基于“卫气内伐”理论探讨心外膜脂肪组织与心房颤动的关系及中医辨治*

作者：黄观明，王菁菁，楚 扬，伍 锋，刘浩琪，崔海明

单位：上海中医药大学附属岳阳中西医结合医院，上海 200437

引用：引用：黄观明，王菁菁，楚扬，伍锋，刘浩琪，崔海明.基于“卫气内伐”理论探讨心外膜脂肪组织与心房颤动的关系及中医辨治[J].中医药导报,2026,32(3):257-261,266.

DOI：10.13862/j.cn43-1446/r.2026.03.043

PDF： 下载PDF

摘要：心外膜脂肪组织已被大量研究证明在心房颤动的发生发展过程中起关键作用。心外膜脂肪组织归属于中医学“膏脂”范畴，生理性心外膜脂肪组织转化为病理性心外膜脂肪组织，产生各类有害细胞因子，通过炎症反应、脂肪浸润等机制，导致心脏电重构与结构重构，诱发心房颤动的过程符合“膏脂蓄积，卫气内伐，痰瘀并生”的现代科学内涵。提出健运脾胃为主，祛除痰瘀为辅的治疗原则，运用益气健脾、祛痰化瘀类中药，通过调节脂质代谢、控制炎症反应等途径干预心外膜脂肪组织，进而对心房颤动发挥积极治疗作用。

关键词：心房颤动；心外膜脂肪组织；膏脂；卫气内伐

Abstract：

A large number of studies have shown that epicardial adipose tissue plays a key role in the occurrence and development of atrial fibrillation. Epicardial adipose tissue belongs to the category of "Gaozhi" in traditional Chinese medicine. The process in which physiological epicardial adipose tissue transforms into pathological epicardial adipose tissue, produces various harmful cytokines, and induces atrial fibrillation through mechanisms such as inflammatory reaction and fatty infiltration, conforms to the modern scientific connotation of "Gaozhi accumulation, Weiqi internal attack, and simultaneous generation of phlegm and stasis". This paper puts forward the treatment principle of strengthening the spleen and stomach as the main method and eliminating phlegm and stasis as the auxiliary method, and points out that the use of Chinese medicines for invigorating Qi and invigorating the spleen, eliminating phlegm and removing stasis can intervene in epicardial adipose tissue by regulating lipid metabolism and controlling inflammatory reactions, thereby exerting a positive therapeutic effect on atrial fibrillation.

Key words：atrial fibrillation; epicardial adipose tissue; Gaozhi; Weiqi internal attack

发布时间：2026-03-28

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