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补阳还五汤防治PCI术后心绞痛作用机制及相关研究进展

Mechanism and Related Research Progress of Buyang Huanwu Decoction(补阳还五汤)in Preventing and Treating Postoperative Angina Pectoris after Percutaneous Coronary Intervention
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摘要 补阳还五汤为《医林改错》中所记载补气活血的名方,常用于气虚血瘀证的临床治疗。经皮冠状动脉介入术(percutaneous coronary intervention,PCI)术后所发心绞痛的辨证多属气虚血瘀。该文章综述了近几年应用补阳还五汤防治PCI术后心绞痛的作用机制及临床相关研究进展。在对抗炎症反应方面,补阳还五汤能够抑制核因子-κB(NF-κB)信号通路、丝裂原活化蛋白激酶(MAPK)信号通路等多种信号通路,降低超敏C反应蛋白(hs-CRP)、白细胞介素-18(IL-18)、可溶性细胞间黏附分子-1(sICAM-1)、肿瘤坏死因子α(TNF-α)等多种炎症因子的水平发挥抗炎作用。在抗氧化损伤方面,补阳还五汤通过激活核因子E2相关因子2/抗氧化反应元件(Nrf 2/ARE)信号通路;提高再灌注期超氧化物歧化酶(SOD)活性,增加丙二醛(MDA)浓度等抗氧化应激损伤途径对抗心肌再灌注时产生的损伤。在保护血管方面,补阳还五汤能够增加血管内皮生长因子(VEGF)水平,减缓内皮祖细胞(EPCs)凋亡进程,促进PCI术后损伤血管的修复以及新生血管的形成。在调节血脂方面,补阳还五汤能够改善血脂水平,降低血液黏稠度,改善PCI术后患者的预后。文章综述以上4个方面以期为后续选择补阳还五汤防治PCI术后心绞痛进行相关作用机制及临床治疗研究提供参考和借鉴。 Buyang Huanwu Decoction(补阳还五汤)is a famous prescription recorded in Correction of Errors in Medical Classics that tonifies Qi and promotes blood circulation.It is commonly used in the clinical treatment of Qi deficiency and blood stasis syndrome.The syndrome differentiation of angina pectoris after percutaneous coronary intervention(PCI)surgery often belongs to Qi deficiency and blood stasis.This article reviews the mechanism and clinical research progress of using Buyang Huanwu Decoction to prevent and treat postoperative angina after PCI in recent years.In terms of combating inflammatory reactions,Buyang Huanwu Decoction can inhibit various signaling pathways such as NF-κB signaling pathway and MAPK signaling pathway,and reduce hs-CRP,IL-18,sICAM-1,TNF-αlevels of various inflammatory factors to exert anti-inflammatory effects.In terms of antioxidant damage,Buyang Huanwu Decoction activates the Nrf2/ARE signaling pathway;Enhance SOD activity during reperfusion period,increase MDA concentration and other antioxidant stress damage pathways to counteract the damage caused by myocardial reperfusion.In terms of protecting blood vessels,Buyang Huanwu Decoction can increase VEGF levels,slow down the apoptosis process of EPCs,promote the repair of damaged blood vessels after PCI,and form new blood vessels.In terms of regulating blood lipids,Buyang Huanwu Decoction can improve blood lipid levels,reduce blood viscosity,and improve the prognosis of patients after PCI.The article reviews the above four aspects in order to provide reference and guidance for future research on the mechanism of action and clinical treatment of Buyang Huanwu Decoction in the prevention and treatment of post PCI angina.
作者 高雨 李平 于金玉 郑雨萌 窦津航 俞婷婷 邹国良 GAO Yu;LI Ping;YU Jinyu;ZHENG Yumeng;DOU Jinhang;YU Tingting;ZOU Guoiang(Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)
出处 《辽宁中医药大学学报》 CAS 2025年第1期134-138,共5页 Journal of Liaoning University of Traditional Chinese Medicine
基金 黑龙江省中医药管理局科研项目(ZHY2023-163)。
关键词 补阳还五汤 PCI术后 心绞痛 补气活血 作用机制 研究进展 Buyang Huanwu Decoction(补阳还五汤) post percutaneous coronary intervention angina pectoris replenish Qi and activate blood mechanism of action research progress
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