摘要
慢性心力衰竭(CHF)是由于多种病因导致心脏疾病的终末阶段,具有极高的致残率和病死率,已成为心血管领域的热点研究问题。真武汤出自《伤寒论》,该方由附子、茯苓、白术、芍药、生姜等5味中药配伍而成,具有温阳利水的功效,是临床上治疗CHF的经典方剂。笔者通过检索中国知网(CNKI)、PubMed、万方(Wanfang Data)、维普(VIP)等数据库,发现真武汤能通过多靶点、多途径等机制治疗CHF;作用机制研究显示真武汤能够通过拮抗神经内分泌系统、抑制免疫炎症反应、抑制心脏重构、抑制细胞凋亡、调节细胞自噬、改善心肌能量代谢、抑制氧化应激损伤、保护内皮功能、减轻容量负荷等机制改善CHF;临床研究显示真武汤能够显著缓解CHF患者临床症状,具有疗效可靠、安全性高、不良反应少的特点。该文系统总结近年来有关真武汤治疗CHF的作用机制和临床研究进展,以期为真武汤的进一步研究开发提供理论和实验数据参考。
Chronic heart failure(CHF),the end stage of heart disease due to a variety of causes,features high disability rate and mortality,which has become a hot spot in cardiovascular field.As recorded in Treatise on Cold Damage(《伤寒论》),Zhenwutang is composed of Radix Aconiti Lateralis Preparata,Poria Cocos,Rhizoma Atractylodis Macrocephalae,Paeoniae Radix Alba,and Rhizoma Zingiberis Recens.With the functions of warming Yang and excreting water,it is a classical prescription for the treatment of CHF in clinical settings.By searching China National Knowledge Infrastructure(CNKI),PubMed,Wanfang Data,and VIP,we find Zhenwutang exerts therapeutic effect on CHF through multiple targets and multiple pathways.Experiments show that it alleviates CHF by antagonizing the overactivation of neuroendocrine system,inhibiting immune-inflammatory response,suppressing cardiac remodeling,restricting apoptosis,regulating autophagy,improving myocardial energy metabolism,inhibiting oxidative stress injury,protecting endothelial function,and decreasing volume load.Clinical research shows that Zhenwutang can significantly alleviate the clinical symptoms of CHF patients in a safe manner with little adverse reactions.This paper systematically summarizes the mechanisms of and clinical research on Zhenwutang in the treatment of CHF in recent years,so as to provide theoretical and experimental data for the further research and development of Zhenwutang.
作者
张杼惠
陈程
刘建和
曹蛟
夏帅帅
ZHANG Zhuhui;CHEN Cheng;LIU Jianhe;CAO Jiao;XIA Shuaishuai(Hunan University of Chinese Medicine,Changsha 410208,China;Sub-center of National Clinical Research Center for Cardiovascular Diseases of Traditional Chinese Medicine,The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine(TCM),Huangpu Hospital of Guangdong Second TCM Hospital,Guangzhou 510530,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第13期242-249,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家重大疑难疾病慢性心力衰竭中西医协作试点项目(国中医药办医政发[2018]3号)
湖南省中医药科研计划重点项目(2021011)
湖南省研究生科研创新项目(CX20200782)。
关键词
真武汤
慢性心力衰竭
作用机制
临床应用
研究进展
Zhenwutang
chronic heart failure
mechanism
clinical applications
research progress
