Improvement of Quality of Life with Shenfu Injection (参附注射液) in Non Small Cell Lung Cancer Patients Treated with Gemcitabine plus Cisplatin Regimen

Objective： To observe the effect of Shenfu injection （参附注射液, SFI） in treating non small cell lung cancer （NSCLC） patients on quality of life with gemcitabine （GEM） plus cisplatin （GP） regimen. Methods： Thirty-four patients were ready to receive GP regimen chemotherapy for treating NSCLC disease, according to lot-drawing, they were divided into SFI pre-treatment group （18 cases） and SFI post-treatment group （ 16 cases）. SFI pre-treatment group： During the first treatment course, chemotherapy was begun with SFI 60 ml, intravenous dripping on the 3rd day, once daily, consecutively for 10 days; on the 1st day, GP regimen （GEM 1250 mg/m^2 , intravenous dripping, on the 1st and 8th day; cisplatin 70 mg/m^2 on the 2nd day; 21 days as one cycle） was carried out; in the second treatment course GP regimen was merely given to serve as the self-control. SFI post-treatment group： the medicament sequence order was reversed from that of pre-treatment group. Using dual international quality of life （QOL） scores, the effect of SFI on the patients＂ QOL was observed through randomized self pre- and post- crossover control. Results： The QOL in the 34 patients after being treated by SFI in combination with GP chemotherapy regimen in one group, and GP chemotherapy regimen alone in the other, was improved in different degrees, with significant difference （P〈0.01）; comparision of SFI combined with GP chemotherapy regimen with GP chemotherapy alone showed that QOL in patients was significantly different （P〈0.01）. Conclusion： SFI could improve QOL in patients with NSCLC who were treated with GP regimen.

Effect of Shenfu injection on ischemia-reperfusion injury of rat liver graft

BACKGROUND: It is reported that Shenfu injection (an injection prepared from traditional Chinese medicines red ginseng and aconite root) can decrease the extent of ischemia-reperfusion injury to many organs, such as the heart and kidney. We therefore investigated the effect of Shenfu injection on ischemia-reperfusion injury of rat liver graft and its mechanism. METHODS: Male Sprague Dawley (SD) rats were used as a model for isogeneic orthotopic liver transplantation. Sixty rats were randomly devided into two groups (30 in each group). The recipient was given intravenous Shenfu injection immediately before the removal of the liver in the Shenfu group and normal saline of the same volume in the control group. At 3, 6 and 24 hours after the reperfusion, blood and hepatic tissue were taken for examination. RESULTS: The levels of superoxide dismutase (SOD) and nitric oxide (NO) increased more significantly in the Shenfu group than in the control group (P <0.05). The levels of serum liver enzymes, hyaluronic acid (HA), malondialde-hyde (MDA), tumor necrosis factor-alpha(TNF-α), inter-leukin-1 (IL-1), endothelin -1 (ET-1) and liver cell apopto-sis index were lower in the Shenfu group than in the control group (P <0. 05). Microscopic examination revealed that the morphological changes of hepatic tissue were more severe in the control group than in the Shenfu group. CONCLUSIONS: Shenfu injection has protective effect on ischemia-reperfusion injury of rat liver graft. It inhibits the production of oxygen free radical and the activation of Kupffer cells, decreases apoptosis of liver cell, and improves microcirculation.

Effect of Shenfu injection on microcirculation effect index in early-and middle-stage of cardiogenic shock rats

OBJECTIVE Shenfu injection(SFI)is an effective treatment of cardiogenic shock,the pathology of the central link was microcirculation disturbance.However,whether the microcirculation status of the early-and mid-stage of cardiogenic shock has any difference is unclear.This study aimed to observe the effect of SFI on the microcirculatory disturbance in mesentery for early-and mid-stage of cardiogenic shock rat.METHODS The early-and mid-stage model of cardiogenic shock was established by ligating the ending or root of left anterior descending coronary arteries(LADCA).The rats were randomly divided into 9 groups,ie control group,early-stage model group,mid-stage model group,3 early medicated groups and 3 mid medicated groups(the dosage was 1,3.33,10 mL·kg^(-1) SFI for cardiogenic shock rats of early-and mid-stage,respectively).Parameters in mesenteric microcirculation,such as velocity of RBCs in venules,diameters of venules,the count of leukocyte adhesion and vascular permeability which calculated by FITC-dextran leakage were observed through an GeneandiM2 inverted intravital microscope and high-speed video camera system.RESULTS The cardiogenic shock induced by ligating the LADCA resulted in a number of responses in microcirculation,including a significant increase in the counts of adhesive leukocytes,narrowing of the vascular diameter,decrease in the velocity of RBCs and dextran efflux.All of the above parameters for early-stage cardiogenic shock rats were attenuated by the treatment with SFI,especially the dosage of 10 mL·kg^(-1).While SFI had no apparent time-effect on the vascular diameter and vascular permeability in mesentery for mid-stage cardiogenic shock rats.CONCLUSION The microcirculation status of the early-and mid-stage of cardiogenic shock rats were quite different.The efficacy of early treatment with SFI was more obvious than the mid administration,which could provide experimental and theoretical basis for the patients with cardiogenic shock in an earlier time.

Effect of shenfu injection on gastrointestinal microcirculation in rabbits after myocardial ischemia-reperfusion injury

瞄准：在心肌的 ischemic-reperfusion (红外) 以后在胃肠的微循环上调查 shenfu 注射的效果在进机制的兔子和探针的损害。方法：四十只健康大耳朵的白兔子随机被划分成 4 个组：红外损害控制组(组我) ， shenfu 注射 5 mL/kg 每 h 组织(组 II ) ，每 h 组(组 III ) 和 shenfu 注射， 20 mL/kg 每 h 组织的 shenfu 注射 10 mL/kg (组 IV ) 。四个组与喂奶的 Ringer 的答案被对待， shenfu 注射 5， 10，和 20 mL/ kg 静脉内地每 h 被灌输在实验前的 30 min 分别地。血液动力学的价值[吝啬的动脉压(地图)，心搏率( HR )，二氧化碳( PCO2 )的胃的 intramucosal 分压，血气体分析和 pH ]被测量并且与那些相比以前心肌的局部缺血，在心肌的局部缺血以后的 60 min 并且 60 ， 90 ，并且在灌注以后的 180 min 。结果：地图， HR 和胃的 intramucosal pH 是( 70.50 +/- 4.50 ) kPa ，( 165 +/- 14 )每 min 跳动， 7.032 +/- 0.024 在组我在心肌的局部缺血以后的 60 min ，它是显著地在心肌的局部缺血前与那些相比减少了( 88.50 +/- 9.75 kPa ， 18 每 min 打败的 217 +/-， 7.112 +/- 0.035 ， P 【 0.05 )。地图， HR 和胃的 intramucosal pH 显著地在组被减少我在灌注以后的 60 ， 90 ，和 180 min ( 61.50 +/- 5.25 kPa ， 31 每 min 打败的 133 +/-， 6.997 +/- 0.025 )与那些相比在灌注前分别地( P 【 0.05 )，而价值是在在灌注以后的组 II ， III 或 IV 不同的不足道，与那些相比在灌注前，并且在在灌注以后的组 II ， III ，和 IV 之间没有有效差量。结论：shenfu 注射的注入前在兔子在心肌的红外损害以后在胃肠的微循环上有保护的效果，以一种剂量独立人士方式。

Therapeutic Effect of Shenfu Injection (参附注射液) on Secondary Aplastic Anemia of Tumor Patients after Chemotherapy

Objective: To explore the effect of Shenfu Injection (参府注射液, SFI) on the secondary aplastic anemia (AA) of tumor patients after chemotherapy (CT). Methods: The 15 cases of SFI treated group, 10 cases of control group, 25 cases of SFI + granulocyte-macrophage colony stimulating factor (GM-CSF) treated group and the group of 23 GM-CSF-treated tumor cases of secondary AA after CT were compared, with their increasing rate and the rebound speed of neutrophil, platelet, bone marrow nucleated RBC, granulocyte, and megakaryocyte all being investigated. Results: The increasing rate and rebound speed of granulocyte, platelet, and the increasing rate of bone marrow nucleated RBC, granulocyte, megakaryocyte were obviously higher than those of the control, and the clinical manifestations were also obviously improved. The increasing rate of platelet, bone marrow nucleated RBC, megakaryocyte of the SFI + GM-CSF group were higher than those of the group which used GM-CSF alone, while the increasing rate of granulocyte in blood and bone marrow in both groups was similar. Conclusion: Significant efficacy was shown in SFI for the treatment of secondary AA of tumor patients after CT.

Protective Effect of Shenfu Injection on Rats with Chronic Heart Failure Induced by Doxorubicin

[Objectives] To determine the protective effect of Shenfu injection( SFI) on chronic heart failure( CHF) in rats induced by doxorubicin. [Methods] CHF was induced by doxorubicin via intraperitoneal injection in rats. The cardiac function parameters,the heart index,the serum brain natriuretic peptide( BNP) level and cardiac histopathology were measured 4 weeks after Shenfu injection treatment. [Results]Shenfu injection remarkably improved the heart index and cardiac histopathology,increased the heart rate( HR),left ventricular systolic pressure( LVSP),maximum rising rate of left ventricular pressure( + dp/dtmax) and dropping rate of left ventricular pressure(-dp/dtmax),reduced the left ventricular end-diastolic pressure( LVEDP) and serum BNP level of rats with CHF induced by doxorubicin. [Conclusions]Shenfu injection exerts protective effect on CHF induced by doxorubicin.

Exploration on the Effect and Mechanism of Shenfu Injection (参附注射液) on Resuscitation from General Anesthesia

Objective: To investigate the effect and the mechanism of Shenfu injection (SFI, ) on the resuscitation from general anesthesia . Methods: Forty patients who received selective abdominal surgery with general anesthesia for 3-4 hrs and ASA grade Ⅰ-Ⅱ were divided into two groups, the trial group and the control group, 20 patients in each group. After being sent into the postanesthesia care unit (PACU), the trial group was treated with intravenous dripping of SFI 1.0 ml/kg and the control group was treated with intravenous dripping of equal volume of normal saline. All patients were observed in double blindly manner, the self ventilation recovery time, extubation time, the time of leaving PACU and their Glasgow coma scale (GCS) were recorded and compared. 2 ml of peripheral venous blood were taken to determine the plasma β-endorphin (β-EP) content at the time points of before (T1), 5min (T2), 15min (T3) and 30 min (T4) after dripping. Results: The self ventilation recovery time, extubation time and time of leaving PACU in the trial group were all shorter than those in the control group (P<0 01), the GCS in the trial group was better than that in the control group (P<0 01). The plasma content of β-EP raised gradually along the recovering of patients consciousness, as compared with the content before dripping (T1), it showed insignificant difference at time point T2 but significant difference at T3 and T4, comparison at the corres ponding time point showed that the content at T1 and T2 were similar in the two groups (P>0 05), but at T3 and T4, the content was higher in the trial group than that in the control group respectively (P<0 01). There was insignificant difference between T1 and before treatment ( P>0 05), but significant difference was found when compared T3, T4 and before treatment (P<0 01).Conclusion: SFI could accelerate the resuscitation after general anesthesia, the mechanism may be related with its action in raising plasma β-EP level.

Systematic Evaluation and Meta-Analysis of the Efficacy and Safety of Shenfu Injection in the Treatment of Septic Cardiomyopathy

Objective:To evaluate the efficacy and safety of Shenfu injection in the treatment of septic cardiomyopathy.Methods:Literatures on Shenfu injection for the treatment of sepsis published from the establishment of each database to December 31,2020,were searched by computer;Cochrane risk-of-bias tool was used for evaluating the quality of literatures,and Review Manager 5.4 software was used for meta-analysis.Results:Twenty random controlled trials(RCTs)were included,with a total of 1,179 patients;the meta-analysis showed that the routine treatment of Western medicine combined with Shenfu injection can reduce the 28-day mortality,the length of hospital stay,cardiac troponin I(cTnI),and N-terminal pro-brain natriuretic peptide(NT-proBNP)as well as improve the left ventricular ejection fraction(LVEF)with low incidence of adverse reactions.Conclusion:Western medicine combined with Shenfu injection can further reduce myocardial injury in patients with sepsis and improve cardiac function as well as the prognosis of patients with septic cardiomyopathy.

Meta-analysis of the Effect of Shenfu Injection on Immune Function in Patients with Sepsis

Objective:To systematically evaluate the effects of Shenfu Injection on immune function of sepsis patients by meta-analysis.Methods:The randomized controlled trials of Shenfu Injection in the treatment of sepsis published from 2000 to February 2021 were searched in CNKI,WanFang database and VIP database.The control group was treated with routine treatment;The experimental group was treated with Shenfu Injection on the basis of routine treatment.The included literature was evaluated by Cochrane bias risk evaluation table,and Shenfu Injection was used to treat patients with sepsis with RevMan 5.3 software.The results of meta-analysis were as reported.Conclusion:However,due to the limitation of the quality and quantity of the included research,multi center,large sample volume and high-quality RCT are still needed to verify the research results.

参附注射液对急性心衰患者炎性指标、心功能及临床疗效的影响

目的观察参附注射液对急性心力衰竭(心肾阳虚型)患者的疗效,并探讨其作用机制。方法89例患者按随机数字表法分为观察组45例与对照组44例,两组均给予常规西药治疗,观察组在对照组基础上加用参附注射液。比较两组血清炎性指标、血流动力学指标、心功能及临床疗效。结果两组治疗前白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、左心室射血分数(LVEF)、脑利钠肽(BNP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)水平和血流动力学指标心排血量(CO)、平均动脉压(MAP)、肺动脉压(PAP)水平比较,差异无统计学意义(均P>0.05)。两组治疗后5、10 d,IL-6、hs-CRP、LVEF、BNP、CK-MB、cTnT水平和血流动力学指标CO、MAP、PAP水平均较治疗前改善(均P<0.05),且观察组的各项指标改善均优于对照组(P<0.05)。治疗后观察组的总有效率为86.67%,高于对照组的72.73%。两组治疗期间及治疗后均未发现不良反应。结论参附注射液治疗急性心力衰竭可有效降低患者的血清炎性指标,改善血流动力学,提高心功能,改善生活质量,疗效良好。

参附汤抑制铁死亡缓解化疗药物心脏毒性研究

目的:本研究拟验证参附汤这一经典名方是否通过铁死亡缓解心力衰竭。方法:网络药理学寻找参附汤、心力衰竭、铁死亡重叠基因。Metascape数据库进行基因本体(GO)富集分析及富集分析和京都基因和基因组百科全书(KEGG)通路预测。用阿霉素对H9C2细胞造心肌细胞损伤模型,测定细胞活力、Fe2+含量、铁死亡marker蛋白、蛋白酪氨酸激酶2(JAK2)-信号转导及转录激活蛋白3(STAT3)信号通路表达。C57小鼠阿霉素注射4周造心力衰竭模型,测定左室心射血分数,观察心肌形态学改变,测定肌肉Fe2+含量,免疫组织化学检测验证心肌相关蛋白表达水平。结果:网络药理学研究证实,共有13个重叠基因。PTGS2蛋白等为参附汤基于铁死亡对心力衰竭调控的核心节点。GO功能分析证实,生物过程相关条目有11个,细胞组分3个;分子功能3个。KEGG预测分信号通路4条。Jak-STAT等通路是心力衰竭主要机制。分子对接证实对接能均小于-5 kcal/mol。参附注射液含药血清汤提高细胞活力,减少铁含量,抑制铁死亡marker蛋白,JAK2-STAT3信号通路。动物实验证实,参附注射液改善了小鼠心肌细胞形态学改变,增加了心功能,佐证了细胞实验中铁死亡及JAK2-STAT3调控机制研究。结论:本研究证实铁死亡是参附汤对心力衰竭调控机制,丰富了参附汤调控心肌死亡途径的科学证据。

参附注射液治疗心肾阳虚型慢性心力衰竭急性加重的临床研究

目的:观察参附注射液治疗心肾阳虚型慢性心力衰竭急性加重的临床疗效。方法:选取2023年10月—2024年1月在安徽中医药大学第一附属医院住院的慢性心力衰竭急性加重病人60例,按照随机数字表法分为观察组与对照组,各30例。观察组给予参附注射液加西医常规治疗,对照组仅给予西医常规治疗,比较两组治疗前后血浆氨基末端B型钠尿肽前体(NT-proBNP)、超敏肌钙蛋白I(hs-cTnI)、6 min步行试验(6MWT)、明尼苏达州心力衰竭生活质量问卷评分(MLHFQ)、中医证候积分及纽约心脏病协会(NYHA)心功能分级。结果:与治疗前比较,两组治疗后NT-proBNP、hs-cTnI水平降低(P<0.05),两组治疗后NT-proBNP、hs-cTnI水平比较差异均无统计学意义(P>0.05);与治疗前比较,两组治疗后6MWT、MLHFQ评分均明显改善(P<0.05),观察组改善程度优于对照组(P<0.05);两组治疗后各单项中医证候积分低于治疗前(P<0.05),观察组治疗后喘促气短、倦怠乏力、畏寒肢冷及言语声低评分低于对照组(P<0.05)。观察组总有效率为96.7%,对照组为80.0%,两组比较差异有统计学意义(P<0.05)。结论:参附注射液联合西药常规治疗可改善心肾阳虚型慢性心力衰竭急性加重病人心功能,提高病人运动耐量和生活质量。

张申府实现哲学之“通”的三重维度及其启示

张申府哲学之思的一个重要目的和追求,在于立足于中西古今哲学之间,以实现哲学之“通”。他以“大客观主义”和“具体相对论”作为实现哲学之“通”的理论根据,从“解析”与“唯物”的结合、西学与中学的融通、逻辑与诗的共存三重维度,融会贯通不同的哲学传统、形态和资源,力求创造体现新的时代精神和民族精神的现代形态中国哲学。这对于现代形态中国哲学的发展,对于马克思主义哲学中国化的推进,都是富有启发性的。

“兼和论”与综合创新论的理论奠基

综合创新论发源自张申府,张岱年一直试图为这种文化观提供理论基础。1987年,张岱年正式提出综合创新论,在同一年,张岱年还发表了1948年完成的个人哲学体系的代表作《天人简论》。如何解读《天人简论》?《天人简论》与综合创新论有何联系?这些问题成为综合创新论研究的重要问题。在2000年以前,学者仍以传统的苏式唯物辩证法框架作为解读《天人简论》与综合创新论关系的参考系,“两一”被看成张岱年哲学体系的核心范畴。2000年,刘鄂培重新发掘与阐释张岱年《天人简论》中的“兼和”思想,并提出:张岱年哲学体系的中心范畴是“兼和”,“兼和”是综合创新论的理论基础,从而给出了解读《天人简论》与综合创新论的另一种可能性。

参附注射液治疗心脏骤停后脑复苏的研究进展

心脏骤停是由多种因素引起的心脏停止泵血,导致患者出现意识丧失、循环衰竭、呼吸心跳停止的临床急危症,具有极高的病死率。脑复苏的程度是判断心肺复苏术成功的关键环节之一,对于评估患者的预后具有重要的价值。参附注射液是治疗心脏骤停后脑复苏的有效方法之一,已在临床急救中广泛应用。本文通过分析心脏骤停后脑复苏的发病机制,总结多靶点之参附注射液在临床及实验方面的研究,以期为机制学研究提供新思路。

参附注射液联合血必净注射液对脓毒症心肌病患者循环和毛细血管充盈时间的影响

目的 评价参附注射液加血必净注射液对(脓毒症心肌病SIC)患者循环和毛细血管充盈时间的影响。方法 将87例SIC患者随机分为治疗组和对照组,对照组44例,治疗组43例。对照组患者给予脓毒症集束化治疗;治疗组在对照组的基础上给予血必净注射液加参附注射液静脉滴注,两组疗程均为3 d。评估病情和预后指标(APACHEⅡ评分、SOFA评分)、心肌损伤标志物(cTnT、NT-ProBNP)、血流动力学指标(MAP、CVP、CI)、微循环指标(Lac、24 h Lac清除率、CRT)。结果 治疗后,两组APACHEⅡ评分、SOFA评分、cTnT、NT-ProBNP、Lac、CRT均降低(P<0.05),均以治疗组更明显(P<0.05),24 h Lac清除率治疗组高于对照组(P<0.05)。治疗后两组患者MAP、CVP较治疗前均升高,治疗后24、48、72 h,治疗组CI高于照组;治疗后第6、24 h,治疗组患者Lac低于对照组(P<0.05);治疗后第3、6、24 h,治疗组患者CRT低于对照组(P<0.05)。结论 在西医常规集束化治疗的基础上,加用参附注射液和血必净注射液治疗,可改善微循环及血流动力学,抑制心肌损伤,有利于改善SIC患者的心功能。

神府矿区采空区精细化综合勘探技术研究

为精细化查明神府矿区亿源煤矿井田内原不明小煤窑采空区,为采空区治理提供科学依据,需开展瞬变电磁法、钻探及测井等综合勘查技术工作,以明确采空区分布范围及富水情况。结果表明:从测井曲线中可以看出煤岩层物性稳定,曲线形态明显,煤层具有高电阻率、低密度、低伽玛特性,煤层属导电性较差的高阻层(最高大于1000Ω·m),其他泥岩、砂质泥岩、砂岩等呈现相对低阻特征,煤层与围岩物性差异明显;瞬变电磁法采用280 m矩形发射线框、发射频率25 Hz、增益2^(2)~2^(5)之间、发射电流8 A、积分时间15 s的参数组合进行探测,对已知采空区反映明显,推断3^(-1)煤层房柱式采空区总面积0.985 km^(2);通过钻探揭露了2^(-2)煤和3^(-1)煤房柱式采空区,验证了物探推断的3^(-1)煤采空区。测井、瞬变电磁法探测、钻探相互依托、相辅相成,达到了精细化综合勘探的目的。

参附注射液联合西医疗法治疗急性心力衰竭的疗效观察

目的观察参附注射液联合西医疗法治疗急性心力衰竭(AHF)的疗效。方法94例AHF患者随机分为观察组与对照组各47例。对照组应用西医疗法,观察组应用参附注射液联合西医疗法。对比两组疗效、比较氨基末端脑利钠肽前体(NT-proBNP)、乳酸(Lac)、左室射血分数(LVEF)、心率(HR)、呼吸频率(R)、血氧饱和度(SaO_(2))值。结果观察组的总有效率为89.36%,高于对照组的72.34%(P<0.05)。治疗后两组NTproBNP、Lac值降低,且观察组NT-proBNP、Lac值低于对照组(P<0.05);两组LVEF值增加,且观察组LVEF值高于对照组(P<0.05);两组HR、R值降低,SaO_(2)值增加,但组间HR、R、SaO_(2)值差异无统计学意义(P<0.05)。结论参附注射液联合西医疗法治疗AHF,能显著促进心功能及病情恢复,疗效好。

参附注射液联合乌司他丁辅助治疗脓毒症休克的临床研究及预后分析

目的 探讨参附注射液联合乌司他丁辅助治疗脓毒症休克的临床效果。方法 选取2022年1月至2023年6月于邯郸市中心医院就诊的91例脓毒症休克患者为研究对象,根据随机数字表法将其分为治疗组(47例)和对照组(44例)。两组患者均给予常规治疗,对照组给予乌司他丁注射液治疗,治疗组给予参附注射液联合乌司他丁注射液治疗。比较两组患者治疗前和治疗1d、3d、7d的超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、一氧化氮(nitric oxide,NO)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及两组患者入住急诊重症监护室(emergency intensive care unit,EICU)时间和28d死亡率。结果 治疗组患者入住EICU时间显著短于对照组,28d死亡率显著低于对照组(P<0.05)。治疗1d、3d、7d,两组患者的血清TNF-α、IL-6、MDA、NO水平均显著低于本组治疗前,治疗组患者的SOD水平均显著高于治疗前,对照组患者的SOD水平先下降后升高(P<0.05);治疗组患者的血清TNF-α、IL-6、MDA、NO水平均显著低于对照组,SOD水平显著高于对照组(P<0.05)。结论 在常规治疗的基础上,应用参附注射液联合乌司他丁治疗可进一步抑制炎症因子释放,减轻氧化应激水平,缩短患者入住EICU时间,降低28d死亡率,为脓毒症休克治疗提供新的思路。

基于miR-139/Wnt/β-catenin信号通路探讨参附注射液对慢性心力衰竭大鼠心肌纤维化的保护作用

目的探讨参附注射液对盐酸异丙肾上腺素(isoprenaline hydrochloride,ISO)诱导的慢性心力衰竭(chronic heart failure,CHF)大鼠心肌纤维化的作用与机制。方法采用随机数字表法将45只SD大鼠随机分为正常组9只,造模组36只,采用ISO背部皮下多点注射14天制备CHF大鼠模型,再正常饲养14 d通过模型验证和评价,期间死亡大鼠5只,未成模大鼠4只。将造模成功的27只大鼠按随机数字表法分为3组:模型组(腹腔注射6 mL·kg^(-1)氯化钠注射液+灌胃10 mL·kg^(-1)蒸馏水)、参附注射液组(腹腔注射6 mL·kg^(-1)参附注射液+灌胃10 mL·kg^(-1)蒸馏水)、卡托普利组(腹腔注射6 mL·kg^(-1)生理盐水+灌胃10 mL·kg^(-1)蒸馏水,蒸馏水含8.8 mg·kg^(-1)卡托普利,相当于临床等效量)。药物干预15 d后,检测各组大鼠心功能及心肌纤维化的相关指标:超声心动图、体质量、心脏质量指数及左心室质量指数;ELISA法检测氨基末端脑钠肽前体(N-terminal pro brain natriuretic peptide,NT-proBNP);HE染色、Masson染色检测心肌组织病理形态及纤维化状态;RT-qPCR检测心肌组织中miR-139、Wnt家族成员3a(Wnt family member 3a,Wnt3a)、β-连环蛋白(β-catenin)、糖原合成酶激酶3β(glycogen synthase kinase 3β,GSK3β)、Ⅰ型胶原蛋白(typeⅠcollagen,Col-Ⅰ)、Ⅲ型胶原蛋白(typeⅢcollagen,Col-Ⅲ)及α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)、基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)mRNA的表达;Western blot检测心肌组织中Wnt3a、β-catenin、GSK3β、Col-Ⅰ、Col-Ⅲ、α-SMA、MMP-2、MMP-9蛋白表达。结果与正常组比较,模型组左室射血分数(left ventricular ejection fraction,LVEF)、左室短轴缩短率(left ventricular fraction shortening,LVFS)、体质量降低(P<0.01),左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)、NT-proBNP、心脏质量指数、左心室质量指数升高(P<0.01),miR-139表达量下降(P<0.01),Wnt3a、β-catenin、GSK3β、Col-Ⅰ、Col-Ⅲ、α-SMA、MMP-2、MMP-9蛋白和mRNA表达升高(P<0.01);细胞排列紊乱,心肌纤维化明显,伴有明显的炎症浸润。与模型组比较,参附注射液组LVEF、LVFS、体质量升高(P<0.01或P<0.05),LVEDD、LVESD、NT-proBNP、心脏质量指数、左心室质量指数降低(P<0.01),miR-139表达量升高(P<0.01),Wnt3a、β-catenin、GSK3β、Col-Ⅰ、Col-Ⅲ、α-SMA、MMP-2、MMP-9蛋白和mRNA表达降低(P<0.01);细胞排列趋于整齐,纤维结缔组织增生及炎症细胞浸润现象减少,胶原纤维沉积减少,纤维化程度减轻。结论参附注射液能改善CHF大鼠心功能及心肌纤维化状态,其机制可能与调控miR-139/Wnt/β-catenin信号通路有关。