Chin Med J:北京医院李宏义团队提出经络可能是组织液循环网络,开拓经络全新领域

2021-10-24 MedSci原创 MedSci原创

梅斯医学简评:有关经络,从古至今,未观察到实体。但是,最近十数年来,大家越来越倾向认为经络可能是人体的骨筋膜(间隙)或肌肉筋膜间隙,它的部分特点比较符合“穴位敏化”&ldquo

梅斯医学简评:有关经络,从古至今,未观察到实体。但是,最近十数年来,大家越来越倾向认为经络可能是人体的骨筋膜(间隙)或肌肉筋膜间隙,它的部分特点比较符合“穴位敏化”“经络循行”的一些特点。李宏义教授进一步扩展了这一理论,认为人体组织液循环网络,主要仍然是骨筋膜(间隙)或肌肉筋膜间隙,但是中间循环着组织间液,这些组织间液扮演什么样的作用,目前确实是未知,是不是就是经络,也无从得知。不过,组织间隙应该是全身都存在,是否象经络这样“管状”结构,难以知晓。当然,经络也不只是中医的全部,中医还认为除经络这些大脉络外,还有浮络,孙络等小的联系。但是,这一新的学说提出,对于对经络的理解,是近十数年来,最为新颖的一种说法,具体还有待将来进一步验证。可以考虑通过在组织间隙中注射特定的示踪物质,观察其循行特征,以及在组织间隙中注射炎症因子等刺激性物质,也可以观察它对于神经的刺激,甚至中枢神经系统,以至对内脏的影响,这些都是可以考虑的,而且对组织间隙,是比较容易进行阻断,或加压,从而有助于经络本身的研究。

总之,这套理论学说,自从30年前张颖清提出的“全息生物学”的经络学说外,最为落地的一种学说。但是未来的研究与应用,还需要更多的实验支持。

以下是报道:

北京医院李宏义教授团队重大原创性科学发现发布会23日在北京举行。据悉,该团队首次发现“人体组织液(interstitial fluid)循环网络”解剖学结构,提出在已知的血液循环系统、淋巴循环系统之外,还存在第三种体液循环系统,即“组织液循环网络”系统,并开拓了从组织液循环网络的角度研究经络穴位的新领域。

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人体中存在大量的组织液,约占成年人体重的20%。迄今为止,国内外研究对组织液是否全身循环尚不明确。北京医院内科主任医师李宏义团队采用医学磁共振示踪成像技术和高分辨率生物成像技术,在国际上首次发现“人体组织液循环网络”的解剖学结构,这种组织液流动网络广泛分布在静脉和动脉外膜、神经和皮肤等部位的纤维结缔组织中,并与人体四肢远端的穴位相连接;研究团队还在国际上首次提出“组织液循环网络”学说,即组织液不仅在局部扩散,而且能够像血液、淋巴液一样全身流动,在血管外膜、神经和皮肤等多种解剖学部位形成组织液循环网络。上述研究成果提出在已知的血液循环系统、淋巴循环系统之外,人体还存在第三种体液循环系统,即“组织液循环网络”系统,并开拓从组织液循环网络的角度研究经络穴位的新领域。

李宏义教授自 2006 年以来,对比增强磁共振成像 (MRI) 技术被用于研究源自健康志愿者穴位的流体流动[图】。通过皮下注射顺磁示踪剂(钆二亚乙基三胺五乙酸 [Gd-DTPA])进入手或脚的穴位,高空间分辨率(约 1 毫米)MRI 可视化两种类型的源自穴位的长距离流体流动路径:平滑和非平滑路径。平滑的路径显示出连续的轨迹,而非平滑的路径显示出不连续的轨迹。 MRI 确定的同一穴位的平滑或非平滑通路均与碘化油显示的淋巴管共定位。如果注射点不是穴位而是在静脉附近,则只能观察到光滑的通路。如果注射点是穴位,那么可以同时观察到光滑和非光滑的路径。相比之下,无论是畅通还是非畅通,都不能完全匹配地图集上的12条主要经线。

“组织液不仅在局部扩散,而且能够像血液、淋巴液一样全身流动,在血管外膜、神经和皮肤等多种解剖学部位形成组织液循环网络。”李宏义说,其中,血管外膜组织液的流动方向与静脉血流方向相同,与动脉血流方向相反;组织液循环网络的动力学机制与心脏的机械搏动相关;组织液循环网络具有重要的生理学功能。

针对组织液循环和经络穴位的关系是否真实存在这一问题,中国医学科学院基础医学研究所解剖与组胚学系主任马超表示,一系列形态学研究数据表明,人体组织液传输路径的解剖学结构和四肢的穴位分布有密切联系,可以形成从特定外周穴位到内脏器官的连续通道,以上发现为穴位和经络研究提供了新视角。

李宏义还在会上呼吁绘制“人类组织液连接组图谱”,力争在数年内,阐明“人体组织液循环网络”的解剖学分布、生理学和病理生理学功能、与疾病的关系等,同时绘制与穴位连接的“人体组织液循环网络图谱”,在此基础上再与传统的经络穴位进行比对。

“这一工作将建立起一个融贯传统中医与现代医学的全新理论——‘组织液循环网络’理论,推动医学诊断和治疗新技术发展,为维护人类的健康、预防和治疗疾病服务。”李宏义说。

“如果绘制出与体表穴位相关的人体组织液循环网络图谱,将不仅为传统‘穴位给药’的治疗提供一种全新科学解释,也将科学系统建立一种新型给药方式。”北京医院副院长张烜亦表示,在穴位区注射药物,通过与这个穴位连接的特定组织液循环网络,有可能实现针对特定器官的靶向药物治疗,从而避免全身给药对其他相对正常组织器官的不利影响

李宏义表示,研究工作由其团队联合中国医科院基础医学研究所、清华大学、中科院计算所等单位,前后历经16年。

 

北京医院副院长张烜介绍,李宏义研究团队原创性发现提示我们,人体内存在这样一个庞大的组织液循环网络,“全面深入系统解析其中奥秘和功能,将对我们重新认识和理解心血管循环系统以及人体各个器官系统的生理学功能及其异常在疾病中的作用,展开全新的研究篇章,例如,动静脉管壁及其周围的组织液流动参与动脉粥样硬化和冠心病高血压等血管性疾病的发生发展,对于血管和器官炎症、局部免疫应答微环境影响等。”

张烜表示,这一研究成果还有望建立一种新型给药方式。传统的药物运输途径主要是通过血液循环系统将药物输送到身体的各个部位,难以实现针对靶器官的“点对点”输送。据了解,中医临床会采用“穴位注射”治疗疾病,在“穴位注射”,通过相应的“经络”传输,达到治疗的目的,其背后的机制一直不清楚。“李宏义研究团队的工作,如果绘制出与体表穴位相关的人体组织液循环网络图谱,将不仅为传统‘穴位给药’治疗提供一种全新科学的解释,也将科学系统地建立一种新型给药方式,在穴位区注射药物,通过与这个穴位连接的特定组织液循环网络,有可能实现针对特定器官的靶向药物治疗,从而避免全身给药对其他相对正常组织器官的不利影响。”

中国科学院院士、科技部原部长徐冠华指出,组织液循环网络学说有望发展为一项具有重大国际影响的基础科学原创性理论,将有可能把中医和西医真正结合起来,创造一个全新的医学模式,建立起一个包括血液循环、淋巴循环和组织液循环的人体完整循环系统的宏观图像,形成一项全新的医学理论,这其中很可能孕育着一系列新的发现、新的理论和新的技术。

李宏义教授发表的相关文献:

Li HY, Wang F, Chen M, Zheng ZJ, Yin YJ, Hu J, Li H, Sammer A, Feigl G, Maurer N, Ma C, Ji FS.An acupoint-originated human interstitial fluid circulatory network.Chin Med J (Engl). 2021 Sep 21;134(19):2365-2369

Li HY, Han D, Li H, Chen M. A biotic interfacial fluid transport phenomenon in the meshwork of fibrous connective tissues over the whole body (in Chinese)Prog Physiol Sci 2017; 48:81–87. doi: 10.3969/j.issn.0559-7765.2017.02.001.

Li HY, Yin Y, Yang C, Chen M, Wang F, Ma C, et al. . Active interfacial dynamic transport of fluid in a network of fibrous connective tissues throughout the whole bodyCell Prolif 2020; 53:e12760.doi: 10.1111/cpr.12760

Li HY, Ji FS, Wang F, Yang CQ, Ma C, Yin YJ, et al. . Research progresses on active interfacial fluid flow and its dynamic mechanism in a network of human fibrous connective tissuesProg Physiol Sci 2021; 52:155–161. doi: 10.3969/j.issn.0559-7765.2021.02.016

Kong Y, Yu X, Huang R, Li Z, Yin Y, Li H. Preliminary study on the drainage effect of the venous and arterial adventitia and perivascular connective tissue on edema of lower Limbs in mice (in Chinese)Chin J Geriatr 2021; 40:9–14. doi: 10.3760/cma.j.issn.0254-9026.2021.08.000

Li HY, Chen M, Yang JF, Yang CQ, Xu L, Wang F, et al. . Fluid flow along venous adventitia in rabbits: is it a potential drainage system complementary to vascular circulations? PLoS One 2012; 7:e41395.doi: 10.1371/journal.pone.0041395

Li HY, You LV, Chen XL, Li B, Hua Q, Ji FS, et al. . Layers of interstitial fluid flow along a “slit-shaped” vascular adventitia (in Chinese)J Zhejiang Univ-Sci B 2021; 22:647–663. doi: 10.1631/jzus.B2000590

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    学习

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1611306, encodeId=1132161130649, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Oct 26 11:01:34 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063604, encodeId=f15b10636046f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f22999147, createdName=denglimoxiaoran, createdTime=Sun Oct 24 23:07:09 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063582, encodeId=798210635827c, content=太厉害了,学习了不少。, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ee95582917, createdName=唐唐露露, createdTime=Sun Oct 24 21:44:49 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063543, encodeId=b6501063543ea, content=总之,这套理论学说,自从30年前张颖清提出的“全息生物学”的经络学说外,最为落地的一种学说。但是未来的研究与应用,还需要更多的实验支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a54e5645039, createdName=ms9000000212834100, createdTime=Sun Oct 24 20:57:25 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063536, encodeId=5d8e106353647, content=经络一直是个迷。病人常常讲,针灸很神奇,其实,我觉得是人体很微妙,针灸不过是用不同方法去刺激,激发人体的功能,对人体进行探索。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/08/05/9b4c18dcaa300d0f1afa44f3307139a0.jpg, createdBy=e8f25148686, createdName=赵小喏, createdTime=Sun Oct 24 20:55:24 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063530, encodeId=423f106353040, content=坚持学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210313/9df56058b3964a8cac82563f95f0389d/c1b478592e8e4463bef44d32712e98fd.jpg, createdBy=ea905324251, createdName=SR~young海东, createdTime=Sun Oct 24 20:19:46 CST 2021, time=2021-10-24, status=1, ipAttribution=)]
    2021-10-24 唐唐露露

    太厉害了,学习了不少。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1611306, encodeId=1132161130649, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Oct 26 11:01:34 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063604, encodeId=f15b10636046f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f22999147, createdName=denglimoxiaoran, createdTime=Sun Oct 24 23:07:09 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063582, encodeId=798210635827c, content=太厉害了,学习了不少。, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ee95582917, createdName=唐唐露露, createdTime=Sun Oct 24 21:44:49 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063543, encodeId=b6501063543ea, content=总之,这套理论学说,自从30年前张颖清提出的“全息生物学”的经络学说外,最为落地的一种学说。但是未来的研究与应用,还需要更多的实验支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a54e5645039, createdName=ms9000000212834100, createdTime=Sun Oct 24 20:57:25 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063536, encodeId=5d8e106353647, content=经络一直是个迷。病人常常讲,针灸很神奇,其实,我觉得是人体很微妙,针灸不过是用不同方法去刺激,激发人体的功能,对人体进行探索。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/08/05/9b4c18dcaa300d0f1afa44f3307139a0.jpg, createdBy=e8f25148686, createdName=赵小喏, createdTime=Sun Oct 24 20:55:24 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063530, encodeId=423f106353040, content=坚持学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210313/9df56058b3964a8cac82563f95f0389d/c1b478592e8e4463bef44d32712e98fd.jpg, createdBy=ea905324251, createdName=SR~young海东, createdTime=Sun Oct 24 20:19:46 CST 2021, time=2021-10-24, status=1, ipAttribution=)]
    2021-10-24 ms9000000212834100

    总之,这套理论学说,自从30年前张颖清提出的“全息生物学”的经络学说外,最为落地的一种学说。但是未来的研究与应用,还需要更多的实验支持

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1611306, encodeId=1132161130649, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Oct 26 11:01:34 CST 2021, time=2021-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063604, encodeId=f15b10636046f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f22999147, createdName=denglimoxiaoran, createdTime=Sun Oct 24 23:07:09 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063582, encodeId=798210635827c, content=太厉害了,学习了不少。, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ee95582917, createdName=唐唐露露, createdTime=Sun Oct 24 21:44:49 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063543, encodeId=b6501063543ea, content=总之,这套理论学说,自从30年前张颖清提出的“全息生物学”的经络学说外,最为落地的一种学说。但是未来的研究与应用,还需要更多的实验支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a54e5645039, createdName=ms9000000212834100, createdTime=Sun Oct 24 20:57:25 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063536, encodeId=5d8e106353647, content=经络一直是个迷。病人常常讲,针灸很神奇,其实,我觉得是人体很微妙,针灸不过是用不同方法去刺激,激发人体的功能,对人体进行探索。, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/08/05/9b4c18dcaa300d0f1afa44f3307139a0.jpg, createdBy=e8f25148686, createdName=赵小喏, createdTime=Sun Oct 24 20:55:24 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063530, encodeId=423f106353040, content=坚持学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210313/9df56058b3964a8cac82563f95f0389d/c1b478592e8e4463bef44d32712e98fd.jpg, createdBy=ea905324251, createdName=SR~young海东, createdTime=Sun Oct 24 20:19:46 CST 2021, time=2021-10-24, status=1, ipAttribution=)]
    2021-10-24 赵小喏

    经络一直是个迷。病人常常讲,针灸很神奇,其实,我觉得是人体很微妙,针灸不过是用不同方法去刺激,激发人体的功能,对人体进行探索。

    0

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    2021-10-24 SR~young海东

    坚持学习

    0

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