基于“阳化气，阴成形”理论探讨调控细胞自噬治疗溃疡性结肠炎的中医内涵
Exploring the TCM Connotation of Regulating Autophagy for Ulcerative Colitis Treatment Based on the Theory of “Yang Transforms Qi, Yin Forms Shape”
DOI: 10.12677/tcm.2026.1510609, PDF,   
作者: 冉 葎, 张 怡*：成都中医药大学临床医学院，四川 成都；成都中医药大学附属医院，四川 成都
关键词: 细胞自噬；阳化气；阴成形；溃疡性结肠炎；温阳消浊；Cellular Autophagy； Yang Transforms Qi； Yin Forms Shape； Ulcerative Colitis； Warming-Yang and Eliminating Turbidity
摘要: 溃疡性结炎(UC)是以肠黏膜屏障损伤为核心的慢性肠道炎症性疾病，全球发病率呈上升趋势，其病理进程与细胞自噬功能失调密切相关。研究表明，自噬通过调控肠道免疫应答、清除病理产物及维持物质能量代谢稳态修复受损肠黏膜屏障，发挥关键保护作用。“阳化气，阴成形”理论出自《黄帝内经》，是对阴阳功能的高度概括，指导着自然万物包括疾病的发生发展变化。基于中医“取类比象”思想，中医认为“阳化气不足，阴成形太过”导致UC的发病病机与自噬功能失调高度相关：自噬活性下降(阳化气不足)导致病理产物堆积(阴成形太过)，加剧肠道炎症与黏膜损伤。本文从生理、病理及治疗角度系统阐释“阳化气，阴成形”理论与自噬机制的动态联系，提出“温阳消浊”法治疗UC——即以温补脾肾阳气为本，辅以祛湿化瘀解毒，通过调节自噬恢复“阳化气，阴成形”的正常功能，从而改善肠道炎症、促进黏膜屏障修复，以期为临床防治UC提供新的思路。
Abstract: Ulcerative colitis (UC) is a chronic inflammatory intestinal disease characterized by intestinal mucosal barrier injury, with an increasing global incidence. Its pathological progression is closely associated with dysfunctional cellular autophagy. Existing studies have confirmed that autophagy exerts critical intestinal-protective effects by modulating intestinal immune responses, eliminating pathological products, and maintaining homeostasis of material and energy metabolism, thereby repairing the damaged intestinal mucosal barrier. The theory of “yang transforms qi, yin forms shape”, originating from Huangdi Neijing (Yellow Emperor’s Internal Classic), highly generalizes the functional properties of yin-yang and guides the occurrence, development and evolution of natural substances as well as diseases. From the TCM analogy-based thinking, the pathogenesis of UC is summarized as insufficient yang transforming qi and excessive yin forming shape, which is highly correlated with dysregulated autophagy. Reduced autophagic activity (insufficient yang transforming qi) leads to accumulation of pathological products (excessive yin forming shape), further aggravating intestinal inflammation and mucosal injury. This paper systematically illustrates the dynamic correlation between the theory of “yang transforms qi, yin forms shape” and the mechanism of cellular autophagy from physiological, pathological and therapeutic perspectives. A therapeutic method named warming-yang and eliminating turbidity is proposed for UC treatment: warming and tonifying spleen-kidney yang qi as the fundamental principle, combined with therapies of dampness-removing, stasis-resolving and detoxification. It restores the physiological function of “yang transforms qi, yin forms shape” via regulating autophagy, alleviates intestinal inflammation and promotes the repair of intestinal mucosal barrier, so as to provide novel insights for the clinical prevention and treatment of UC.
文章引用：冉葎, 张怡. 基于“阳化气，阴成形”理论探讨调控细胞自噬治疗溃疡性结肠炎的中医内涵[J]. 中医学, 2026, 15(10): 716-726. https://doi.org/10.12677/tcm.2026.1510609

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