载脂蛋白E4在阿尔茨海默病发病机制中的作用及中医药早期干预思路

关键词：阿尔茨海默病；载脂蛋白E4；代谢紊乱；本虚标实；未病先防；中医药干预中图分类号：R277.742 文献标志码：A 文章编号：1007-3213（2025）02-0512-06DOI：10.13359/j. cnki. gzxbtcm.2025.02.037

Role of Apolipoprotein E4 in the Pathogenesis of Alzheimer's Disease and Thoughts for Early Intervention with Traditional Chinese Medicine

LIU Jingwen，ZHANG Zijia，WANG Kaili，HUANG Jiayan，LI Weimin，ZHOU Xinxin（Guangzhou University of Chinese Medicine，Guangzhou 51OoO6 Guangdong，China）

Abstract：Alzheimer’s disease （AD） is a progresive neurodegenerative disease with hidden onset.Recent researches have shown that apolipoprotein E4（APOE4） is a high-risk genetic factor of AD，and theclinical symptoms in APOE4 genotype AD patients are closely related to metabolic disorders.This paper reviewed the role of APOE4in the pathogenesisof AD，and it is indicated that APOE4 contributes to the injury ofthecerebral bloodbrain barrier，is assciated withthe disorderofcerebral glucose and lipid metabolism，and leads tothe damage of thescavenging abilityof microglia.Moreover，this paper explored the approach of early intervention of AD with traditional Chinese medicine（TCM） based on the APOE4 pathogenesis.Based on the pathogenesis of AD being deficiency in originand exess insuperficiality，and under the guidance of the principle of prevention before illnesin TCM，itis proposed that early TCM intervention for APOE4 genotypeAD patients with metabolic disorders can be performed through improving the phlegm-dampness constitution，by focusing on insulin resistance-related indicators，and with traditional Chinesedrugtherapy based on syndrome diferentiation alone or together withcomprehensive management of exercises，dietcontroland drug interventions，thus to reduce or delay the onset of APOE4 genotype AD.

Keywords：Alzheimer's disease；apolipoprotein E4（APOE4）；metabolic disorders；deficiency in origin anc excess in superficiality；prevention before illness；traditional Chinese medicine intervention

随着社会的发展、科技水平的提高及老龄化进程的加快，人类疾病谱已由以传染性疾病为主转向以循环系统疾病、代谢性疾病、老年疾病如阿尔茨海默病（Alzheimer'sdisease）等为主的阶段[1]。（剩余14132字）