中医药对缺血再灌注损伤心肌保护作用研究进展

Advances in Research on the Protective Effect of Traditional Chinese Medicine on Myocardial Ischemia-reperfusion Injury

缺血性心脏病是临床常见病、多发病,其中急性心肌梗死严重威胁着全球人类的身体健康,目前主要的治疗手段是通过血管再通,实现心肌再灌注,但是在冠脉缺血基础上恢复血流时,组织细胞损伤反而加重,甚至发生不可逆性损伤,此现象称为心肌缺血再灌注损伤(myocardial ischemia reperfusioninjury,MIRI)。MIRI严重影响缺血性心脏病的治疗效果,加重患者身体负担,有效防治MIRI成为临床工作中亟待解决的问题。近年来中药广泛应用于MIRI,对心肌细胞起到了保护作用,目前现代药理学认为其作用机制主要与减轻心肌细胞线粒体损伤、调节一氧化氮(NO)的表达、减少心肌细胞凋亡、抑制炎症反应、调控细胞自噬等有关,该文对上述作用机制进行归纳总结。

Ischemic heart disease is a common and frequently-occurring disease in the clinic. Acute myocardial infarction is a serious threat to the health of human beings around the world. At present,the main treatment is to achieve myocardial reperfusion through revascularization,but on the basis of coronary ischemia. When the blood flow is restored,the tissue damage is aggravated and even irreversible damage occurs. This phenomenon is called myocardial ischemia reperfusion injury(MIRI). MIRI seriously affects the therapeutic effect of ischemic heart disease,aggravates the patients’ physical burden,and effective prevention and treatment of MIRI has become an urgent problem in clinical work. In recent years,traditional Chinese medicine has been widely used in MIRI to protect cardiomyocytes. At present,modern pharmacology believes that its mechanism of action is mainly to reduce myocardial cell mitochondrial damage,regulate the expression of nitric oxide(NO),reduce myocardial cell apoptosis,inhibition of inflammatory response and regulation of autophagy,etc. This paper summarizes the above mechanisms.