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“痰”是中医常见致病因素与病理产物，致病广泛，痰邪停聚脏腑，流窜周身，形成复杂多变的痰证病理状态。脂质代谢异常与中医痰邪存在显著相关性，而脂噬作为脂滴降解的一种形式，参与调控机体脂质代谢稳态，其功能障碍可引发多种代谢性疾病。从脂噬功能障碍角度系统分析痰证微观病理内涵，解析其分子物质基础及动态演变规律，探讨脂噬稳态失衡通过介导脂滴沉积、线粒体功能障碍、脂毒性、泡沫细胞生成和炎症级联反应等病理过程，在痰证形成过程中发挥的枢纽调控作用。同时基于脂噬探讨痰证治法（益气祛痰、健脾祛痰、化浊降脂、化瘀祛痰、清热化痰）对脂噬功能的影响，从脂噬调控角度为痰证提供潜在治疗靶点。
Abstract：In traditional Chinese medicine(TCM), "phlegm" serves as both a pathogenic factor and pathological product, exhibiting extensive pathogenicity. The stagnation and accumulation of phlegm pathogens in the viscera or their dispersion throughout the body result in complex and variable pathological states known as phlegm syndrome. There is a significant correlation between lipid metabolism disorders and TCM phlegm pathogenesis. Lipophagy, as a specific form of lipid droplet degradation, plays a vital role in maintaining lipid metabolic homeostasis, and its dysfunction can lead to a variety of metabolic diseases. From the perspective of lipophagy dysfunction, this paper systematically analyzed the microscopic pathological connotation of phlegm syndrome, elucidating its molecular material basis and dynamic evolution patterns. It further explores how lipophagy imbalance, by mediating pathological processes such as lipid droplet deposition, mitochondrial dysfunction, lipotoxicity, foam cell formation, and inflammatory cascades, serves as a pivotal regulatory mechanism in the formation of phlegm syndrome. Meanwhile, the how therapeutic approaches for phlegm syndrome such as tonifying qi to resolve phlegm, fortifying spleen to dispel phlegm, resolving turbidity to lower lipids, dissolving stasis to dispel phlegm, and clearing heat to dissolve phlegm influence lipophagy function has been discussed based on the concept of lipophagy, providing potential targets for the prevention and treatment of phlegm syndrome from the perspective of lipophagy regulation.
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基本信息:
DOI：10.13288/j.11-2166/r.2025.22.001
中图分类号:R228
引用信息:
[1]卓祖顺,丁珊珊,韩海瑞,等.基于脂噬功能障碍探讨“痰证”的生物学内涵[J].中医杂志,2025,66(22):2297-2302.DOI:10.13288/j.11-2166/r.2025.22.001.
基金信息:
国家自然科学基金（82474391）; 福建省自然科学基金（2024J01133）
2025-11-17
2025-11-17