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1.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 227-234, 2022.
Artigo em Chinês | WPRIM | ID: wpr-940538

RESUMO

The normal function of vascular endothelial cells is an important foundation for maintaining vascular permeability, restricting inflammatory activities of the vascular wall, and balancing the coagulation and fibrinolytic system. Endothelial dysfunction caused by persistent damage from pathological factors is considered as an early and prominent event of diabetic macroangiopathy. In traditional Chinese medicine, the classical theory of "restraining excessiveness to acquire harmony" was originally a condensed generalization of the rule of generation, restriction, replacement and evolution in the natural world, revealing the internal regulation mechanism of the stable operation of things. Then it gradually evolved into an important rule to explain the physiological phenomena and pathological mechanism of human body and guide the treatment. Corresponding to the nature, the body homeostasis also requires to achieve a state of strong viscera function and inexhaustible Qi and blood generation under the rule of restriction and generation. The pathogenesis of diabetic macroangiopathy is the process of "the predominant one failing to restrict and the hyperactive one becoming harmful". The loss of restriction and generation of the five organs leads to powerless Qi transformation and, as a result, the Qi, blood and body fluid cannot be dispersed. Therefore, the Qi, blood and body fluid turn into phlegm and blood stasis, such as glucose and lipid metabolism disorder, oxidative stress, inflammatory response and high blood viscosity, and finally block the veins. Excessive phlegm and blood stasis cannot be resolved, instead they become harmful and invade the blood vessel, causing endothelial dysfunction and further resulting in diabetic macroangiopathy. Under the guidance of the theory of "restraining excessiveness to acquire harmony", the method of "harmonizing viscera, eliminating pathogen and removing turbidity" can effectively regulate the function of vascular endothelial cells, thus playing a positive role in preventing and treating diabetic macroangiopathy. The mechanism may be related to reducing oxidative stress, inhibiting inflammation, limiting vascular smooth muscle proliferation, and reducing platelet adhesion.

2.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 211-218, 2020.
Artigo em Chinês | WPRIM | ID: wpr-872670

RESUMO

The long-term existence of hyperglycemia leads to the occurrence of metabolic memory effect, which is an important reason for the formation of diabetic macrovascular disease, so the early control of metabolic memory is the key to the prevention and treatment of diabetes and its complications. The excessive formation of advanced glycation end products (AGEs) is not only an important factor to cause metabolic memory, but also the core mechanism for diabetic macrovascular disease. It is believed in traditional Chinese medicine(TCM) that Fu-xie (incubative pathogen) is the key pathogenesis of the formation of diabetic vascular diseases, and it is necessary to adopt the principle of removing pathogenic factors and opening collaterals as early as possible to prevent and cure the disease. During the Spring and Autumn Period and the Warring States Period, the theory of Fu-xie was germinated, and got mature in the Ming and Qing dynasties after the continuous development. The so-called Fu-xie means that the pathogens are of a potential nature but not cause diseases immediately. The theory of Fu-xie first appeared in Huangdi Neijing, with an original meaning of epidemic febrile disease occurring after incubation, and then its meaning continues to expand, now referring to all potential pathogenic factors that would not immediately cause diseases. As the cause and pathogenesis of many diseases, the theory of Fu-xie is widely used in clinical practice to guide the treatment of diseases. In the body, the accumulation of AEGs can induce the subsequent cascade effect in the body, and finally promote the formation and development of diabetic macrovascular diseases. This is very similar to the process of inducing metabolic disorder and disease in TCM due to the accumulation of phlegm and silt. Therefore, under the guidance of Fu-xie theory, the mechanism of AEGs in blocking metabolic memory and preventing and treating diabetic macrovascular disease was analyzed in this paper. On the one hand, it will provide a scientific basis for the exploration of Fu-xie theory affecting the disease course of diabetic macrovascular disease by regulating the generation of AEGs. On the other hand, it can also provide the material change basis for the development of Fu-xie theory in the occurrence and development of diabetic macroangiopathy.

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