病态窦房结综合征中西医结合诊治进展  

Diagnosis and Treatment of Sick Sinus Syndrome by Integrated Traditional Chinese and Western Medicine

作　　者：程佳新 侯平[2] CHENG Jiaxin;HOU Ping(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《实用中医内科杂志》2022年第11期39-43,共5页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家自然科学基金(81874403)。

摘　　要：病态窦房结综合征在临床上可以表现为窦性心动过缓、窦性停搏、窦房传导阻滞以及合并室上性心动过速而发展成的慢-快综合征在内的以心率明显减慢为特点的一类症状性心律失常的总称,是临床上较常见和多发的心血管疾病。针对病窦综合征发病机制的研究较多但结论尚未明确。除植入起搏器治疗外西药在治疗病态窦房结综合征呈现出诸多局限性长期获益差。根据以往研究报道,中医药在病窦综合征的治疗上因其不良反应少、提升心率的疗效显著而具有明显优越性但其缺乏作用机制的研究。中西医结合诊治病窦综合征是心血管领域热点话题。近年来随网络药理学的发展,也为此类可提升心律失常的药物作用靶点研究提供了较大帮助。因此,对近年来中西医结合诊疗病窦综合征的临床研究以及学术思想进行探究评述,将从病窦的发病机制,诊疗相关药物靶点及作用的基因通路等方面进行论述。病窦窦房结综合征的发病机制复杂由多基因、多通路共同调控其发病进展其中TGF-β1/Smad通路、TRPC3/TRPC6通路、Wnt/-catenin信号通路的过表达以及Nrf2/HO-1通路在其中发挥主要作用,延缓病窦的进程可以从以上靶点进行调控。参仙升脉口服液、益心复脉颗粒等可用于对症治疗。Sick sinus syndrome can be clinically manifested as sinus bradycardia,sinus arrest,sinus block and slow fast syndrome developed from supraventricular tachycardia.It is the general name of a class of symptomatic arrhythmias characterized by obvious slowing of heart rate.It is a common and multiple cardiovascular disease in clinic.There are many studies on the pathogenesis of sick sinus syndrome,but the conclusion is not clear yet.In addition to pacemaker implantation,western medicine has many limitations in the treatment of sick sinus syndrome.According to previous research reports,traditional Chinese medicine has obvious advantages in the treatment of sick sinus syndrome due to its less adverse reactions and significant effect on heart rate,but it lacks the research on the mechanism of action.The diagnosis and treatment of sick sinus syndrome with integrated traditional Chinese and western medicine is a hot topic in the cardiovascular field.In recent years,the development of network pharmacology has also provided great help for the research of such drug targets that can enhance arrhythmia.Therefore,the exploration and review of the clinical research and academic ideas of the diagnosis and treatment of sick sinus syndrome with integrated traditional Chinese and western medicine in recent years were discussed from the aspects of the pathogenesis of sick sinus,the diagnosis and treatment related drug targets and the role of gene pathways.The pathogenesis of sick sinus syndrome is complex.The pathogenesis of sick sinus syndrome is regulated by multiple genes and pathways.Among them,the over-expressions of TGF-β1/Smad pathway,TRPC3/TRPC6 pathway and Wnt/-catenin signaling pathway and Nrf2/HO-1 pathway plays a major role on delaying the progression of sick sinus.The above targets can be regulated.Shenxian Shengmai Oral Liquid(参仙升脉口服液)and Yixin Fumai Granules(益心复脉颗粒)can be used for symptomatic treatment.

关 键 词：脂代谢 病窦 阳虚痰凝 综述 基因通路 

分 类 号：R541.7[医药卫生—心血管疾病]