真武汤治疗慢性心衰药效基础、作用机制研究进展及质量标志物预测分析

Progress in pharmacodynamic basis, mechanism, and prediction of Q-markers of Zhenwu Decoction in treatment of chronic heart failure

真武汤在中医中已有1 800多年的历史,用于治疗各种以阳气亏虚、水湿泛滥为特征的疾病,是目前治疗慢性心衰(chronic heart failure,CHF)的经典方剂。该文从真武汤传统功效及其治疗CHF理论基础、作用机制角度阐述,为该方治疗CHF提供了依据。基于中药质量标志物(Q-marker)的研究方法与判断依据,从质量传递与溯源、成分特有性、成分与"有效性"关联、复方配伍环境、成分可测性以及中药炮制角度预测真武汤治疗CHF的质量标志物。结果提示去甲乌药碱、苯甲酰乌头原碱、白术内酯Ⅲ、芍药苷、6-姜酚、8-姜酚、茯苓酸、去氢土莫酸可作为真武汤治疗CHF的质量标志物,为探究真武汤治疗CHF的药效物质基础提供了参考。

Zhenwu Decoction(ZWD) has a history of more than 1 800 years in traditional Chinese medicine(TCM), which is used to treat various diseases characterized by Yangqi deficiency and exuberant water and dampness. It is currently the classic prescription for the treatment of chronic heart failure(CHF). This study provides a basis for the treatment of CHF with ZWD by elaborating the traditional efficacy, theoretical basis, and underlying mechanism of the prescription. Based on the research methods and judgment basis of quality markers(Q-markers) of Chinese medicine, the Q-markers of ZWD in the treatment of CHF were predicted from the aspects of transfer and traceability, specificity, effectiveness, compatibility environment, measurability, and processing. Demethyl-coclaurine,benzoylaconine, atractylenolide Ⅲ, paeoniflorin, 6-gingerol, 8-gingerol, pachymic acid, and dehydrotumulosic acid can be used as Q-markers of ZWD for treating CHF. The result provides a reference for exploring the pharmacodynamic substances of ZWD in the treatment of CHF.