中医学“湿蒙清窍”病机理论的现代科学实质研究

In clinic，obese patients often complain unclear mind, daytime drowsiness, inactivity, etc. Traditional Chinese medicine (TCM) theory believes that most fat people have dampness constitution. The symptoms of obese people, such as drowsiness, heavy head as if swathed, heavy body, weakness, and fatigue and somnolence is closely related with dampness. Its pathogenesis is the failure of the spleen to transport. As a result, dampness is generated within the body and clouds the brain, also called " dampness clouding the clear orifices ". So far, the modern science mechanism of pathogenesis of " dampness clouding the clear orifices " theory is not completely clear. The studies in recent years revealed that the insufficiency of function of orexin nervous system can lead to more sleep and decrease of motive activity, and development of obese. This is consistent with symptoms of " dampness clouding the clear orifices " in TCM.. According to the theory that over eating .fatty and sweet rich foods injure the spleen, and that spleen deficiency gives rise to dampness stagnation which clouds the brain in TCM, this study will establish “dampness clouding the clear orifices” mice model through long-term HIGH-FAT diet. This model will be used to analyze the functions of orexin system related to cibation and arousal maintenance and energy metabolism in the damp constitution (obesity). Based on the elucidating the pathophysiological mechanism of somnia, drowsy, less movement s, etc. of obese patient, we will reveal the connotation of modern science of pathogenetic theory of “dampness clouding the clear orifices” of TCM and make contribution to the further development of TCM.

在临床上肥胖患者常常主诉头脑不清，白天困倦、不爱活动等。传统中医学理论认为肥人多湿，肥胖者昏昏欲睡、头重如裹、沉困无力、怠惰嗜卧等症候与湿邪密切相关，其病机是脾失健运，湿邪内生，蒙蔽清窍，又称“湿蒙清窍”。迄今为止，“湿蒙清窍”病机理论的现代科学实质尚完全不清楚。近年研究发现，orexin神经系统功能不足会导致动物睡眠增多，自主活动减少，肥胖等。这与中医学湿蒙清窍病症表现一致。.本研究拟根据中医学过食肥甘厚味伤脾以及脾虚湿滞蒙蔽清窍的理论，通过长期高脂饮食饲养来建立湿蒙清窍小鼠动物模型。并应用此模型通过实验解析多湿体质（肥胖）的摄食、觉醒维持及能量代谢等相关的orexin系统功能，在阐明脾虚肥胖者多眠困倦少动等表象的病理生理学机制的基础上，揭示中医学“湿蒙清窍”病机理论的现代科学内涵，为中医学的进一步发展做出贡献。

本研究根据中医学过食肥甘厚味伤脾以及脾虚湿滞蒙蔽清窍的理论，采用长期高脂饮食饲养的方法成功的建立了湿蒙清窍小鼠动物模型。该模型准确的模拟了中医学湿蒙清窍的临床表征，包括多眠嗜睡，自主活动减少，欲望低下等。并应用此动物模型通过实验手段解析了与摄食、觉醒维持、能量代谢以及情绪调节相关的Orexin神经系统功能。研究结果表明，湿蒙清窍动物的长期高血脂及肥胖导致Orexin受体敏感性及胰岛素敏感性降低，进而诱发的脑内Orexin神经系统功能活动低下，是动物湿蒙清窍外在表象发生的现代科学机制。本研究首次建立了的中医学‘湿蒙清窍’证的动物模型，首次阐明了中医学湿蒙清窍病机理论的现代科学实质。为传统中医理论的现代科学解析提供了新的理论思维和研究工具。