肺泡丢失型慢性阻塞性肺疾病的多机制病理网络解析及中西医协同干预新进展

Pathological network analysis of alveolar loss-type chronic obstructive pulmonary disease mediated by multiple mechanisms and recent advances in integrated traditional Chinese and Western medicine interventions

摘要

现有慢性阻塞性肺疾病（COPD）研究多聚焦于气道病变，对肺泡结构损伤的关键作用关注不足。肺泡丢失型 COPD 以肺气肿为主要特征，是肺功能下降及临床结局恶化的核心结构基础。文章系统梳理蛋白酶-抗蛋白酶失衡、氧化应激持续激活、慢性炎症反应及其内型差异、自身免疫异常、肺泡上皮与间质细胞修复功能障碍等介导肺泡丢失的病理网络；重点分析西医靶向治疗与中医辨证施治在调节炎症微环境、改善修复能力中的协同作用，探讨非药物干预的综合管理价值，阐明肺泡丢失的多机制调控网络及中西医协同干预潜力。从结构损伤-炎症内环境-修复失衡整体视角，为肺泡丢失型 COPD 精准分型诊疗及中西医联合干预提供理论依据与实践参考。

Abstract

Existing studies on chronic obstructive pulmonary disease (COPD) have mostly focused on airway lesions, with insufficient attention paid to the critical role of alveolar structural damage. Alveolar loss-type COPD, characterized primarily by emphysema, is the core structural basis for lung function decline and worsening clinical outcomes. This article systematically reviews the pathological network mediating alveolar loss through multiple mechanisms, including protease-antiprotease imbalance, persistent activation of oxidative stress, chronic inflammatory responses and differences in inflammatory endotypes, autoimmune abnormalities, and impaired repair function of alveolar epithelial and mesenchymal cells. It focuses on analyzing the synergistic effects of targeted Western medical therapies and traditional Chinese medicine treatment based on syndrome differentiation in regulating the inflammatory microenvironment and improving repair capacity, explores the value of non-pharmacological interventions in comprehensive management, and clarifies the multiple mechanism-mediated regulatory network of alveolar loss and the potential of integrated traditional Chinese and Western medicine interventions. From an integrated perspective of structural damage, inflammatory milieu, and repair imbalance, this article provides a theoretical basis and practical reference for precision classification, diagnosis, and treatment of alveolar loss-type COPD and combined Chinese and Western medicine interventions.

关键词

肺泡丢失 / 慢性阻塞性肺疾病 / 炎症内型 / 肺泡修复 / 中西医协同 / 肺气肿 / 补肺益肾

Key words

Alveolar loss / Chronic obstructive pulmonary disease / Inflammatory endotype / Alveolar repair / Integrated traditional Chinese and Western medicine / Emphysema / Tonifying the lung and benefiting the kidney

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基金资助

江苏省中医药科技发展计划项目(ZD202420)