中药增强心力衰竭时的心肌代谢

2022-04-10 August MedSci原创

各种心血管疾病的预后最终导致心力衰竭(HF)。心肌细胞的能量代谢紊乱对于解释 HF 的分子基础很重要,这将有助于从心肌代谢的角度对心衰治疗方案进行全球研究。

由各种器质性或功能性心脏病引起的心力衰竭 (HF) 会导致心室能力受损。全球有 6200 万患者因 HF 导致严重的健康负担,死亡率约为 50%。尽管 HF 的治疗取得了长足的进步,但死亡率持续上升。

有许多药物可以改善心肌代谢以治疗 HF,包括血管紧张素受体阻滞剂脑啡肽酶抑制剂 (ARNi) 和钠葡萄糖协同转运蛋白 2 (SGLT-2) 抑制剂。尽管西医在心衰治疗方面取得了长足的进步,但该病的发病率和死亡率仍然很高。因此,HF引起了全世界研究人员的关注。

代谢性心力衰竭 (HF) 的发展

近年来,应用中医药治疗心衰已逐渐被接受,许多研究探讨了中医药改善心肌代谢的机制;研究的中药包括丹参饮,复方丹参滴丸,参麦注射液。这使得中医通过改善心肌代谢在心衰治疗中的临床应用成为可能。此文系统地回顾了中药改善心衰期间心肌代谢的功效,以及中药活性成分对心血管系统的药理作用及其改善心肌代谢能力的潜在机制。

HF 的代谢疗法:

中药可通过多方面改善心肌能量代谢,对改善心功能有明显作用。这拓宽了慢性心衰的治疗范围,并提供了独特的优势和增强的疗效。中医的两大特点是整体观念和辨证论治

中药在心衰中的代谢作用机制:

综上所述,中医在调节能量代谢的同时,遵循“同病异治、因人而异、病程不同”的特点。此外,中医药克服了西医的许多不良反应和其他缺点。中医的这一方面在能量代谢领域非常明显。未来应开展中医药改善心肌能量代谢的实验研究,为新药的临床应用和开发提供依据,并着眼于中医整体观的特点和各种辨证论治。涉及心血管系统的代谢综合征

此研究也为深化中医改革,推动中西医结合治疗心衰提供经验。在现代医学实践中,中药与其他药物一起用于治疗心血管疾病和心力衰竭。因此,在未来的研究中,应仔细考虑和评估中医与传统药物治疗之间的相互作用。未来精心设计的临床试验和实验研究将有助于更好地了解中药的作用机制,还将促进中医药治疗和预防心衰的现代化。

 

原文:Shao-Mei W, Li-Fang Y, Li-Hong W. Traditional Chinese medicine enhances myocardial metabolism during heart failure. Biomed Pharmacother. 2022 Feb;146:112538. doi: 10.1016/j.biopha.2021.112538. Epub 2021 Dec 15. PMID: 34922111.

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