补气活血类中药及间充质干细胞治疗肺动脉高压的研究进展

Research progress on the treatment of pulmonary hypertension with qi-tonifying and blood-activating herbs and mesenchymal stem cells

关键词:  间充质干细胞  肺动脉高压  补气活血  中医药

Key words:  mesenchymal stem cells  pulmonary hypertension  qi-tonifying and blood-activating  traditional Chinese medicine

摘要:

肺动脉高压是世界范围内的重大疾病问题，作为一种血流动力学疾病其特征在于平均肺动脉压高于正常上限，与不良的血管重塑相关，右心室肥大并最终衰竭是致使肺动脉高压死亡的主要原因，药物治疗虽可暂时缓解肺动脉高压症状，但无法逆转肺血管重塑。间充质干细胞治疗肺动脉高压有其独特的优势，可通过改善肺血管重塑、调控炎症免疫、调控肠道菌群治疗肺动脉高压。根据干细胞可以修复损伤组织等特征可将其归属于中医学正气的范畴，并且干细胞与肾精在生命起源和生理功能等方面存在较多共性，骨髓干细胞循环与中医学祛瘀生新理论相似，可知干细胞与中医学所论气血精存在一定联系。使用补气活血类中药能够促进干细胞的增殖与分化，肺动脉高压的中医关键病机在于气虚血瘀，补气活血类中药亦能够改善肺血管重塑、减轻炎症反应、调控机体代谢、改善线粒体功能治疗肺动脉高压。基于此，文章总结了间充质干细胞、补气活血类中药治疗肺动脉高压的作用机制，并进一步探讨了两者联合治疗肺动脉高压的可行性，旨在为补气活血类中药联合间充质干细胞治疗肺动脉高压的临床应用和实验研究提供思路与参考。

Abstract:

Pulmonary hypertension，a major global health problem and a hemodynamic disease，is characterized by a mean pulmonary artery pressure higher than the upper limit of normal and is associated with abnormal vascular remodeling. Right ventricular hypertrophy and subsequent right heart failure are the main causes of death in pulmonary hypertension patients. Although drug treatments can temporarily relieve pulmonary hypertension symptoms，they cannot reverse pulmonary vascular remodeling. Mesenchymal stem cell therapy for pulmonary hypertension has unique advantages，as it can treat pulmonary hypertension by alleviating pulmonary vascular remodeling，regulating inflammation and immune responses，and regulating the intestinal microbiota. Given their ability to repair damaged tissues，stem cells can be classified as a form of vital energy and share many commonalities with kidney essence in terms of the origin of life and physiological functions. The circulation of bone marrow stem cells，which is similar to the traditional Chinese medicine concept of promoting blood circulation and removing blood stasis，suggests that stem cells have a certain connection with the qi，blood，and essence discussed in traditional Chinese medicine. In traditional Chinese medicine，the key pathogenesis of PH lies in qi deficiency and blood stasis，and traditional Chinese medicine that tonify qi and promote blood circulation can improve pulmonary vascular remodeling，reduce inflammatory responses，regulate the body’s metabolism，and enhance mitochondrial function，thereby treating pulmonary hypertension. Based on this，this article summarizes the mechanisms of action of mesenchymal stem cells and qi-tonifying and blood-activating traditional Chinese medicine in the treatment of pulmonary hypertension. It further explores the feasibility of combining these treatments for pulmonary hypertension，aiming to provide ideas and references for the clinical application and experimental research of using qi-tonifying and blood-activating traditional Chinese medicine in conjunction with mesenchymal stem cells to treat pulmonary hypertension.