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从"清浊相干"理论与铁死亡的相关性探讨癫痫病机OACSTPCD

Pathogenesis of Epilepsy Based on Correlation of "Disorder Between the Clear Qi and the Turbid Qi" with Ferroptosis Theories

中文摘要英文摘要

"清浊相干"是《黄帝内经》中有关气机紊乱失常的重要理论,指清浊二气升降失调,精微物质转输障碍,发为内生浊邪,现已成为探索怪病、难病病因病机的切入点.铁死亡是一种新型细胞程序性死亡方式,其特征是铁沉积与脂质活性氧积聚.铁、脂等物质属于中医水谷精微范畴,可以将其视为清阳.生理状态下,其新陈代谢在脏腑协调运作下,充实脑神;病理状态下,铁、脂异常堆积,机体内活性氧自由基水平升高,大脑内过载的活性氧自由基易导致神经细胞的死亡,视作浊阴范畴;线粒体作为能量场所,则与脾胃的功能类似.当能量代谢异常,脾胃升降失职,运化失司,清阳(铁、脂)不升,无以充实脑髓;浊阴(活性氧自由基)不降,上犯脑窍,清浊相干,致使铁沉积、活性氧自由基堆积,以致气机逆乱,元神失控,发为癫痫.

"Disorder between the clear Qi and the turbid Qi"is an important theory about the disorder of Qi in Huang Di Nei Jing.It refers to the Clear and Turbid Qi dysfunction of ascending and descending as well as transport obstruction of refined Essence,thus indu-cing endogenous Turbidity in body.The theory has become a breakthrough point for exploring the etiology and pathogenesis of strange and difficult diseases.Ferroptosis is a new type of programmed cell death characterized by iron deposition and lipid reactive oxygen spe-cies accumulation.Iron,lipid and other substances are considered as refined essence in foodstuff in TCM,which can be regarded as the Clear Yang Qi.In physiological state,its metabolism is coordinated by the internal organs to enrich the Spirit of brain.Under pathologi-cal conditions,iron and lipid are abnormally accumulated,and the level of reactive oxygen free radicals in the body is increased,which are regarded as the turbidity,inducing the overload of brain and the death of nerve cells.Mitochondria,an energy site of body,functions similarly to that of the Spleen and Stomach.When abnormal energy metabolism occurs,incoordination between ascending and descending of the Spleen and Stomach,as well as dysfunction of the transportation and transformation will bring about the clear Yang Qi(iron and lipid)failing to ascend to enrich the brain,while the Turbidity Yin(reactive oxygen free radicals)failing to descend it would injure the brain.As a result,disorder between the Clear Qi and the Turbid Qi with iron deposition as well as reactive oxygen species accumulation,would lead to the reversal and disturbance of Qi,even uncontrolled primordial Spirit,thus leading to epilepsy.

王凯悦;孙田烨;王越;黎莉莉;阎明源;张宓;刘金民

北京中医药大学东方医院,北京 100078天津中医药大学第二附属医院,天津 300151

中医学

癫痫;"清浊相干";铁死亡;《黄帝内经》

epilepsy;"disorder between the Clear Qi and the Turbid Qi";ferroptosis;Huang Di Nei Jing

《中医学报》 2024 (006)

1177-1181 / 5

国家自然科学基金项目(81774277);天津市教育委员会科研计划项目(2019KJ049)

10.16368/j.issn.1674-8999.2024.06.196

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