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随着分子生物学技术的进步和中药药理学研究的深入,越来越多中药及复方的药理机制被逐步阐明。在此基础上,提出基于中医基本病机与现代医学的病理生理机制,结合中医药传统方药功效与现代药理学研究成果,构建“中医基本病机-病理生理机制”联合的中西医结合病机辨治方法。在诊断层面,“中医基本病机-病理生理机制”联合的辨治模式既能反映疾病的中医病机本质,又能全面反映疾病的各层面病理变化;在治疗层面,该模式可辅助医生为患者选择既能针对中医病机发挥治疗作用,又能对疾病病理生理机制及相关临床指标产生明确药理作用的方药。今后,“中医基本病机-病理生理机制”联合的中西医结合病机辨治方法还可借助表型组学技术实现中医病机判定的客观化,并在立足方药功效的基础上,结合中药药理学研究成果提升遣方用药的精准性,既有助于提高中医临床疗效,又能推动现代疾病中医病机体系与诊疗体系的完善,促进当代中医诊疗模式的革新。
Abstract:With the advancement of molecular biology technology and the in-depth research of the pharmacology of traditional Chinese medicine(TCM), the pharmacological mechanisms of more and more Chinese materia medica and their formulas have been gradually clarified. By coordinating the basic pathogenesis of TCM with the pathological and physiological mechanisms of modern medicine, and combining the efficacy of TCM formulas with the results of modern pharmacological research, a method for pathogenesis differentiation and treatment based on "TCM basic pathogenesis/pathophysiological mechanisms" through integrated Chinese and western medicine was constructed. This method selects prescriptions that can not only exert therapeutic effects targeting TCM pathogenesis but also produce definite pharmacological effects on modern pathophysiological mechanisms and related clinical indicators for treatment. Phenomics technology was used to realize objective judgment of TCM pathogenesis, and based on the efficacy of formulas, the precision of prescription could improve based on the results of TCM pharmacological research. This not only helps improve the clinical efficacy of TCM but also promote the improvement of the TCM pathogenesis system and diagnosis-treatment system for modern diseases, thereby facilitating the innovation of contemporary TCM diagnosis and treatment models.
[1]卢红蓉,赵晨希,王俊文,等.辨机论治诊疗模式探析[J].中国中医基础医学杂志,2024,30(7):1131-1134.
[2]张莉莉,薛崇祥,周凌,等.由靶及态之现代中西医结合医学模式探析[J].中医杂志,2023,64(22):2269-2274.
[3]梁晓.基于白介素及相关炎症通路探讨清热活血组分治疗急性脑梗死火毒证协同增效机制[D].北京:北京中医药大学,2018.
[4]周仲瑛,周学平.中医病机辨证学[M]. 2版.北京:中国中医药出版社,2015:4.
[5]周仲瑛,叶放,周学平,等.病机十三条理论渊源及学术意义[J].南京中医药大学学报,2017,33(5):433-435,514.
[6]周子译,冯哲,周学平.系统思维视域下中医病机辨证体系的研究策略[J].中医杂志,2025,66(8):765-768,774.
[7]周学平,叶放,郭立中,等.以病机为核心构建中医辨证论治新体系:国医大师周仲瑛教授学术思想探讨[J].中医杂志,2011,52(18):1531-1534.
[8]丁齐又,赵林华,宋斌,等.两个重构:中医药传承创新发展的重要路径[J].中医杂志,2023,64(9):865-869.
[9]王翼天,仝小林.分类、分期、分证思想对慢性病中医理论构建的启示[J].中医杂志,2017,58(24):2091-2094.
[10]董立硕,李青伟,张莉莉,等.基于态靶辨治选方用药的思路与临床应用[J].中医杂志,2023,64(3):250-254.
[11]薛崇祥,李青伟,邢惠琴,等.现代医学疾病阶段病理生理状态与态靶辨治关系[J].中国中西医结合杂志,2024,44(10):1258-1262.
[12]凌金忠,李珊珊,朱国旗,等.人参的文献计量学研究:热点与趋势分析[J].中草药,2024,55(17):5952-5963.
[13]洪玉书,张晶,黄一珊,等.重构本草:黄芪[J].吉林中医药,2023,43(3):327-330.
[14]靳紫翔,吴汶轩,方彭华,等.基于网络药理学和分子对接探讨黄芩-白术-茯苓治疗糖尿病的作用机制[J].中医临床研究,2024,16(30):1-9.
[15]史文锦,刘仁慧.山药在糖尿病及其并发症治疗中的作用机制研究进展[J].山东医药,2025,65(1):144-149.
[16]JI H, ZHAO X, CHEN X, et al. Jinlida for diabetes prevention in impaired glucose tolerance and multiple metabolic abnormalities:the FOCUS randomized clinical trial[J]. JAMA Intern Med, 2024 ,184(7):727-735.
[17]胡诗宛,赵林华,张莉莉.糖络病的研究现状与展望[J].中华中医药杂志,2025,40(2):811-815.
[18]许成群,李中南,周元平.糖尿病“脾病致消”理论及其运用[J].中医研究,2015,28(1):3-6.
[19]仝小林,刘文科,王佳,等.糖尿病郁热虚损不同阶段辨治要点及实践应用[J].吉林中医药,2012,32(5):442-444.
[20]谢鹏飞,张莉莉,赵林华,等.基于态靶辨治理论探讨糖尿病及其并发症的诊疗策略[J].吉林中医药,2025,45(9):1021-1025.
[21]苟筱雯,赵林华,何莉莎,等.从态靶辨证谈中医治疗2型糖尿病的用药策略[J].辽宁中医杂志,2020,47(4):1-4.
[22]王晨秀,林安华.黄芪及其有效成分对糖尿病小鼠血糖及胰岛β细胞的影响[J].中国医药科学,2023,13(12):18-21.
[23]杨宏莉,张宏馨,李兰会,等.山药多糖对体外培养大鼠胰岛细胞活性及胰岛素分泌的影响[J].河北大学学报(自然科学版),2010,30(4):408-412.
[24]潘囿伊.人参皂苷Rg3通过增强自噬溶酶体功能保护胰岛β细胞的机制研究[D].长春:吉林大学,2021.
[25]SUN J,WANG Y, FU X, et al. Magnolia officinalis extract contains potent inhibitors against PTP1B and attenuates hyperglycemia in db/db mice[J]. Biomed Res Int,2015:139451. doi:10. 1155/2015/139451.
[26]RéGNIER M, RASTELLI M, MORISSETTE A, et al.Rhubarb supplementation prevents diet-induced obesity and diabetes in association with increased akkermansia muciniphila in mice[J]. Nutrients,2020,12(10):2932.
[27]CUI X, WANG S, CAO H, et al. A review:the bioactivities and pharmacological applications of polygonatum sibiricum polysaccharides[J]. Molecules, 2018,23(5):1170.
基本信息:
DOI:10.13288/j.11-2166/r.2026.02.001
中图分类号:R2-031
引用信息:
[1]胡锦浩,杨金生,石岩,等.“中医基本病机-病理生理机制”联合的中西医结合病机辨治方法的构建[J].中医杂志,2026,67(02):121-125.DOI:10.13288/j.11-2166/r.2026.02.001.
基金信息:
国家中医药管理局高水平中医药重点学科建设项目(KYG202407)