真武汤在慢性心力衰竭治疗中的应用与机制研究进展  

Application and Mechanism of Zhenwu Decoction(真武汤)in the Treatment of Chronic Heart Failure

作　　者：陈博航 李文杰[2] CHEN Bohang;LI Wenjie(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;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：《辽宁中医药大学学报》2024年第10期74-79,共6页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81173184)。

摘　　要：慢性心力衰竭(CHF)作为心血管疾病的严重终末期表现,以其高患病率和病死率成为全球21世纪最关注的心血管疾病之一。近年来,中药真武汤以其温阳利水的独特功效,在临床治疗中显示出显著效果,并逐渐成为多途径、多靶点治疗CHF的研究热点。通过系统回顾已发表的文献,文章发现真武汤在缓解CHF患者临床体征、改善患者心功能、提高生存质量及改善预后等方面表现出色,且具备较高的安全性和较少的不良反应。动物实验进一步揭示了真武汤治疗CHF的作用机制,包括调节交感神经系统、肾素-血管紧张素-醛固酮系统,缓解氧化应激,改善水钠潴留,调节外周血管神经激素水平,纠正心衰细胞电异常,抑制左心室重塑和心肌细胞凋亡,调节心肌细胞自噬,调节心脏固有免疫系统,以及改善心肌细胞能量代谢等。文章旨在对真武汤及其加减方治疗CHF的临床疗效和分子生物学机制进行全面归纳和总结,为后续的深入研究提供参考和借鉴,推动中医药在心血管疾病领域的更广泛应用。Chronic heart failure(CHF),as a severe terminal manifestation of cardiovascular disease,has become one of the most concerning cardiovascular diseases globally in the 21st century due to its high prevalence and mortality rate.In recent years,the traditional Chinese medicine Zhenwu Decoction(真武汤),with its unique efficacy of warming yang and promoting diuresis,has demonstrated significant effects in clinical treatment and gradually become a research hotspot for multi-pathway and multi-target treatment of CHF.Through a systematic review of published literature,this article finds that Zhenwu Decoction excels in alleviating clinical symptoms of CHF patients,improving cardiac function,enhancing quality of life,and improving prognosis,while possessing high safety and few adverse reactions.Animal experiments have further revealed the mechanism of action of Zhenwu Decoction in treating CHF,including regulating the sympathetic nervous system,renin-angiotensin-aldosterone system,alleviating oxidative stress,improving water and sodium retention,modulating peripheral vascular neurohormonal levels,correcting electrical abnormalities in heart failure cells,inhibiting left ventricular remodeling and cardiomyocyte apoptosis,regulating cardiomyocyte autophagy,modulating the inherent immune system of the heart,and improving cardiomyocyte energy metabolism.This article aims to comprehensively summarize the clinical efficacy and molecular biological mechanisms of Zhenwu Decoction and its modified prescriptions in treating CHF,providing references and insights for subsequent in-depth research and promoting the wider application of traditional Chinese medicine in the field of cardiovascular diseases.

关 键 词：慢性心力衰竭 真武汤 中医药治疗 研究现状 临床疗效 分子生物学机制 

分 类 号：R259[医药卫生—中西医结合]