补气中药治疗心衰新机制的研究——调节心肌能量代谢  

New idea of treatment of heart failure with traditional Chinese medical

作　　者：马琰岩[1] 张萌[2] 马淑骅[1] 王玉敏[1] 高峻虹[3] 王洪新[2] 喻晓春[1] 

机构地区：[1]中国中医科学院医学实验中心,北京100700 [2]辽宁医学院药理学系,辽宁锦州121001 [3]中国中医科学院针灸研究所,北京100700

出　　处：《中国中药杂志》2011年第22期3210-3212,共3页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(30873295;81073089);中国中医科学院基本科研业务项目(ZZ2007001)

摘　　要：以心肌能量代谢紊乱为切入点探讨中药特别是补气中药治疗慢性心力衰竭的新思路。总结既往学术文献及研究结果,分析心衰与心肌能量代谢之间的关系及补气中药与能量代谢的关系。能量缺乏及能量代谢障碍是心衰的主要标志之一,是心衰发生、发展和恶化的重要因素。研究表明抑制脂肪酸代谢产能、增加葡萄糖代谢产能可以改善心脏功能。中医学"气"的概念很大程度上与现代医学中"能量"密切相关。党参黄芪等补气中药及其相关复方及/或有效成分在改善心衰、调节脂质和糖代谢供能方面显示了较好的效果。更重要的是,这些中药大都含有多糖,其代谢成单糖后可能成为心肌能量代谢的底物,从而发挥对心衰心肌的保护作用。以心肌能量代谢为切入点开展中药特别是补气中药治疗心衰的研究,将有可能找到改善心肌能量代谢障碍、改善心衰预后的新的药物作用途径,从而从一个新的视角进一步完善补气中药对心衰治疗作用的机制研究,同时也为中药治疗能量代谢紊乱相关疾病的机制研究提供一个新的研究思路。To discuss the potential role of medicinal herbs,especially those with effect of strengthening Qi,in the treatment of chronic heart failure（CHF） via modulating myocardial substrate metabolism.The relationships among heart failure,myocardial energetic metabolism and herbal medicine were analyzed in detail through reviewing and summarizing the accumulating knowledge and recent findings on myocardial metabolism,heart failure and herbal medicine.Either energy lack or abnormal energetic metabolism is one of the main causes to the initiation and development of heart failure.Recent studies suggest that the cardiac function in the patients with CHF could be improved by inhibiting the energy production from metabolism of fatty acid and enhancing the energy production from glucose metabolism.The concept of Qi in Chinese medicine is very close to the energy in western medicine.The decoction of Chinese medicine containing herbal medicine with effect of strengthening Qi and the herbal medicine themselves and their components were evidenced to be effective in improvement of heart failure and regulation of both lipid and glucose metabolism;more importantly,all these herbal medicine contain the multi-sugar which can be metabolized into single unit of sugar which may be metabolized as a substrate by myocardium and potentially produce the cardioprotective effect.Therefore,we may find out a novel way to explain why the herbal medicine with effect of strengthening Qi can improve cardiac function in patients with CHF.In other words,regulating myocardial metabolism is one of the mechanisms underlying the cardioprotection produced by herbal medicine with effect of strengthening Qi in the treatment of heart failure.

关 键 词：慢性心力衰竭 能量代谢 补气中药 心脏保护机制 

分 类 号：R285[医药卫生—中药学]