β1肾上腺素受体通路介导针刺与乌头碱合用治疗心衰增效减毒作用的思路探讨  

Considerations about β1-Adrenergic Receptor Pathway-Mediated Efficacy-Enhancing and Toxicity-Attenuating Effects of Acupuncture Combined with Aconitine for Treatment of Heart Failure

作　　者：刘群 周晨 辛娟娟[1] 赵玉雪[1] 高俊虹[1] 喻晓春[1] LIU Qun;ZHOU Chen;XIN Juan-Juan;ZHAO Yu-Xue;GAO Jun-Hong;YU Xiao-Chun(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院针灸研究所,北京100700

出　　处：《广州中医药大学学报》2020年第7期1274-1278,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：中央级公益性科研院所基本科研业务费专项资金资助项目(编号:zz201711003);国家自然科学基金资助项目(编号:81674089);北京市自然科学基金资助项目(编号:7132137)。

摘　　要：附子等乌头碱类中药是临床常用强心药,可用于心力衰竭等虚证的治疗。然而,临床上也常出现用量不当造成的毒副作用。乌头碱是附子中含量较多的活性成分,也是造成其毒副作用的主要原因之一。寻找促使乌头碱类药物增效减毒的方法对提高其疗效和安全性意义重大。针灸可改善缺血性心脏功能损害,抑制缺血性心律失常,针灸与洋地黄联用亦可减少其毒副作用,提示针灸与乌头碱类药物联用可能起到增效减毒的作用。β1肾上腺素受体是心脏中最强有力的受体,通过细胞内一系列信号转导系统调节细胞内钙离子,进而调节心脏功能,与正常心脏和衰竭心脏的功能调节都密切相关。β1肾上腺素受体信号系统也可能参与介导了乌头碱的正性肌力效应及其毒理作用。本研究探讨了β1肾上腺素受体及其受体后信号转导系统介导针刺与乌头碱类药物合用治疗心力衰竭的增效减毒作用,可为针灸与乌头碱合用治疗心力衰竭研究提供新的思路与方法。Chinese herbs containing aconitine,such as Radix Aconiti Lateralis Preparata,etc.,are a clinical usual cardiotonic drug,and is applied for treatment of deficiency syndrome diseases involving heart failure,but it is easy to cause toxic and side effects due to improper dosing.Aconitine is an active ingredient with higher content in Radix Aconiti Lateralis Preparata,and is one of main causes resulting in toxic and side effects.So,it is of important significance that searching for some methods produces efficacy-enhancing and toxicity-attenuating effects for increasing therapeutic efficacy and safety of drug containing aconitine.Acupuncture can improve the ischemic cardiac function impairment and attenuate ischemic arrhythmias,and combination of acupuncture and digitalis also can relieve toxic and side effects,indicating combination of acupuncture and drug containing aconitine possible plays a role in enhancing efficacy and attenuating toxicity.β1 adrenergic receptor(β1-AR)is the most powerful receptor in the heart.It can adjust intracellular calcium concentration through a series of intracellular signal transduction system to further regulate cardiac function.β1-AR signal system may be involved in the positive inotropic effect and toxicological effect of aconitine. In the paper, we will explore β1 adrenergicreceptor pathway- mediated efficacy- enhancing and toxicity- attenuating effects of acupuncture combined withaconitine for treatment of heart failure to provide a new idea and therapy for research on combination of acupuncturewith aconitine treatment of heart failure.

关 键 词：针药结合 Β1肾上腺素受体 乌头碱 心力衰竭 增效减毒 

分 类 号：R246.9[医药卫生—针灸推拿学]