射血分数保留型心力衰竭的病理机制及中药干预研究进展

Progress in the study of pathological mechanisms of heart failure with preserved ejection fraction and intervention with traditional Chinese medicine

关键词:  射血分数保留型心力衰竭  病理机制  中医辨证  中药  作用机制

Key words:  heart failure with preserved ejection fraction  pathological mechanism  traditional Chinese medicine syndrome differentiation  traditional Chinese medicine  pharmacological mechanism

摘要:

射血分数保留型心力衰竭是一种由心脏应对机体代谢需求能力受损，从而导致微血管炎症、代谢紊乱、氧化应激的异质性临床综合征。中医药在防治心力衰竭疾病方面具有独特的优势，中医辨证可以使中医药治疗达到诊断精确、用药准确、疗效明确。文章综述射血分数保留型心力衰竭的病理机制，气虚血瘀证、气阴两虚血瘀证、阳气亏虚血瘀证3种中医证候分型，以及中药治疗射血分数保留型心力衰竭的作用机制，以期为临床防治射血分数保留型心力衰竭提供新策略。

Abstract:

Heart failure with preserved ejection fraction（HFpEF） is a heterogeneous clinical syndrome caused by the impaired ability of the heart to cope with the metabolic demands of the body，which leads to microvascular inflammation，metabolic disorders，and oxidative stress. Traditional Chinese medicine（TCM） has unique advantages in the prevention and treatment of heart failure，and TCM diagnosis can enable TCM treatment to achieve precise diagnosis，accurate medication，and clear therapeutic effects. The article reviews the main pathological mechanisms of HFpEF，the three TCM symptomatic subtypes of qi deficiency and blood stasis，qi and yin deficiency and blood stasis，and yang deficiency and blood stasis，as well as the mechanism of the effects of TCM on HFpEF，with a view to providing a new strategy for the clinical management of heart failure with preserved ejection fraction.