中医药治疗心力衰竭的研究进展
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摘要
心力衰竭具有高发病率,高死亡率,预后不利等特点,已成为严重危害人类健康,影响人类生活质量的公共卫生问题。因心力衰竭发病机制复杂,累及全身重要的器官,以往研究其分子机制相对独立,难以全面揭示发病机理,并且西药在治疗心衰的过程中带来的不良反应难以避免,不利于心衰患者的预后,因此文章围绕中药在治疗心衰,心室重构,减轻心肌纤维化,改善心功能,降低心衰复发率等方面的研究进展进行系统的综述。
As for the high morbidity,high mortality and poor prognosis,heart failure has become a really bad health public problem and has bad effect for our human life. The mechanism of the disease is complex and involves the important organs of the whole body,and the molecular mechanism research of the disease in the past is relatively independent and difficult to fully reveal the pathogenesis. The side effects of the western medicine treatment for heart failure are difficult to avoid,which is not conducive to the prognosis of the patients with heart failure. Therefore,this article systematically reviews ventricular remodeling,myocardial fibrosis reduction,cardiac function improvement and heart failure recurrence rate reduction in Chinese medicine treatment for heart failure.
As for the high morbidity,high mortality and poor prognosis,heart failure has become a really bad health public problem and has bad effect for our human life. The mechanism of the disease is complex and involves the important organs of the whole body,and the molecular mechanism research of the disease in the past is relatively independent and difficult to fully reveal the pathogenesis. The side effects of the western medicine treatment for heart failure are difficult to avoid,which is not conducive to the prognosis of the patients with heart failure. Therefore,this article systematically reviews ventricular remodeling,myocardial fibrosis reduction,cardiac function improvement and heart failure recurrence rate reduction in Chinese medicine treatment for heart failure.
引文
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[2]王科军,张秀荣,苏德成.古代医家对慢性心衰病因病机的认识[J].吉林中医药,2011,31(8):711-712.
[3]杨婷,王迪.中医药治疗慢性心力衰竭研究简况[J].实用中医内科杂志,2015,29(11):174-176.
[4] Corella Dolores,SorlíJose-V,González Jose-I,et al. Novel association of the obesity risk-allele near Fas Apoptotic Inhibitory Molecule 2(FAIM2)gene with heart rate and study of its effects on myocardial infarction in diabetic participants of the PREDIMED trial[J]. Cardiovascular Diabetology,2014,13(5):671-684.
[5] Jiangyou Wang,Han Chen,You Zhou,et al. Atorvastatin Inhibits Myocardial Apoptosis in a Swine Model of Coronary Microembolization by Regulating PTENPI3KAkt Signaling Pathway[J]. Cellular Physiology and Biochemistry,2106,38(6):207-219.
[6] Matkovich Scot-J,Margulies Kenneth-B,Youker Keith-A,et al. Reversibility of Signature miRNA Dysregulation in Failing Human Hearts by Mechanical Unloading[J]. Journal of Cardiac Failure,2008,14(6):40.
[7] Sun Ha Lim,Mi Young Kim,Jongwon Lee. Apple pectin,a dietary fiber,ameliorates myocardial injury by inhibiting apoptosis in a rat model of ischemiareperfusion[J]. Nutrition Research and Practice,2014,8(4):391-397.
[8] Wei Yu,Wenliang Zha,Shuang Guo,et al. Flos Puerariae Extract Prevents Myocardial Apoptosis via Attenuation Oxidative Stress in Streptozotocin-Induced Diabetic Mice[J]. Plos One,2014,9(5):1-10.
[9] Can Weia,Yuehong Wang,Meixiu Li,et al. Spermine Inhibits Endoplasmic Reticulum Stress-Induced Apoptosis a New Strategy to Prevent Cardiomyocyte Apoptosis[J]. Cell Physiol Biochem,2016,38(4):531-544.
[10]韩磊森.黄芪注射液联合美托洛尔治疗心力衰竭的短期疗效及对BNP和CA125的影响[J].心脏杂志,2016,28(6):701-703.
[11]温志浩,农一兵,潘朝锌,等.黄芪注射液治疗慢性心力衰竭临床研究的Meta分析[J].中西医结合心脑血管病杂志,2011,9(7):770-772.
[12]杨喆,柴洪佳,严夏.活血强心方治疗慢性充血性心力衰竭的临床观察[J].世界中西医结合杂志,2016,11(7):976-978.
[13]倪青,汪升薏,黄静.益气活血中药对糖尿病心肌病大鼠心肌细胞凋亡的影响[J].北京中医药,2016,36(6):560-563,617.
[14]李志会,李国辉,石占利.益气活血化瘀汤对慢性心力衰竭大鼠心肌组织AngⅡ、BNP的影响[J].中华中医药学刊,2013,31(2):394-396.
[15]韩凌,唐朝枢.肾素-血管紧张素系统在心力衰竭中的作用[J].心血管病学进展,2013,34(2):177-181.
[16]李庆.附子汤对慢性心力衰竭大鼠心室重构及肾素血管紧张素醛固酮系统的影响[J].新中医,2015,47(1):222-224.
[17] Braunwald E,Bristow M R. Congestive Heart Failure:Fifty Years of Progress[J]. Circulation,2000,102(20):14-23.
[18] Hugel S,Horn M,Remkes H,et al. Preservation of cardiac function and energy reserve by the angiotensin-converting enzyme inhibitor quinapril during postmyocardial infarction remodeling in the rat[J].Journal of cardiovascular magnetic resonance,2002,3(3):215-225.
[19]王秋宁,王洪新,杨育红,等.黄芪甲苷对异丙肾上腺素诱导的乳大鼠心肌细胞肥大的保护作用[J].中国药理学与毒理学杂志,2011,25(1):29-33.
[20]胡鸣旭,刘莉.黄芪甲苷对心力衰竭大鼠心肌细胞凋亡的影响[J].中国中医药信息杂志,2014,21(1):40-42.
[21]陈欣华,梁建英,孟文格,等.芪苈强心胶囊对缺血性心肌病心力衰竭患者左室重构、心功能、N-末端脑钠肽前体及肌钙蛋白I的影响[J].疑难病杂志,2014,13(8):831-834.
[22] L Zhang,Y Wu,Y Li,et al. Tanshinone IIA Improves miR-133 Expression Through MAPK ERK1/2 Pathway in Hypoxic Cardiac Myocytes[J]. S. Karger AG,2012,30(4):843-852.
[23]胡宁,徐长福.参芪养心汤对心力衰竭大鼠心功能的保护作用及相关机制研究[J].新中医,2017,49(3):1-4.
[24]付金容,郭芙蓉,黎明江.红景天苷保护慢性间断性缺氧心肌细胞作用及机制[J].武汉大学学报(医学版),2017,38(2):212-215,252.
[25] PANG H,HAN B,YU T,et al. The complex regulation of tanshinoneⅡA in rats with hypertension-induced left ventricular hypertrophy[J].Plos One,2014,9(3):741-745.
[26] Gu Jing,Li Hai-Long,Wu Hong-Yan,et al. Sodium tanshinone IIA sulfonate attenuates radiation-induced fibrosis damage in cardiac fibroblasts[J]. Journal of Asian Natural Products Research,2014,16(9):941-952.
[27]陈飞,解颖,常佳怡,等.基于蛋白芯片技术研究参苈加颗粒对慢性心衰大鼠心肌活性蛋白表达谱的影响[J].中华中医药杂志,2017,32(3):1064-1067.
[28]肖云峰,刘爽,李文妍,等.黄芪甲苷对CVB3所致病毒性心肌炎模型小鼠TIMP-1和MMP-1的影响[J].中医药导报,2016,22(23):22-24,28.
[29]蔡娟,高想,张锋莉,等.曲美他嗪对心力衰竭大鼠的抗炎、抗氧化应激作用[J].交通医学,2013,27(5):454-456,460.
[30] Xiao-Bing,Ji Xiu-Rong,Li Hao-Ding Qi,et al. Inhibition of Uncoupling Protein 2 Attenuates Cardiac Hypertrophy Induced by Transverse Aortic Constriction in Mice[J]. Cell Physiol Biochem,2015,36(10):1688-1698.
[31] Arash Harzand,Leonardo Tamariz,M Hare-Joshua. Uric acid,heart failure survival,and the impact of xanthine oxidase inhibition[J]. Congestive heart failure,2012,18(3):179-182.
[32] Fukushima Arata,Kinugawa Shintaro,Takada Shingo,et al. Direct renin inhibitor ameliorates insulin resistance by improving insulin signaling and oxidative stress in the skeletal muscle from post-infarct heart failure in mice[J]. European Journal of Pharmacology,2016,779(12):147-156.
[33] Essa Essa-M,Zile Michael-R,Stroud Robert-E,et al. Changes in Plasma Profiles of Matrix Metalloproteinases(MMPs)and Tissue Inhibitors of MMPs in Stress-Induced Cardiomyopathy[J]. Journal of Cardiac Failure,2012,18(6):487-492.
[34]贺蕾.参附注射液联合阿托伐他汀对慢性心力衰竭患者氧化应激和心室重构的影响[J].临床医学,2012,32(10):44-46.
[35]赵立志,冯莉,罗钢,等.参附注射液对慢性心力衰竭合并缓慢性心律失常患者的疗效分析[J].西部医学,2012,24(3):501-503.
[36]王俊龙,王胜林,董耀荣.参附注射液对慢性收缩性心力衰竭患者心功能及血浆脑钠肽的影响[J].中国中医急症,2011,20(11):1838-1839.
[37]张芳,任开涵,陈玉林.参附注射液对扩张型心肌病心力衰竭患者心功能及心室重构的影响[J].中国临床药理学杂志,2014,30(6):478-480.
[38]黄琼,杨沙宁,金立军.参附注射液对大鼠慢性心力衰竭保护作用的实验研究[J].现代临床医学,2012,38(3):173-175.
[39]杨启悦,张帅,谢春光,等.参芪复方防治糖尿病大血管病变机制研究[J].中草药,2014,45(8):1179-1183.
[40]王艳红,岳宗相,刘致勤,等.参芪复方对自发性2型糖尿病GK大鼠氧化应激损伤的影响[J].现代临床医学,2013,39(1):29-31.
[2]王科军,张秀荣,苏德成.古代医家对慢性心衰病因病机的认识[J].吉林中医药,2011,31(8):711-712.
[3]杨婷,王迪.中医药治疗慢性心力衰竭研究简况[J].实用中医内科杂志,2015,29(11):174-176.
[4] Corella Dolores,SorlíJose-V,González Jose-I,et al. Novel association of the obesity risk-allele near Fas Apoptotic Inhibitory Molecule 2(FAIM2)gene with heart rate and study of its effects on myocardial infarction in diabetic participants of the PREDIMED trial[J]. Cardiovascular Diabetology,2014,13(5):671-684.
[5] Jiangyou Wang,Han Chen,You Zhou,et al. Atorvastatin Inhibits Myocardial Apoptosis in a Swine Model of Coronary Microembolization by Regulating PTENPI3KAkt Signaling Pathway[J]. Cellular Physiology and Biochemistry,2106,38(6):207-219.
[6] Matkovich Scot-J,Margulies Kenneth-B,Youker Keith-A,et al. Reversibility of Signature miRNA Dysregulation in Failing Human Hearts by Mechanical Unloading[J]. Journal of Cardiac Failure,2008,14(6):40.
[7] Sun Ha Lim,Mi Young Kim,Jongwon Lee. Apple pectin,a dietary fiber,ameliorates myocardial injury by inhibiting apoptosis in a rat model of ischemiareperfusion[J]. Nutrition Research and Practice,2014,8(4):391-397.
[8] Wei Yu,Wenliang Zha,Shuang Guo,et al. Flos Puerariae Extract Prevents Myocardial Apoptosis via Attenuation Oxidative Stress in Streptozotocin-Induced Diabetic Mice[J]. Plos One,2014,9(5):1-10.
[9] Can Weia,Yuehong Wang,Meixiu Li,et al. Spermine Inhibits Endoplasmic Reticulum Stress-Induced Apoptosis a New Strategy to Prevent Cardiomyocyte Apoptosis[J]. Cell Physiol Biochem,2016,38(4):531-544.
[10]韩磊森.黄芪注射液联合美托洛尔治疗心力衰竭的短期疗效及对BNP和CA125的影响[J].心脏杂志,2016,28(6):701-703.
[11]温志浩,农一兵,潘朝锌,等.黄芪注射液治疗慢性心力衰竭临床研究的Meta分析[J].中西医结合心脑血管病杂志,2011,9(7):770-772.
[12]杨喆,柴洪佳,严夏.活血强心方治疗慢性充血性心力衰竭的临床观察[J].世界中西医结合杂志,2016,11(7):976-978.
[13]倪青,汪升薏,黄静.益气活血中药对糖尿病心肌病大鼠心肌细胞凋亡的影响[J].北京中医药,2016,36(6):560-563,617.
[14]李志会,李国辉,石占利.益气活血化瘀汤对慢性心力衰竭大鼠心肌组织AngⅡ、BNP的影响[J].中华中医药学刊,2013,31(2):394-396.
[15]韩凌,唐朝枢.肾素-血管紧张素系统在心力衰竭中的作用[J].心血管病学进展,2013,34(2):177-181.
[16]李庆.附子汤对慢性心力衰竭大鼠心室重构及肾素血管紧张素醛固酮系统的影响[J].新中医,2015,47(1):222-224.
[17] Braunwald E,Bristow M R. Congestive Heart Failure:Fifty Years of Progress[J]. Circulation,2000,102(20):14-23.
[18] Hugel S,Horn M,Remkes H,et al. Preservation of cardiac function and energy reserve by the angiotensin-converting enzyme inhibitor quinapril during postmyocardial infarction remodeling in the rat[J].Journal of cardiovascular magnetic resonance,2002,3(3):215-225.
[19]王秋宁,王洪新,杨育红,等.黄芪甲苷对异丙肾上腺素诱导的乳大鼠心肌细胞肥大的保护作用[J].中国药理学与毒理学杂志,2011,25(1):29-33.
[20]胡鸣旭,刘莉.黄芪甲苷对心力衰竭大鼠心肌细胞凋亡的影响[J].中国中医药信息杂志,2014,21(1):40-42.
[21]陈欣华,梁建英,孟文格,等.芪苈强心胶囊对缺血性心肌病心力衰竭患者左室重构、心功能、N-末端脑钠肽前体及肌钙蛋白I的影响[J].疑难病杂志,2014,13(8):831-834.
[22] L Zhang,Y Wu,Y Li,et al. Tanshinone IIA Improves miR-133 Expression Through MAPK ERK1/2 Pathway in Hypoxic Cardiac Myocytes[J]. S. Karger AG,2012,30(4):843-852.
[23]胡宁,徐长福.参芪养心汤对心力衰竭大鼠心功能的保护作用及相关机制研究[J].新中医,2017,49(3):1-4.
[24]付金容,郭芙蓉,黎明江.红景天苷保护慢性间断性缺氧心肌细胞作用及机制[J].武汉大学学报(医学版),2017,38(2):212-215,252.
[25] PANG H,HAN B,YU T,et al. The complex regulation of tanshinoneⅡA in rats with hypertension-induced left ventricular hypertrophy[J].Plos One,2014,9(3):741-745.
[26] Gu Jing,Li Hai-Long,Wu Hong-Yan,et al. Sodium tanshinone IIA sulfonate attenuates radiation-induced fibrosis damage in cardiac fibroblasts[J]. Journal of Asian Natural Products Research,2014,16(9):941-952.
[27]陈飞,解颖,常佳怡,等.基于蛋白芯片技术研究参苈加颗粒对慢性心衰大鼠心肌活性蛋白表达谱的影响[J].中华中医药杂志,2017,32(3):1064-1067.
[28]肖云峰,刘爽,李文妍,等.黄芪甲苷对CVB3所致病毒性心肌炎模型小鼠TIMP-1和MMP-1的影响[J].中医药导报,2016,22(23):22-24,28.
[29]蔡娟,高想,张锋莉,等.曲美他嗪对心力衰竭大鼠的抗炎、抗氧化应激作用[J].交通医学,2013,27(5):454-456,460.
[30] Xiao-Bing,Ji Xiu-Rong,Li Hao-Ding Qi,et al. Inhibition of Uncoupling Protein 2 Attenuates Cardiac Hypertrophy Induced by Transverse Aortic Constriction in Mice[J]. Cell Physiol Biochem,2015,36(10):1688-1698.
[31] Arash Harzand,Leonardo Tamariz,M Hare-Joshua. Uric acid,heart failure survival,and the impact of xanthine oxidase inhibition[J]. Congestive heart failure,2012,18(3):179-182.
[32] Fukushima Arata,Kinugawa Shintaro,Takada Shingo,et al. Direct renin inhibitor ameliorates insulin resistance by improving insulin signaling and oxidative stress in the skeletal muscle from post-infarct heart failure in mice[J]. European Journal of Pharmacology,2016,779(12):147-156.
[33] Essa Essa-M,Zile Michael-R,Stroud Robert-E,et al. Changes in Plasma Profiles of Matrix Metalloproteinases(MMPs)and Tissue Inhibitors of MMPs in Stress-Induced Cardiomyopathy[J]. Journal of Cardiac Failure,2012,18(6):487-492.
[34]贺蕾.参附注射液联合阿托伐他汀对慢性心力衰竭患者氧化应激和心室重构的影响[J].临床医学,2012,32(10):44-46.
[35]赵立志,冯莉,罗钢,等.参附注射液对慢性心力衰竭合并缓慢性心律失常患者的疗效分析[J].西部医学,2012,24(3):501-503.
[36]王俊龙,王胜林,董耀荣.参附注射液对慢性收缩性心力衰竭患者心功能及血浆脑钠肽的影响[J].中国中医急症,2011,20(11):1838-1839.
[37]张芳,任开涵,陈玉林.参附注射液对扩张型心肌病心力衰竭患者心功能及心室重构的影响[J].中国临床药理学杂志,2014,30(6):478-480.
[38]黄琼,杨沙宁,金立军.参附注射液对大鼠慢性心力衰竭保护作用的实验研究[J].现代临床医学,2012,38(3):173-175.
[39]杨启悦,张帅,谢春光,等.参芪复方防治糖尿病大血管病变机制研究[J].中草药,2014,45(8):1179-1183.
[40]王艳红,岳宗相,刘致勤,等.参芪复方对自发性2型糖尿病GK大鼠氧化应激损伤的影响[J].现代临床医学,2013,39(1):29-31.