Cardiovascular Medicine Department, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 158 Shangtang Road, Hangzhou 310014, Zhejiang, China.
Cardiovascular Medicine Department, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 158 Shangtang Road, Hangzhou 310014, Zhejiang, China.
Biomed Pharmacother. 2022 Feb;146:112538. doi: 10.1016/j.biopha.2021.112538. Epub 2021 Dec 15.
The prognosis of various cardiovascular diseases eventually leads to heart failure (HF). An energy metabolism disorder of cardiomyocytes is important in explaining the molecular basis of HF; this will aid global research regarding treatment options for HF from the perspective of myocardial metabolism. There are many drugs to improve myocardial metabolism for the treatment of HF, including angiotensin receptor blocker-neprilysin inhibitor (ARNi) and sodium glucose cotransporter 2 (SGLT-2) inhibitors. Although Western medicine has made considerable progress in HF therapy, the morbidity and mortality of the disease remain high. Therefore, HF has attracted attention from researchers worldwide. In recent years, the application of traditional Chinese medicine (TCM) in HF treatment has been gradually accepted, and many studies have investigated the mechanism whereby TCM improves myocardial metabolism; the TCMs studied include Danshen yin, Fufang Danshen dripping pill, and Shenmai injection. This enables the clinical application of TCM in the treatment of HF by improving myocardial metabolism. We systematically reviewed the efficacy of TCM for improving myocardial metabolism during HF as well as the pharmacological effects of active TCM ingredients on the cardiovascular system and the potential mechanisms underlying their ability to improve myocardial metabolism. The results indicate that TCM may serve as a complementary and alternative approach for the prevention of HF. However, further rigorously designed randomized controlled trials are warranted to assess the effect of TCM on long-term hard endpoints in patients with cardiovascular disease.
各种心血管疾病的预后最终都会导致心力衰竭（HF）。心肌细胞的能量代谢障碍是解释 HF 分子基础的重要因素；这将有助于从心肌代谢的角度对 HF 的治疗选择进行全球研究。有许多改善心肌代谢的药物可用于治疗 HF，包括血管紧张素受体阻滞剂-脑啡肽酶抑制剂（ARNi）和钠-葡萄糖共转运蛋白 2（SGLT-2）抑制剂。尽管西医在 HF 治疗方面取得了相当大的进展，但该病的发病率和死亡率仍然很高。因此，HF 引起了全球研究人员的关注。近年来，中药（TCM）在 HF 治疗中的应用逐渐被接受，许多研究探讨了 TCM 改善心肌代谢的机制；研究的 TCM 包括丹参饮、复方丹参滴丸和参麦注射液。这使得 TCM 通过改善心肌代谢在 HF 的临床应用成为可能。我们系统地回顾了 TCM 改善 HF 时心肌代谢的疗效，以及 TCM 活性成分对心血管系统的药理作用及其改善心肌代谢的潜在机制。结果表明，TCM 可能是预防 HF 的一种补充和替代方法。然而，需要进一步设计严格的随机对照试验来评估 TCM 对心血管疾病患者长期硬终点的影响。
