Zhang Chang-Hua, Sheng Jun-Qing, Xie Wei-Hua, Luo Xiao-Quan, Xue Ya-Nan, Xu Guo-Liang, Chen Chen
College of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, China.
College of Life Science, Nanchang University, Nanchang, China.
Front Pharmacol. 2021 Mar 8;12:615895. doi: 10.3389/fphar.2021.615895. eCollection 2021.
In the last few decades, the incidences of obesity and related metabolic disorders worldwide have increased dramatically. Major pathophysiology of obesity is termed "lipotoxicity" in modern western medicine (MWM) or "dampness-heat" in traditional Chinese medicine (TCM). "Dampness-heat" is a very common and critically important syndrome to guild clinical treatment in TCM. However, the pathogenesis of obesity in TCM is not fully clarified, especially by MWM theories compared to TCM. In this review, the mechanism underlying the action of TCM in the treatment of obesity and related metabolic disorders was thoroughly discussed, and prevention and treatment strategies were proposed accordingly. Hypoxia and inflammation caused by lipotoxicity exist in obesity and are key pathophysiological characteristics of "dampness-heat" syndrome in TCM. "Dampness-heat" is prevalent in chronic low-grade systemic inflammation, prone to insulin resistance (IR), and causes variant metabolic disorders. In particular, the MWM theories of hypoxia and inflammation were applied to explain the "dampness-heat" syndrome of TCM, and we summarized and proposed the pathological path of obesity: lipotoxicity, hypoxia or chronic low-grade inflammation, IR, and metabolic disorders. This provides significant enrichment to the scientific connotation of TCM theories and promotes the modernization of TCM.
在过去几十年间,全球肥胖症及相关代谢紊乱的发病率急剧上升。肥胖症的主要病理生理学在现代西医中被称为“脂毒性”,而在中医中则被称为“湿热”。“湿热”是中医临床治疗中一种非常常见且至关重要的证型。然而,中医对肥胖症发病机制的认识尚未完全阐明,尤其是与西医理论相比。在本综述中,深入探讨了中医治疗肥胖症及相关代谢紊乱的作用机制,并据此提出了防治策略。肥胖症中存在由脂毒性引起的缺氧和炎症,这是中医“湿热”证型的关键病理生理特征。“湿热”在慢性低度全身炎症中普遍存在,易导致胰岛素抵抗(IR),并引发各种代谢紊乱。特别是,运用西医的缺氧和炎症理论来解释中医的“湿热”证型,我们总结并提出了肥胖症的病理路径:脂毒性、缺氧或慢性低度炎症、IR以及代谢紊乱。这极大地丰富了中医理论的科学内涵,推动了中医现代化进程。