以《内经》“心受气于脾”理论为指导，以中医药“治未病”理念为启示，将动脉粥样硬化研究重心前移。课题组前期研究发现健脾祛痰中药能够调节microRNA155水平改善冠脉内皮功能及炎症水平，延缓粥样斑块形成，但作用机制仍不明确。基于前期基础结合国内外研究进展，提出假说：脾失健运，痰浊内生，因痰致瘀，触发和加剧冠状动脉粥样硬化免疫炎症反应，引起血管内皮损伤，痰浊之邪进入内膜，致内皮下microRNA155及靶基因SOCS1表达异常，活化JAK/STAT信号通路，致Th细胞亚群分化失衡，分泌促炎性细胞因子而加速As斑块发生发展，阻碍脉道气血运行，心脉阻滞。健脾祛痰中药可能影响上述病理机制防治动脉粥样硬化。本项目将复制巴马猪动脉粥样硬化模型，从器官、组织、细胞、分子水平阐明《内经》“心受气于脾”的科学内涵，阐述“脾虚生痰”与“心脉阻滞”的关系，为中医“从脾论治”冠心病提供科学依据，丰富脾脏象理论。

Our research group was guided by the theory of the heart receiving qi from the spleen in Inner Canon of Huangdi.We were also inspired by the theory of preventive treatment of diseases in TCM.We moved the focus of the study of atherosclerosis formerly,and found that the Chinese medicine of invigorating the spleen and eliminating phlegm had the functions of regulateing microRNA155 level, improving the function of coronary endothelial and inflammation level, delaying the formation of atherosclerotic plaque in preliminary study of our group.But the mechanism is still unclear. Now we put forward the following hypotheses based on previous research and combination with the research progress at home and abroad: dysfunction of spleen in transport can cause endogeny of phlegm turbidity,which can lead to blood stasis. It can touch off and aggravate the immune inflammatory response of coronary atherosclerosis,then make injury to vessel endothelial cell. Thus the pathogenic factor of phlegm-turbid can enter inner membrance.It can lead to abnormal expression of endothelial microRNA155 and target gene SOCS1,then activate signal channel of JAK/STAT.This can cause differential disorders of Th cell subsets and secretion of proinflammatory cytokines,which accelerate the development of AS plaque, obstruct qi and blood circulation in vessel system.Finally it can lead to blockage stasis of heart vessel.Chinese medicine of invigorating the spleen and eliminating phlegm can affect the pathological mechanism above,and play a role in the prevention and treatment of atherosclerosis. Our project will replicate the atherosclerosis model of minipigs.Clarify the scientific connotation of the heart receiving qi from the spleen in Inner Canon of Huangdi from organ, tissue, cell and molecular level. Expatiate the relationship between dysfunction of spleen in transport and blockage stasis of heart vessel in TCM.Provide scientific basis for treating coronary heart disease based on spleen in TCM,and enrich viscera theory of spleen.