基于“湿浊痰饮”理论探讨中医药调节 免疫机制治疗慢性心衰的研究进展

作者：崔瀚文 ，贾福运2，张 茜2，马轶楠1，张正威1，徐 强2

单位：1.天津中医药大学，天津 301617； 2.天津中医药大学第二附属医院，天津 300150

引用：

DOI：10.13862/j.cn43-1446/r.20260225.001

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摘要：心力衰竭作为心系统疾病的终末阶段，其发病率和死亡率呈上升趋势，已经成为全球严重的公共卫生问题。心衰的发病涉及多种机制，其中免疫系统激活是重要途径之一，贯穿疾病始终。“湿浊痰饮类病”理论，为临床心衰的辨证论治提供了理论指导，湿、浊、痰、饮类阴邪是心衰发生发展的核心病理因素，在治疗上采用温阳化湿类中药以求化湿泻浊，涤痰逐饮。而免疫机制失衡与湿浊痰饮的产生密切相关，“阳微阴弦”很好地揭示了免疫机制与湿浊痰饮的关联，免疫机制失衡即为“阳微”，湿浊痰饮类阴邪产生即为“阴弦”。中医药在治疗心衰中，用温阳益气类中药调节免疫失衡，以治疗“阳微”本虚；化湿逐瘀类中药治疗湿浊痰饮类邪，以化“阴弦”标实。文章基于免疫机制在心衰发病中的作用，从“湿浊痰饮”理论探讨心衰发病的病机，并基于湿浊痰饮理论综述了温阳化湿类中药如何通过调节免疫机制防治心衰，丰富湿浊痰饮类病理论，为临床心衰的中医诊疗提供更加坚实的科学基础。

关键词：心衰；免疫机制；湿浊痰饮；中医药；阳微阴弦;综述

Abstract：As the terminal stage of cardiac diseases, heart failure has shown an increasing trend in morbidity and mortality and has become a major global public health problem. The pathogenesis of heart failure involves multiple mechanisms, among which immune system activation is one critical pathway throughout the course of the disease. The theory of "damp-turbidity-phlegm-rheum type diseases" provides theoretical guidance for syndrome differentiation and treatment of heart failure in clinical practice. Yin pathogens including dampness, turbidity, phlegm, and rheum are the core pathological factors in the occurrence and progression of heart failure. Inthetreatment, traditional Chinese medicines (TCM) with the actions of warmingYang and resolving dampness are applied to eliminate dampness and turbidity, as well as resolve phlegm and rheum. The imbalance of immune mechanisms is closely associated with the formation of damp-turbidity-phlegm-rheum. "Yang Wei Yin Xian" well illustrates the relationship between immune mechanisms and damp-turbidity-phlegm-rheum. The imbalance of immune mechanisms corresponds to "YangWei", while the production ofYin pathogens such as damp-turbidity-phlegm-rheum corresponds to "Yin Xian". In the treatment of heart failure with TCM, herbs that warmYang and tonifyQi are used to regulate immune imbalance, targeting the root deficiency of "Yang Wei". Herbs that resolve dampness and dispel stasis are used to treat pathogenic factors of damp-turbidity-phlegm-rheum, so as to alleviate the excess manifestation of "Yin Xian". Based on the role of immune mechanisms in the pathogenesis of heart failure, this paper explores the pathogenesis of heart failure from the theory of "damp-turbidity-phlegm-rheum". It also reviews how TCM with the actions of warmingYang and resolving dampness prevents and treats heart failure by regulating immune mechanisms, so as to enrich the theory of diseases induced by damp-turbidity-phlegm-rheum and provide a more solid scientific basis for TCM diagnosis and treatment of heart failure.

Key words：heart failure; immune mechanism; damp-turbidity-phlegm-rheum; traditional Chinese medicine; Yang Wei Yin Xian; review

发布时间：2026-02-26

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