基于中医脉络学说探讨补阳还五汤对心脏微血管内皮细胞的保护机制研究

Exploration on the Protective Mechanism of Buyang Huanwu Decoction on Cardiac Microvascular Endothelial Cells Based on TCM Collateral Disease Theory

摘要: 目的：基于中医脉络学说，阐释补阳还五汤“益气活血通络”功效保护冠状动脉微血管内皮细胞(CMECs)的核心中医机制。方法：梳理脉络学说与冠脉微血管病变的理论契合点，解析方剂配伍逻辑，结合现代研究证据，从“补络气、通络瘀、养络体”维度展开探讨。结果：孙络与冠脉微血管在解剖、功能、病理上高度契合，冠脉微血管病变核心病机为“络气亏虚、络脉瘀阻、络体损伤”，补阳还五汤通过三维协同作用改善CMECs功能。结论：方剂对CMECs的保护源于其与脉络学说的理论协同，可为中医防治冠脉微血管病变提供理论支撑，需加强中西医融合研究。

Abstract: Objective: Based on the theory of Traditional Chinese Medicine (TCM) collateral disease, to clarify the core TCM mechanism of Buyang Huanwu Decoction in protecting coronary microvascular endothelial cells (CMECs) through its efficacy of “replenishing qi, activating blood circulation and dredging collaterals”. Methods: The theoretical connection between collateral disease theory and coronary microvascular disease (CMVD) was sorted out, the compatibility logic of the prescription was analyzed, and combined with modern research evidence, the discussion was carried out from the dimensions of “replenishing collateral qi, dredging collateral stasis, and nourishing collateral body”. Results: Collaterals are highly consistent with coronary microvessels in anatomy, function and pathology. The core pathogenesis of CMVD is “collateral qi deficiency, collateral stasis and collateral body injury”, and Buyang Huanwu Decoction improves CMECs function through three-dimensional synergistic effect. Conclusion: The protection of CMECs by the prescription originates from its theoretical synergy with collateral disease theory, which can provide theoretical support for TCM prevention and treatment of CMVD, and it is necessary to strengthen integrated traditional Chinese and Western medicine research.