【摘要】 巨噬细胞糖代谢重编程在病毒感染的免疫反应中起着关键作用，病毒感染促使它从氧化磷酸化向糖酵解亢进驱动的促炎M1型极化，加剧炎症反应和组织损伤，形成“正虚邪盛”的病理格局。正邪斗争与代谢-免疫紊乱贯穿流行性感冒的疾病过程，线粒体功能障碍抑制氧化磷酸化，削弱M2型巨噬细胞的抗炎和修复能力，形成易受外邪入侵的微环境；邪盛致病诱导糖酵解依赖的M1型巨噬细胞过度活化并释放促炎性细胞因子，导致“正不胜邪”的炎症损伤。正虚邪盛作为流行性感冒的核心病机，治疗宜扶正与祛邪并重。从正邪理论出发，系统阐释流行性感冒“代谢紊乱-炎症免疫失衡”的病理机制，并探讨中医药在调节巨噬细胞代谢表型及防治流行性感冒中的作用，为临床应用提供思路，推动经典理论与现代诊疗体系的深度融合。更多还原

【Abstract】 Metabolic reprogramming of macrophages plays a critical role in the immune response to viral infections. Viral infection induces a shift in macrophage metabolism from oxidative phosphorylation to enhanced glycolysis, driving pro-inflammatory M1 polarization. This process exacerbates inflammatory responses and tissue damage, ultimately forming a pathological pattern characterized by "healthy qi(Zheng Qi) deficiency and pathogenic factors(Xie Qi) excessiveness". The struggle between healthy qi and pathogenic factors and metabolismimmune disorders run through the disease process of influenza. Mitochondrial dysfunction inhibits oxidative phosphorylation, weakening the anti-inflammatory and repair ability of M2 macrophages and creating a microenvironment susceptible to invasion by external pathogenic factors. The exuberance of these pathogenic factors induces disease by promoting the excessive activation of glycolysis-dependent M1 macrophages and the release of proinflammatory cytokines, resulting in the inflammatory damage characteristic of a state where "healthy qi fails to overcome pathogenic factors". With healthy qi deficiency and pathogenic factors excessiveness as the core pathogenesis of influenza, treatment should place equal emphasis on strengthening healthy qi and eliminating pathogenic factors. Based on the theory of "Zheng and Xie", this study systematically elucidates the pathological mechanism of "metabolic disorder–inflammatory-immune imbalance" in influenza, while exploring the role of traditional Chinese medicine in regulating macrophage metabolic phenotypes and preventing/treating influenza. The findings provide insights for clinical application and promote the deep integration of classical theories with modern diagnosis and treatment systems.更多还原