血管新生相关性论治特发性肺纤维化

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特发性肺纤维化是一种原因不明的慢性进行性肺部疾病。结合现代实验研究,认为气虚血瘀引起的肺部血管新生是特发性肺纤维化的重要病机之一。血管过度新生责之于促/抑血管生成因子的失衡。促血管生成因子过度表达可产生大量无效血管腔,加速蛋白沉积与纤维增生,导致肺脏有效血容量减少,可归因于瘀血阻肺而造成的肺络痹阻不通;抑血管生成因子表达能够抵抗各类因子侵袭对病理性血管的催生作用,可类比于肺气保护卫外之功能。当气虚血瘀存在时,易导致促/抑血管生成系统失常,诱发及加重特发性肺纤维化。基于此理论临床选用补气活血类中药治疗特发性肺纤维化。
Treating Idiopathic Pulmonary Fibrosis Based on Correlation of Qi Deficiency and Blood Stasis with Angiogenesis
Idiopathic pulmonary fibrosis is a chronic progressive pulmonary disease of unknown cause.Combined with modern experimental studies,pulmonary angiogenesis caused by qi deficiency and blood stasis is considered to be one of the important pathogenesis of idiopathic pulmonary fibrosis.Excessive angiogenesis is due to the imbalance of promoting/inhibitory angiogenic factors.Overexpression of angiogenic factor can produce a large number of invalid vascular lumen,accelerate protein deposition and fiber hyperplasia,leading to the reduction of effective blood volume in lung,which can be attributed to obstruction of lung collaterals caused by blood stasis.Inhibition of angiogenic factor expression can resist the invasion of various factors which could promote the development of pathological blood vessels,similar to the defensive function of lung qi.When there is qi deficiency and blood stasis,disorder of promoting/inhibiting angiogenesis often occurs to induce and aggravate idiopathic pulmonary fibrosis.Based on this theory,idiopathic pulmonary fibrosis should be treated with medicinals for invigorating qi and invigorating blood.

idiopathic pulmonary fibrosisqi deficiencyblood stasisangiogenesistonifying qi and invigorating blood

王怡然、张伟

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潍坊市中医院,山东潍坊 261041

山东中医药大学附属医院,山东济南 250014

特发性肺纤维化 气虚 血瘀 血管新生 补气活血

国家自然科学基金项目山东省"泰山学者"建设工程专项经费资助项目

81874442ts201712096

2024

山东中医杂志
山东中医药学会 山东中医药大学

山东中医杂志

CSTPCD
影响因子:0.431
ISSN:0257-358X
年,卷(期):2024.43(4)
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