活血化瘀法治疗慢性心力衰竭的研究进展
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摘要
心力衰竭是心血管系统疾病的终末期表现和最主要的死因,严重危害患者的身心健康。中医理论认为,血瘀证存在于慢性心力衰竭病情发展的始终。在整体审查和辨证论治的基础上,合理运用活血化瘀中药,可与治疗慢性心力衰竭西药产生协同作用,能抗神经-体液调节机制失衡,调节相关体液因子水平,抑制心肌肥大、纤维化以及凋亡信号通路传导,改善心肌细胞代谢,保护心肌细胞,逆转心肌重构,明显改善心功能,从而防治心力衰竭。
Heart failure is the end-stage manifestation of cardiovascular disease and the main cause of death, seriously harming the physical and mental health of patients. The theory of traditional Chinese medicine holds that the syndrome of blood stasis exists in the development of chronic heart failure. On the basis of overall review and syndrome differentiation,the rational use of Chinese medicine for promoting blood circulation and removing blood stasis can produce synergistic effect with western medicine treatment of chronic heart failure. It can control neuro humoral regulation mechanism imbalance,regulate humoral cytokines and inhibit myocardial hypertrophy, fibrosis, apoptosis signaling pathway, improve myocardial cell metabolism, protect myocardial cells and reverse myocardial remodeling and improve cardiac function, thereby preventing heart failure.
Heart failure is the end-stage manifestation of cardiovascular disease and the main cause of death, seriously harming the physical and mental health of patients. The theory of traditional Chinese medicine holds that the syndrome of blood stasis exists in the development of chronic heart failure. On the basis of overall review and syndrome differentiation,the rational use of Chinese medicine for promoting blood circulation and removing blood stasis can produce synergistic effect with western medicine treatment of chronic heart failure. It can control neuro humoral regulation mechanism imbalance,regulate humoral cytokines and inhibit myocardial hypertrophy, fibrosis, apoptosis signaling pathway, improve myocardial cell metabolism, protect myocardial cells and reverse myocardial remodeling and improve cardiac function, thereby preventing heart failure.
引文
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[2]中华人民共和国国家标准.中医临床诊疗术语疾病部分.成都中医药大学学报,1999,22(1):63-64
[3]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要.中国循环杂志,2018,33(1):1-8
[4]Fu S,Zhang J,Gao X,et al.Clinical practice of traditonal Chinese medicines for chronic heartfailure.Heart Asia,2010,2(1):24-27
[5]徐学功,张军鹏,罗良涛,等.中西医结合治疗对慢性心力衰竭患者生活质量的影响.中华中医药杂志,2014,29(8):2697-2701
[6]李立志,陈可冀.陈可冀治疗充血性心力衰竭经验.中西医结合心脑血管病杂志,2006,4(2):136-138
[7]梁逸强,周端.近代、当代8位名老中医论治心衰经验荟萃.辽宁中医杂志,2012,39(3):416-418
[8]唐咏,陈伯钧,曾靖,等.陈伯钧教授中医药治疗慢性心力衰竭临床经验分析.重庆医学,2016,45(9):1284-1285
[9]王娟,陈婵,张鹏,等.630例慢性心衰患者中医证候分布规律研究.北京中医药大学学报,2013,36(8):567-571
[10]张少强,杜武勋,朱明丹,等.296例慢性心力衰竭患者中医证候临床调查分析.辽宁中医杂志,2013,40(8):1528-1530
[11]罗良涛,赵慧辉,王娟,等.中医医院冠心病慢性心力衰竭患者中医证候要素分布特点分析.北京中医药大学学报,2014,37(2):130-134
[12]张洁,仇盛蕾.慢性心力衰竭患者中医证候要素分布特征.中国现代医生,2016,54(7):103-106
[13]黄静文,赛丽,黄平东.益心补肾法对慢性心力衰竭大鼠心功能及血清去甲肾上腺素、血管紧张素Ⅱ、醛固酮水平的影响.中西医结合心脑血管病杂志,2017,15(3):298-302
[14]苗梦露,李七一,严士海,等.抗心衰颗粒对舒张性心衰大鼠RAAS及心肌细胞内TGF-β1的影响.南京中医药大学学报,2013,29(3):247-250
[15]吉利,张艳.益气通脉饮对慢性心力衰竭大鼠心功能及血清ANP、BNP含量的影响.江苏中医药,2014,46(9):73-74
[16]吉利,张艳.益气通脉饮对慢性心力衰竭大鼠心功能及血清TNF-α、IL-6、TGF-β1水平的影响.西部中医药,2015,28(5):25-27
[17]常丽萍.芪苈强心胶囊治疗慢性心力衰竭的作用机理及代谢组学研究.石家庄:河北医科大学,2017
[18]朱凌倜,丁雪峰,付明强,等.芪苈强心提取物对缺氧大鼠心肌微血管内皮细胞VEGF及HIF-1α表达作用的研究.中国分子心脏病学杂志,2014,14(2):887-891
[19]肖红,宋优,李娅,等.芪苈强心调节TNF-α和IL-10之间的平衡及改善心肌梗死大鼠的心脏功能.第十届国际络病学大会论文集,2014:5
[20]李春陵,顾广富,罗建华,等.益气温阳活血方对慢性心力衰竭心室重塑大鼠GATA4表达的影响.中华中医药杂志,2014,29(9):2967-2970
[21]冯庆涛,杨静,张燕,等.参桂益心汤对慢性心力衰竭患者外周血单核细胞Toll样受体4/核转录因子-κB信号通路的影响.中国实验方剂学杂志,2017,23(23):146-151
[22]Turer A T,Malloy C R,Newgard C B,et al.Energetics and metabolism in the failing heart:important but poorly understood.Current Opinion in Clinical Nutrition and Metabolic Care,2010,13(4):458-465
[23]殷仁富,陈金明.心脏能量学:代谢与治疗.上海:第二军医大学出版社,2002:261
[24]郭彩霞,马丽红,沈启明,等.心复力颗粒对阿霉素致心力衰竭大鼠PPAR-α及ET-1的影响.医学研究杂志,2015,44(5):41-44
[25]蒲秀瑛,王恒瑞,许珊丽.当归补血汤对心力衰竭大鼠心肌组织的影响.中医药学报,2013,41(3):102-105
[26]徐颖.益气活血利水方治疗慢性心力衰竭的临床研究.石家庄:河北医科大学,2017
[27]李坤玲.补气活血利水法治疗慢性心力衰竭(气虚血瘀型)的临床疗效观察.成都:成都中医药大学,2015
[28]杜峣楠,宋晨薇,王晓峰.中成药治疗心力衰竭的研究进展.中成药,2017,39(4):794-799
[29]Li X,Zhang J,Huang J,et al.A multicenter randomized doubleblind parallel-group placebo-controlled study of the effects of Qi li Qiang xin Capsules in patients with chronic heart failure.J Am Coll Cardiol,2013,62(12):1065-1072
[30]薛金贵,王肖龙,许勇,等.心脉隆注射液治疗慢性心力衰竭(气阳两虚、瘀血内阻证)的多中心随机对照研究.中国中西医结合杂志,2015,35(7):796-800
[31]杜金行,史载祥.血瘀证中西医结合诊疗共识.中国中西医结合杂志,2011,31(6):839-844
[32]Hao P,Jiang F,Cheng J,et al.Traditional Chinese medicine for cardiovascular disease:Evidence and potential mechanisms.J Am Coll Cardiol,2017,69(24):2952-2966
[2]中华人民共和国国家标准.中医临床诊疗术语疾病部分.成都中医药大学学报,1999,22(1):63-64
[3]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要.中国循环杂志,2018,33(1):1-8
[4]Fu S,Zhang J,Gao X,et al.Clinical practice of traditonal Chinese medicines for chronic heartfailure.Heart Asia,2010,2(1):24-27
[5]徐学功,张军鹏,罗良涛,等.中西医结合治疗对慢性心力衰竭患者生活质量的影响.中华中医药杂志,2014,29(8):2697-2701
[6]李立志,陈可冀.陈可冀治疗充血性心力衰竭经验.中西医结合心脑血管病杂志,2006,4(2):136-138
[7]梁逸强,周端.近代、当代8位名老中医论治心衰经验荟萃.辽宁中医杂志,2012,39(3):416-418
[8]唐咏,陈伯钧,曾靖,等.陈伯钧教授中医药治疗慢性心力衰竭临床经验分析.重庆医学,2016,45(9):1284-1285
[9]王娟,陈婵,张鹏,等.630例慢性心衰患者中医证候分布规律研究.北京中医药大学学报,2013,36(8):567-571
[10]张少强,杜武勋,朱明丹,等.296例慢性心力衰竭患者中医证候临床调查分析.辽宁中医杂志,2013,40(8):1528-1530
[11]罗良涛,赵慧辉,王娟,等.中医医院冠心病慢性心力衰竭患者中医证候要素分布特点分析.北京中医药大学学报,2014,37(2):130-134
[12]张洁,仇盛蕾.慢性心力衰竭患者中医证候要素分布特征.中国现代医生,2016,54(7):103-106
[13]黄静文,赛丽,黄平东.益心补肾法对慢性心力衰竭大鼠心功能及血清去甲肾上腺素、血管紧张素Ⅱ、醛固酮水平的影响.中西医结合心脑血管病杂志,2017,15(3):298-302
[14]苗梦露,李七一,严士海,等.抗心衰颗粒对舒张性心衰大鼠RAAS及心肌细胞内TGF-β1的影响.南京中医药大学学报,2013,29(3):247-250
[15]吉利,张艳.益气通脉饮对慢性心力衰竭大鼠心功能及血清ANP、BNP含量的影响.江苏中医药,2014,46(9):73-74
[16]吉利,张艳.益气通脉饮对慢性心力衰竭大鼠心功能及血清TNF-α、IL-6、TGF-β1水平的影响.西部中医药,2015,28(5):25-27
[17]常丽萍.芪苈强心胶囊治疗慢性心力衰竭的作用机理及代谢组学研究.石家庄:河北医科大学,2017
[18]朱凌倜,丁雪峰,付明强,等.芪苈强心提取物对缺氧大鼠心肌微血管内皮细胞VEGF及HIF-1α表达作用的研究.中国分子心脏病学杂志,2014,14(2):887-891
[19]肖红,宋优,李娅,等.芪苈强心调节TNF-α和IL-10之间的平衡及改善心肌梗死大鼠的心脏功能.第十届国际络病学大会论文集,2014:5
[20]李春陵,顾广富,罗建华,等.益气温阳活血方对慢性心力衰竭心室重塑大鼠GATA4表达的影响.中华中医药杂志,2014,29(9):2967-2970
[21]冯庆涛,杨静,张燕,等.参桂益心汤对慢性心力衰竭患者外周血单核细胞Toll样受体4/核转录因子-κB信号通路的影响.中国实验方剂学杂志,2017,23(23):146-151
[22]Turer A T,Malloy C R,Newgard C B,et al.Energetics and metabolism in the failing heart:important but poorly understood.Current Opinion in Clinical Nutrition and Metabolic Care,2010,13(4):458-465
[23]殷仁富,陈金明.心脏能量学:代谢与治疗.上海:第二军医大学出版社,2002:261
[24]郭彩霞,马丽红,沈启明,等.心复力颗粒对阿霉素致心力衰竭大鼠PPAR-α及ET-1的影响.医学研究杂志,2015,44(5):41-44
[25]蒲秀瑛,王恒瑞,许珊丽.当归补血汤对心力衰竭大鼠心肌组织的影响.中医药学报,2013,41(3):102-105
[26]徐颖.益气活血利水方治疗慢性心力衰竭的临床研究.石家庄:河北医科大学,2017
[27]李坤玲.补气活血利水法治疗慢性心力衰竭(气虚血瘀型)的临床疗效观察.成都:成都中医药大学,2015
[28]杜峣楠,宋晨薇,王晓峰.中成药治疗心力衰竭的研究进展.中成药,2017,39(4):794-799
[29]Li X,Zhang J,Huang J,et al.A multicenter randomized doubleblind parallel-group placebo-controlled study of the effects of Qi li Qiang xin Capsules in patients with chronic heart failure.J Am Coll Cardiol,2013,62(12):1065-1072
[30]薛金贵,王肖龙,许勇,等.心脉隆注射液治疗慢性心力衰竭(气阳两虚、瘀血内阻证)的多中心随机对照研究.中国中西医结合杂志,2015,35(7):796-800
[31]杜金行,史载祥.血瘀证中西医结合诊疗共识.中国中西医结合杂志,2011,31(6):839-844
[32]Hao P,Jiang F,Cheng J,et al.Traditional Chinese medicine for cardiovascular disease:Evidence and potential mechanisms.J Am Coll Cardiol,2017,69(24):2952-2966