心气虚血瘀的科学内涵和芪参益气滴丸补气活血的作用机理  

Scientific Connotation of Cardiac Qi Deficiency and Stasis of Blood, and the Mechanism of Qishen Yiqi Dropping Pills in Invigorating Qi and Activating Blood

作　　者：韩晶岩 Han Jingyan(Department of Integration of Chinese and Western Medicine,Peking University Health Science Center,Beijing 100191,China)

机构地区：[1]北京大学医学部中西医结合学系,北京100191

出　　处：《世界科学技术-中医药现代化》2019年第2期139-147,共9页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委面上项目(81273637):基于心肌能量和功能;心脏微循环动态和微血管通透性的调控;探讨芪参益气滴丸补气行血和补气摄血的机理;负责人:韩晶岩;科技部重大新药创制专项课题(2008ZX09401-006):以现代中药为主;面向国际的创新药物研究与开发技术体系建;负责人:闫希军;第3子课题:药物体内整体药效动态可视化技术研究;负责人:韩晶岩;天士力制药集团股份有限公司合作项目(20121010):芪参益气滴丸;丹酚酸注射液;复方丹参滴丸;注射用益气复脉冻干和养血清脑颗粒药理作用研究;负责人:韩晶岩

摘　　要：心肌缺血再灌注损伤和心肌肥厚常继发心肌纤维化,是尚未解决的临床问题。心气虚血瘀是临常见证型,补气活血是其常用治法。芪参益气滴丸是具有补气活血作用的复方中药制剂,用于心气虚血瘀型冠心病心绞痛的治疗。但是,其能否改善心肌缺血再灌注损伤、逆转心肌肥厚、阻断心肌纤维化,及其补气活血的作用机理尚不清晰。为此,笔者在3项基金项目的支撑下,历时10年,用缺血再灌注引起的大鼠心肌损伤和心脏前阻力增加引起的大鼠心肌肥厚模型,通过对心肌能量代谢途径、心肌线粒体复合物及其亚单位、调控线粒体复合物的去乙酰化酶-1、小G蛋白家族的RhoA/Rock1、细胞骨架、心肌结构、心功能、心脏微循环动态等的综合研究,部分地阐明了心气虚血瘀的科学内涵,揭示了芪参益气滴丸补气活血的作用机理,及其主要成分协同作用的机理,支撑了芪参益气滴丸在治疗心肌缺血再灌注损伤和心肌肥厚方面的应用。Ischemia/reperfusion(I/R)-induced myocardial injury and cardiac hypertrophy could lead to fibrosis of heart,which is an unsolved issue in clinic.Cardiac qi deficiency and stasis of blood is its common symptom,which is often treated by invigorating qi and activating blood.Qishen Yiqi Dropping Pills(QSYQ),a compound Chinese medicine with potential of invigorating qi and activating blood,is used for treating qi deficiency and stasis of blood-caused angina pectoris and coronary heart disease.However,the effect of QSYQ in cardiac I/R injury and hypertrophy/myocardial fibrosis and the underlying mechanism in terms of invigorating qi and activating blood remain unclear.In the past 10 years by the support of 3 projects,the author of this paper used cardiac I/R injury or pressure over-load induced cardiac hypertrophy in rat as models and partly clarified the scientific connotation of cardiac qi deficiency and stasis of blood.The study covered cardiac energy metabolism,mitochondria complexes and subunits,histone deacetylase Sirt1,small Gprotein RhoA/ROCK,cytoskeleton,cardiac function and dynamic characteristics of the microcirculation.The results disclosed the mechanisms of QSYQ’s effect and the rationale behind synergistic effect of major ingredients,providing support for application of QSYQ in treatment of cardiac I/R injury and hypertrophy.

关 键 词：线粒体呼吸链 小G蛋白 氧化应激 细胞骨架 心功能 

分 类 号：R289.5[医药卫生—方剂学]