Discussion on the Pathogenetic Evolution of Cerebral Small Vessel Disease in the Elderly Based on the "Form-Function" Disharmony of Brain Collaterals

XU Ying; GE Jinwen

doi:10.13288/j.11-2166/r.2026.15.008

您当前的位置：

首页 >

文章列表页 >

Discussion on the Pathogenetic Evolution of Cerebral Small Vessel Disease in the Elderly Based on the "Form-Function" Disharmony of Brain Collaterals

更新时间：2026-08-05

- Discussion on the Pathogenetic Evolution of Cerebral Small Vessel Disease in the Elderly Based on the "Form-Function" Disharmony of Brain Collaterals
- Journal of Traditional Chinese Medicine Vol. 67, Issue 15, Pages: 1623-1626(2026)
- 作者机构：
  
  1.湖南中医药大学，湖南省长沙市岳麓区含浦科教园学士路300号，410208
  2.湖南省中医药研究院
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2026.15.008
  CLC：
- Received：10 November 2025，
  
  Revised：2026-05-30，
  
  Accepted：22 February 2026，
  
  Online First：03 August 2026，
  
  Published：02 August 2026
- 稿件说明：
移动端阅览
许盈,葛金文.基于脑络“体-用”失衡的老年脑小血管病病机演变规律[J].中医杂志,2026,67(15):1623-1626.

XU Ying,GE Jinwen.Discussion on the Pathogenetic Evolution of Cerebral Small Vessel Disease in the Elderly Based on the "Form-Function" Disharmony of Brain Collaterals[J].Journal of Traditional Chinese Medicine,2026,67(15):1623-1626.
许盈,葛金文.基于脑络“体-用”失衡的老年脑小血管病病机演变规律[J].中医杂志,2026,67(15):1623-1626. DOI： 10.13288/j.11-2166/r.2026.15.008.

XU Ying,GE Jinwen.Discussion on the Pathogenetic Evolution of Cerebral Small Vessel Disease in the Elderly Based on the "Form-Function" Disharmony of Brain Collaterals[J].Journal of Traditional Chinese Medicine,2026,67(15):1623-1626. DOI： 10.13288/j.11-2166/r.2026.15.008.

摘要

脑小血管病（CSVD）是累及脑内小血管的异质性病变，与老年人认知功能障碍、步态异常、情感障碍等密切相关。立足中医络病学说，从体用关系切入，提出老年CSVD“体-用”病机分析框架，以脑内络脉与玄府等形质结构为“体”，以气血运行、濡养调控及津液输布等功能活动为“用”，体用互根互济，共同维持脑之神机运转。在此框架下，系统阐释CSVD络脆-络僵-络滞-络损的动态病机演变规律，以揭示老年脑络从生理性衰退向病理性损害转化的可能机制，为老年CSVD的中医辨治提供依据。

Abstract

Cerebral small vessel disease （CSVD） is a heterogeneous condition affecting small vessels in the brain and is closely associated with cognitive dysfunction， gait abnormalities， and emotional disorder in the elderly. Based on the collateral disease theory of traditional Chinese medicine （TCM）， a "form-function" pathogenesis framework for elderly CSVD is proposed from the perspective of their relationship. In this framework， the "form" refers to the morphological basis of the brain collaterals and sweat pore， while the "function" refers to the activities of

-blood circulation， nourishment and regulation， as well as the body fluid transportation and distribution； the two are interdependent and jointly maintain the mental activities of the brain. Under this framework， the dynamic pathogenesis evolution patterns of CSVD， namely collateral fragility， collateral rigidity， collateral stagnation， and collateral damage， are systematically explained， revealing the potential mechanisms underlying the transformation of age-related physiological decline of brain collaterals into pathological impairment. This provides a theoretical foundation for the diagnosis and treatment of elderly CSVD with TCM.

关键词

Keywords

references

Chojdak-Łukasiewicz J ， Dziadkowiak E ， Zimny A ， et al . Cerebral small vessel disease： a review ［J］. Adv Clin Exp Med ， 2021 ， 30 （ 3 ）： 349 - 356 .

Berrocal-Izquierdo N ， Bioque M ， bernardo M . Is cerebrovascular disease a silent condition in patients with chronic schizophrenia-related disorders？［J］. Int Clin Psychopharmacol ， 2017 ， 32 （ 2 ）： 80 - 86 .

周德生，谭惠中 . 基于络脉理论辨治脑小血管病：中医脑病理论与临床实证研究（二）［J］. 湖南中医药大学学报， 2019 ， 39 （ 2 ）： 153 - 158 .

吴以岭，张运，张伯礼，等 . 络病学［M］. 2 版. 北京：中国中医药出版社， 2019： 49 .

吴以岭 . 中医络病学说与三维立体网络系统［J］. 中医杂志， 2003 ， 44 （ 6 ）： 407 - 409 .

常富业，王永炎 . 浅谈津络学说［ J］. 北京中医药大学学报， 2022 ， 45 （ 1 ）： 11 - 14 .

罗再琼，黄文强，杨九一，等 . “玄府”：藏象理论的微观结构［J］. 中医杂志， 2011 ， 52 （ 16 ）： 1354 - 1356 .

董丽，李波，白雪，等 . 脑之玄府与血脑屏障的相关性［J］. 中医杂志， 2013 ， 54 （ 22 ）： 1969 - 1971 .

Willie C K ， Tzeng Y C ， Fisher J A ， et al . Integrative regulation of human brain blood flow ［J］. J Physiol ， 2014 ， 592 （ 5 ）： 841 - 859 .

Iadecola C . The neurovascular unit coming of age： a journey through neurovascular coupling in health and disease ［J］. Neuron ， 2017 ， 96 （ 1 ）： 17 - 42 .

Zeng P ， Zeng B ， Luo D ， et al . Neurovascular coupling alterations in cerebral small vessel disease： a multi-delayed ASL and fMRI perspective on cognitive impairment ［J］. Magn Reson Imaging ， 2025 ， 122 ： 110425 . DOI： 10.1016/j.mri.2025.110425 http://dx.doi.org/10.1016/j.mri.2025.110425 .

常富业，杨宝琴，王永炎，等 . 玄府概念诠释（五）：玄府流通气液功能的探讨［J］. 北京中医药大学学报， 2005 ， 28 （ 4 ）： 13 - 15 .

Iliff J J ， Wang M ， Liao Y ， et al . A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes， including amyloid β ［J］. Sci Transl Med ， 2012 ， 4 （ 147 ）： 147ra111 .

Zimmerman B ， Rypma B ， Gratton G ， et al . Age‐related changes in cerebrovascular health and their effects on neural function and cognition： a comprehensive review ［J］. Psychophysiology ， 2021 ， 58 （ 7 ）： e13796 .

Graff B J ， Payne S J ， El-bouri W K . The ageing brain： investigating the role of age in changes to the human cerebral microvasculature with an in silico model ［J］. Front Aging Neurosci ， 2021 ， 13 ： 632521 . DOI： 10.3389/fnagi.2021.632521 http://dx.doi.org/10.3389/fnagi.2021.632521 .

Lundgren C . Cognitive changes in again：the implications for us as anaesthetists ［J］. South Afr J Anaesth Analg ， 2008 ， 14 （ 5 ）： 5 - 6 .

Kinoshita K . Traumatic brain injury： pathophysiology for neurocritical care ［J］. J Intensive Care ， 2016 ， 4 （ 1 ）： 29 .

Xiong Y ， Yu Q ， Zhi H ， et al . Advances in the study of the glymphatic system and aging ［J］. CNS Neurosci Ther ， 2024 ， 30 （ 6 ）： e14803 .

赵晓燕，张慧，张璇，等 . 基于“以补为通”论补益药在脑小血管病中的应用［J］. 辽宁中医药大学学报， 2026 ， 28 （ 5 ）： 117 - 123 .

Wardlaw J M ， Smith C ， Dichgans M . Small vessel disease： mechanisms and clinical implications ［J］. Lancet Neurol ， 2019 ， 18 （ 7 ）： 684 - 696 .

Caplan L R . Lacunar infarction and small vessel disease： pathology and pathophysiology ［J］. J Stroke ， 2015 ， 17 （ 1 ）： 2 - 6 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Exploring the Pathogenesis Evolution and Treatment Strategies of Skin Cancer from the Perspective of "Spleen Deficiency， Sweat Pore Obstruction，and Toxin Accumulation"

Syndrome Differentiation and Treatment of Cholinergic Urticaria from the Perspective of "Treating Fire Constraint by Dispersing It"

Exploration on the Approach to Syndrome Differentiation and Treatment of Pediatric Infectious Mononucleosis Based on the "Sweat Pore-Qi and Liquid-Collaterals" Theory

Dynamic Sequential Diagnosis and Treatment of Pediatric Nephrotic Syndrome Based on the "Sweat Pore-Qi and Liquid-Kidney Collaterals"

Analysis of the Diagnostic and Treatment Approach for Cough Variant Asthma Based on the Concept of "Wind Medicinal Opening Sweat Pores"

Related Author

LIN Hongsheng

HAN Baojin

TAN Ying

CAI Ruijuan

WANG Xueqian

ZHONG Yiwei

WANG Qixuan

LIU Chunhong

Related Institution

Guang'anmen Hospital，China Academy of Chinese Medical Sciences

Heilongjiang University of Traditional Chinese Medicine

School of Pediatrics，Henan University of Chinese Medicine

Hospital of Pediatrics，The First Affiliated Hospital of Henan University of Chinese Medicine

Pediatric Medical College，Henan University of Chinese Medicine

Address：No.16, Nanxiao street, Dongzhimen, Dongcheng District, Beijing Postal code：100700
Tel：010-64035632 Email：jtcmcn@188.com
Technical support is provided by Beijing Founder electronics co., LTD 京ICP备09064830号-19 京公网安备11010102007558号
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰