[1]黎金羽,梁祥翰,吴晓航,等.基于脂质代谢探讨中医从脾论治骨关节炎的作用机制[J].中医正骨,2023,35(03):37-41.
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基于脂质代谢探讨中医从脾论治骨关节炎的作用机制()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年03期
页码:
37-41
栏目:
学术探讨
出版日期:
2023-03-20

文章信息/Info

作者:
黎金羽1梁祥翰1吴晓航1李飞龙2谢平金3柴生颋2
(1.广州中医药大学第三临床医学院,广东 广州 510405; 2.广州中医药大学第三附属医院,广东 广州 510378; 3.深圳市罗湖区中医院,广东 深圳 518001)
关键词:
骨关节炎 脂类代谢 脾(中医) 作用机制
摘要:
骨关节炎是临床常见的慢性退行性疾病,属中医学“痹证”范畴。中医学理论认为,该病的发生离不开肝脾肾三脏,其中后天之本脾脏在该病的进程中尤为重要。但目前中医从脾论治骨关节炎只有单纯经典理论支撑,而从脾脏出发得到的脂质代谢与骨关节炎关系的研究成果有助于阐明中医学从脾论治骨关节炎的作用机制。本文从脾与脂质代谢的关系、脂质代谢与骨关节炎的关系及从脾论治骨关节炎的中医理论3个方面,对中医从脾论治骨关节炎的作用机制进行了探讨。

参考文献/References:

[1] 张鹤,白宇宁,刘绍能,等.现代医学视角下中医“脾主运化”探析[J].北京中医药,2022,41(2):179-181.
[2] MOHAMMADI S,HEDJAZI A,SAJJADIAN M,et al.Accessory spleen in the splenic hilum:a cadaveric study with clinical significance[J].Med Arch,2016,70(5):389-391.
[3] KLOSKA A,WESIERSKA M,MALINOWSKA M,et al.Lipophagy and lipolysis status in lipid storage and lipid metabolism diseases[J].Int J Mol Sci,2020,21(17):6113.
[4] ALMEIDA I,MAGALHÃES S,NUNES A.Lipids:bio-markers of healthy aging[J].Biogerontology,2021,22(3):273-295.
[5] SCHOELER M,CAESAR R.Dietary lipids,gut microbiota and lipid metabolism[J].Rev Endocr Metab Disord,2019,20(4):461-472.
[6] BERMUDEZ-CARDONA J,VELÁSQUEZ-RODRÍGUEZ C.Profile of free fatty acids and fractions of phospholipids,cholesterol esters and triglycerides in serum of obese youth with and without metabolic syndrome[J].Nutrients,2016,8(2):54.
[7] ASAI K,KUZUYA M,NAITO M,et al.Effects of splenectomy on serum lipids and experimental atherosclerosis[J].Angiology,1988,39(6):497-504.
[8] ASAI K,HAYASHI T,KUZUYA M,et al.Delayed clea-rance of beta-very low density lipoprotein after feeding cholesterol to splenectomized rabbits[J].Artery,1990,18(1):32-46.
[9] FATOUROS M,BOURANTAS K,BAIRAKTARI E,et al.Role of the spleen in lipid metabolism[J].Br J Surg,1995,82(12):1675-1677.
[10] 王向东.脾切除对大鼠脂代谢的影响[J].四川医学,2015,36(6):825-826.
[11] BAKER K R,MATTHAN N R,LICHTENSTEIN A H,et al.Association of plasma n-6 and n-3 polyunsaturated fatty acids with synovitis in the knee:the MOST study[J].Osteoarthritis Cartilage,2012,20(5):382-387.
[12] LOEF M,IOAN-FACSINAY A,MOOK-KANAMORI D O,et al.The association of plasma fatty acids with hand and knee osteoarthritis:the NEO study[J].Osteoarthritis Cartilage,2020,28(2):223-230.
[13] FREY N,HÜGLE T,JICK S S,et al.Hyperlipidaemia and incident osteoarthritis of the hand:a population-based case-control study[J].Osteoarthritis Cartilage,2017,25(7):1040-1045.
[14] ZHOU M,GUO Y,WANG D,et al.The cross-sectional and longitudinal effect of hyperlipidemia on knee osteoarthritis:results from the Dongfeng-Tongji cohort in China[J].Sci Rep,2017,7(1):9739.
[15] MATHIEU S,COUDERC M,TOURNADRE A,et al.Cardiovascular profile in osteoarthritis:a meta-analysis of cardiovascular events and risk factors[J].Joint Bone Spine,2019,86(6):679-684.
[16] BAUDART P,LOUATI K,MARCELLI C,et al.Association between osteoarthritis and dyslipidaemia:a systematic literature review and meta-analysis[J].RMD Open,2017,3(2):e000442.
[17] FARNAGHI S,CRAWFORD R,XIAO Y,et al.Cholesterol metabolism in pathogenesis of osteoarthritis disease[J].Int J Rheum Dis,2017,20(2):131-140.
[18] POUSINIS P,GOWLER P R W,BURSTON J J,et al.Lipi-domic identification of plasma lipids associated with pain behaviour and pathology in a mouse model of osteoarth-ritis[J].Metabolomics,2020,16(3):32.
[19] IOAN-FACSINAY A,KLOPPENBURG M.Bioactive lipids in osteoarthritis:risk or benefit?[J].Curr Opin Rheumatol,2018,30(1):108-113.
[20] LOEF M,SCHOONES J W,KLOPPENBURG M,et al.Fatty acids and osteoarthritis:different types,different effects[J].Joint Bone Spine,2019,86(4):451-458.
[21] MIAO H,CHEN L,HAO L,et al.Stearic acid induces proinflammatory cytokine production partly through acti-vation of lactate-HIF1α pathway in chondrocytes[J].Sci Rep,2015,5:13092.
[22] AHMAD R,AKHTER N,AL-ROUB A,et al.MIP-1α induction by palmitate in the human monocytic cells implicates TLR4 signaling mechanism[J].Cell Physiol Biochem,2019,52(2):212-224.
[23] MUSTONEN A M,KÄKELÄ R,LEHENKARI P,et al.Distinct fatty acid signatures in infrapatellar fat pad and syno-vial fluid of patients with osteoarthritis versus rheumatoid arthritis[J].Arthritis Res Ther,2019,21(1):124.
[24] MUSTONEN A M,NIEMINEN P.Fatty acids and oxylipins in osteoarthritis and rheumatoid arthritis—a complex field with significant potential for future treatments[J].Curr Rheumatol Rep,2021,23(6):41.
[25] WANG T,HE C.Pro-inflammatory cytokines:the link between obesity and osteoarthritis[J].Cytokine Growth Factor Rev,2018,44:38-50.
[26] LI L,ZHONG S,SHEN X,et al.Recent development on li-quid chromatography-mass spectrometry analysis of oxidized lipids[J].Free Radic Biol Med,2019,144:16-34.
[27] RECCHIUTI A,ISOPI E,ROMANO M,et al.Roles of specialized pro-resolving lipid mediators in autophagy and inflammation[J].Int J Mol Sci,2020,21(18):6637.
[28] KIM A S,CONTE M S.Specialized pro-resolving lipid mediators in cardiovascular disease,diagnosis,and therapy[J].Adv Drug Deliv Rev,2020,159:170-179.
[29] ZAINAL Z,LONGMAN A J,HURST S,et al.Relative efficacies of omega-3 polyunsaturated fatty acids in reducing expression of key proteins in a model system for studying osteoarthritis[J].Osteoarthritis Cartilage,2009,17(7):896-905.
[30] JÓNASDÓTTIR H S,BROUWERS H,KWEKKEBOOM J C,et al.Targeted lipidomics reveals activation of resolution pathways in knee osteoarthritis in humans[J].Osteoarthritis Cartilage,2017,25(7):1150-1160.
[31] HUANG J,BURSTON J J,LI L,et al.Targeting the D series resolvin receptor system for the treatment of osteoarthritis pain[J].Arthritis Rheumatol,2017,69(5):996-1008.
[32] BENABDOUNE H,RONDON E P,SHI Q,et al.The role of resolvin D1 in the regulation of inflammatory and catabolic mediators in osteoarthritis[J].Inflamm Res,2016,65(8):635-645.
[33] PAPATHANASIOU I,ANASTASOPOULOU L,TSEZOU A.Cholesterol metabolism related genes in osteoarthritis[J].Bone,2021,152:116076.
[34] GIERMAN L M,KÜHNAST S,KOUDIJS A,et al.Osteoarthritis development is induced by increased dietary cholesterol and can be inhibited by atorvastatin in APOE*3Leiden.CETP mice—a translational model for atherosclerosis[J].Ann Rheum Dis,2014,73(5):921-927.
[35] DE MUNTER W,VAN DEN BOSCH M H,SLÖETJES A W,et al.High LDL levels lead to increased synovial inflammation and accelerated ectopic bone formation during experimental osteoarthritis[J].Osteoarthritis Cartilage,2016,24(5):844-855.
[36] XU S,TANG C.Cholesterol and hedgehog signaling:mutual regulation and beyond[J].Front Cell Dev Biol,2022,10:774291.
[37] CHOI W S,LEE G,SONG W H,et al.The CH25H-CYP7B1-RORα axis of cholesterol metabolism regulates osteoarthritis[J].Nature,2019,566(7743):254-258.
[38] ZHANG W,SUN G,AITKEN D,et al.Lysophosphatidylcholines to phosphatidylcholines ratio predicts advanced knee osteoarthritis[J].Rheumatology(Oxford),2016,55(9):1566-1574.
[39] CASTROGIOVANNI P,RAVALLI S,MUSUMECI G.Apoptosis and autophagy in the pathogenesis of osteoarthritis[J].J Invest Surg,2020,33(9):874-875.
[40] HWANG H S,KIM H A.Chondrocyte apoptosis in the pathogenesis of osteoarthritis[J].Int J Mol Sci,2015,16(11):26035-26054.
[41] WANG T,FU X,CHEN Q,et al.Arachidonic acid metabolism and kidney inflammation[J].Int J Mol Sci,2019,20(15):3683.
[42] ZHAI G,PELLETIER J P,LIU M,et al.Activation of the phosphatidylcholine to lysophosphatidylcholine pathway is associated with osteoarthritis knee cartilage volume loss over time[J].Sci Rep,2019,9(1):9648.
[43] RANJPOUR M,WAJID S,JAIN S K.Elevated expression of cytosolic phospholipase a2 delta is associated with lipid metabolism dysregulation during hepatocellular carcinoma progression[J].Cell J,2020,22(1):17-22.
[44] SUN G,BA C L,GAO R,et al.Association of IL-6,IL-8,MMP-13 gene polymorphisms with knee osteoarthritis susceptibility in the Chinese Han population[J].Biosci Rep,2019,39(2):BSR20181346.
[45] 刘天阳,黄传兵,谌曦,等.“从脾治痹”治疗膝骨关节炎疗效观察[J].辽宁中医杂志,2021,48(6):159-162.
[46] 许坤,张洁帆,陈元川,等.退肿通痹汤治疗膝骨关节炎积液性滑膜炎(脾失健运证)的疗效观察[J].中国中医骨伤科杂志,2021,29(12):26-31.

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备注/Memo

备注/Memo:
基金项目:广东省中医药局科研项目(20202085); 深圳市“医疗卫生三名工程”项目(SZZYSM202101005); 深圳市科技创新委员会2020年基础研究面上项目(JCYJ20190812170815559)
通讯作者:柴生颋 E-mail:cst0192@qq.com
更新日期/Last Update: 1900-01-01