从“脾不散精，毒损脉络"探赜代谢重编程驱动糖尿病大血管病变的机制

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[关键词]糖尿病大血管病变;动脉粥样硬化；脾不散精;毒损脉络；代谢重编程;助脾散精;祛毒通络 [中图分类号]R259 [文献标志码]A [文章编号]doi：10.3969/j.issn.1674-070X.2025.12.016

Mechanism of metabolic reprogramming driving diabetic macroangiopathy from the perspective of "spleen failing to disperse essence and toxins damaging the collaterals"

ZHANG Xiaoqin'， ZHU Zhixian'， TAO Wang2， HUANG Xiangning²， HUA NG Jiavang2， YU Rong2* 1. The First Hospital of Hunan University of Chinese Medicine，Changsha， Hunan 41ooo7，China; 2.Hunan University of Chinese Medicine，Changsha，Hunan 41o208， China

[Abstract]Diabeticmacroangiopathyisacorecomplicationofdiabetesmelitusthatleadstodeathanddisability，and traditionallipid-loweringtherapiesfinditdificulttoamelioratemetabolicimbalancesBasedontheTCMtheoryof"spleenfailing todisperseesenceandtoxinsamagingthecolaterals，"thispaperproposesapathologicalaxisof"failureofrefinedsubstances distribution-endogenousgenerationofturbidpathogens-accumulationofturbidtoxins-erosionofveselsandplaqueforation" Focusingon"metabolicreprogramming"pivotalhubinmodernbiology，itrevealsitsrucialbdgingroleconnecting"spleen failingtodispersesene"and"toinsagingteolaterals."ubseuntlyoelievetiontrategisroposdich involvesregulating"metabolicreprogramming-clearanceof toxicproducts-repairofvascularendothelium"throughthemethodsof assistingthespleenindispersingessenceandeliminatingtoxinstounblockthecollaterals.Thisprovidesatheoreticalbasisforthe precise prevention and treatment of diabetic macroangiopathy.

[Keywords]diabeticmacroangiopathy;atheroslerosis；spleefailing todisperseessencetoxinsdamagingthecolaterals; metabolicreprogramming;asisting the spleen indispersing essence;eliminating toxins tounblock the collaterals

糖尿病大血管病变是糖尿病慢性并发症之一，主要表现为动脉粥样硬化快速进展，累及冠状动脉、脑动脉、外周动脉等大、中动脉，发展为心肌梗死、心绞痛、脑梗死、短暂性脑缺血发作、下肢动脉硬化闭塞症、糖尿病足等病。（剩余18703字）