中医药调控线粒体畸变治疗射血分数保留型心力衰竭的研究进展

Research progress in traditional Chinese medicine regulating mitochondrial aberration for the treatment of HFpEF

关键词:  射血分数保留型心力衰竭  线粒体畸变  中医药

Key words:  heart failure with preserved ejection fraction  mitochondrial aberration  traditional Chinese medicine

摘要:

心力衰竭（HF）是目前全球发病率和病死率最高的疾病之一。其中射血分数保留型心力衰竭（HFpEF）在HF中占比较高。目前的临床治疗手段仍然只是改善临床症状，不能有效地针对疾病本身进行治疗并降低HF造成的病死率。HFpEF的突出特征为舒张功能障碍和心室肌重构，而心室肌重构又与线粒体的畸变密切相关。文章将综述在HFpEF中导致线粒体生物发生障碍、线粒体裂变/融合动力学障碍和线粒体自噬异常等线粒体畸变过程的关键靶标蛋白，以及具有“益气温阳”作用的中药对HFpEF的作用机制及临床研究。总结分析可用于治疗HFpEF的中药复方或活性成分，为中医药有效治疗HFpEF提供参考，也为开发治疗HFpEF的新型药物提供方向。

Abstract:

Heart failure(HF) is currently one of the diseases with most morbidity and mortality rates in the world. Among them,HF with preserved EF(HFpEF) accounts for a relatively high proportion of HF,and the current clinical treatment methods are still only to improve clinical symptoms,but cannot effectively treat the disease itself and reduce mortality due to HF. The prominent feature of HFpEF are diastolic dysfunction and ventricular muscle remodeling,and the remodeling of ventricular muscle is closely related to mitochondrial aberration. Therefore,this article reviews the key target proteins that lead to mitochondrial aberrations in HFpEF,such as mitochondrial biogenesis disorders,mitochondrial fission/fusion kinetic disorders,and mitochondrial autophagy abnormalities,and the mechanism and clinical research of traditional Chinese medicine with the effect of "replenishing qi and assisting yang" on HFpEF. To summarize and analyze the traditional Chinese medicine(TCM) compounds or active ingredients that can be used for the treatment of HFpEF,so as to provide a reference for the effective treatment of HFpEF by TCM,and also to provide a direction for the development of new HFpEF specific drugs.