气虚血瘀型慢性心力衰竭病因病机及治疗的研究进展

Progress in the Etiology and Treatment of Chronic Heart Failure with Qi Deficiency and Blood Stasis

慢性心力衰竭(CHF)以呼吸困难、乏力和体液潴留为主要表现,是各种心血管系统疾病的结局,具有发病率高、病情危重、预后差的特点,其临床症状可参考中医学“心衰”,近年来引起了社会的广泛重视。其病理基础为气虚血瘀,临床上气虚血瘀型慢性心衰较为常见,其他证型多由气虚血瘀演变而来,故关于气虚血瘀型慢性心衰治疗现状及疗效机制的研究十分关键,临床上多采用益气活血,温阳利水等治法。该文根据气虚血瘀型慢性心衰目前治疗的临床文献,分析病因病机、中医选方用药及疗效机制,总结常用方药及其配伍特点。疗效机制主要涉及改善心肌缺血,降低心室舒张压,抑制炎性反应,保护血管内皮和延缓心室重塑等方面。

Chronic heart failure(CHF),characterized by dyspnea,fatigue and fluid retention,is the outcome of various car-diovascular diseases.It has the characteristics of high incidence,critical condition and poor prognosis.Its clinical symptoms can be referred to"heart failure"in traditional Chinese medicine,which has attracted wide attention from the society in recent years.The pathological basis is qi deficiency and blood stasis,clinical qi deficiency and blood stasis and chronic heart failure is com-mon,and other syndrome types mostly evolve from qi deficiency and blood stasis,so the research on the treatment status and cur-ative mechanism of chronic heart failure with qi deficiency and blood stasis is very critical,and the clinical treatment methods are invigorating qi and promoting blood circulation,warming Yang and benefiting water.Based on the current clinical literature of the current treatment of chronic HF with qi deficiency and blood stasis,this paper analyzes the etiology and pathogenesis,Chinese medicine prescription selection and efficacy mechanism,and summarizes the characteristics of common prescriptions and their compatibility.The efficacy mechanism mainly involves improving myocardial ischemia,reducing ventricular diastolic pressure,in-hibiting inflammatory response,protecting vascular endothelium and delaying ventricular remodeling.