中药防治心肌缺血再灌注损伤研究进展  

Research Progress on TCM Prevention and Treatment of Myocardial Ischemia-reperfusion Injury

作　　者：艾莘 李彬[2] 郝轩轩 张晶晶[1] 赵丹丹[1] 朱明军[2] AI Shen;LI Bin;HAO Xuan Xuan;ZHANG Jingjing;ZHAO Dandan;ZHU Mingjun(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2018年第12期2478-2482,共5页Acta Chinese Medicine

基　　金：国家自然科学基金项目(81503435);国家重点基础研究发展计划(973计划)项目(2015CB554401)

摘　　要：中药防治心肌缺血再灌注损伤的临床效果已经得到广泛肯定。大量文献表明,心肌缺血再灌注损伤与氧自由基生成、钙超载、能量代谢障碍、炎症反应、细胞凋亡等因素密切相关,而丹参、红景天、葛根、黄芪、玉郞伞、牡丹皮、当归、川芎、姜黄、五味子、白蒺藜、淫羊藿、黄连、银杏叶等中药皆具有抗心肌缺血再灌注损伤的作用,主要是通过提高内源抗氧化性,抑制Ca2+超载,改善心肌能量代谢,防治炎症反应以及增加抑制细胞凋亡的基因等途径发挥作用。目前,对中药有效成分抑制心肌缺血再灌注损伤的作用机制研究仍存在一些问题,如动物实验样本量较少,说服力不够;临床研究病例数较少,证据尚不充足;缺少规范的动物模型评价体系;研究多针对某单味中药,对复方的研究较少;结合西医机制研究较多,但结合中医理论进行机制研究较少;中医病机、辨证分型尚缺乏统一标准等。以后的研究中,应扩大动物实验样本量,结合中医系统的整体研究及中医理论机制研究,制作更符合研究需要的动物模型,从分子、细胞、生物等不同层面出发,以期为临床应用提供更多有力的支持。The clinical effects of traditional Chinese medicine on prevention and treatment of myocardial ischemia-reperfusion injury have been widely recognized.A large number of literatures indicate that myocardial ischemia-reperfusion injury is closely related to oxygen free radical production,calcium overload,energy metabolism disorder,inflammatory reaction,apoptosis and other factors. Traditional Chinese medicines such as Salvia miltiorrhiza,Rhodiola,Pueraria,Astragalus,Jade umbrella,Cortex Moutan,Angelica, Chuanxiong,Jianghuang,Schisandra,Angelica,Epimedium,Rhizoma Coptidis,Ginkgo Biloba have anti-myocardial ischemia-reperfusion injury,mainly by increasing endogenous antioxidant activity and inhibiting calcium overload.Pathways that improve myocardial energy metabolism,prevent and treat inflammatory reactions,and increase genes that inhibit apoptosis.At present,there are still some problems in the mechanism of inhibition of myocardial ischemia-reperfusion injury by active ingredients of traditional Chinese medicine,such as less sample of animal experiment and insufficient persuasiveness,fewer cases of clinical research,insufficient evidence,lack of standardized animals model evaluation system.Besides,the research is more directed to a single Chinese medicine,and the research on compound is less.There are more studies that combine with the research of western medicine mechanism,but the mechanism research with the theory of traditional Chinese medicine is limited.The traditional Chinese medicine pathogenesis and syndrome differentiation still lack uniform standards.In the future research,we should expand the sample size of animal experiments,combine the overall research of TCM system and the theoretical mechanism research of TCM to produce animal models that are more in line with the research needs,starting from different aspects such as molecules,cells and biology,in order to provide more for clinical application.

关 键 词：中医药 心肌缺血再灌注损伤 心肌细胞 研究进展 

分 类 号：R259.422.1[医药卫生—中西医结合]