从线粒体自噬探析肖敏调平气火辨治皮痹思路

Mitochondrial Autophagy as a Potential Mechanism Underlying Ai Rudi’s “Spleen - Chong Vessel - Xuanfu Qi-Fire Regulation” Therapy for Scleroderma

摘要: 肖敏教授认为“气火失衡”为本病核心病机，基于皮肤病“脏–脉–皮”分部理论，提出从皮痹气火辨治思路，治疗上以补气散火为原则：早期调补中阳消火、中期逐瘀散火、后期破肌复络剔毒火，临床取得满意疗效。本文梳理肖敏临诊医案医话，以此为基础，进一步探讨线粒体异常自噬与皮痹气火失衡相关性，为线粒体异常自噬介导硬皮病“免疫–血管–纤维化”损伤机制提供思路。

Abstract: Professor Xiao Min posits that an “imbalance between qi and fire” constitutes the core pathogenesis of this disease. Grounded in the “Zang - Vessel - Skin” compartment theory of dermatology, she proposes a treatment strategy for cutaneous obstruction (Pi Bi) centered on the regulation of qi and fire. The therapeutic principle is to tonify qi and disperse fire, which is implemented through a staged approach: fortifying the middle yang to eliminate fire in the early stage, expelling stasis to dissipate fire in the middle stage, and breaking through the interstices to restore the network vessels and purge toxic fire in the late stage. This methodology has yielded satisfactory clinical outcomes. This article synthesizes Professor Xiao’s clinical case records and discourses, using them as a basis to further explore the correlation between abnormal mitochondrial autophagy and the qi-fire imbalance in cutaneous obstruction. The aim is to provide insights into the mechanism by which abnormal mitochondrial autophagy mediates the “immune - vascular - fibrotic” injury cascade in scleroderma.