Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.
The First School of clinical medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.
Eur J Drug Metab Pharmacokinet. 2024 Sep;49(5):559-582. doi: 10.1007/s13318-024-00905-4. Epub 2024 Jul 15.
Cardiovascular disease (CVD) is one of the leading causes of death worldwide, and its internal medicine treatments are mostly single/few-target chemical drugs. Long-term use of cardiovascular drugs for complex chronic diseases may lead to serious adverse drug reactions. Traditional Chinese medicine (TCM) has been used to treat heart diseases for thousands of years, helping to ease symptoms and prolong patients' lifespan in ancient China. TCM has the pharmacological characteristics of being multi-component, multi-target and multi-pathway, and the combined application of TCM and western medicine can be an alternative treatment for chronic and intractable diseases with high safety levels. This article reviewed the interactions and synergistic effect of TCM and cardiovascular drugs. In the treatment of arrhythmia, TCM combined with western medicine can more effectively regulate patients' cardiac electrophysiological characteristics, reduce the onsets of premature beat and heart rate variability, lower the levels of QT interval dispersion and serum inflammatory factors, alleviate clinical symptoms and TCM syndromes, and improve cardiac function with good safety levels. In the treatment of hypertension, integrative medicine can more steadily reduce blood pressure and levels of serum inflammatory factors and improve hemodynamic indexes and exercise tolerance, and it has high safety levels, especially for pregnant women. As for coronary heart disease, the combination of TCM and antiplatelet drugs may promote the absorption of each other. However, the interaction risk of pharmacokinetic mechanism between them is low at the dose of efficacy. Integrative medicine can reduce the level of N-terminal pro-brain natriuretic peptide, delay cardiac remodeling and improve heart function and quality of life for patients with heart failure with high safety levels.
心血管疾病（CVD）是全球主要死亡原因之一，其内科治疗大多是单一/少数靶点的化学药物。长期使用心血管药物治疗复杂的慢性疾病可能会导致严重的药物不良反应。中医药（TCM）在治疗心脏病方面已有数千年的历史，在中国古代有助于缓解症状和延长患者的寿命。TCM 具有多成分、多靶点和多途径的药理学特征，TCM 与西药的联合应用可以作为高安全性的慢性和难治性疾病的替代治疗方法。本文综述了 TCM 与心血管药物的相互作用和协同作用。在心律失常的治疗中，TCM 与西药联合使用可以更有效地调节患者的心脏电生理特征，减少早搏和心率变异性的发作，降低 QT 间期离散度和血清炎症因子水平，缓解临床症状和 TCM 证候，改善心功能，安全性良好。在高血压的治疗中，整合医学可以更稳定地降低血压和血清炎症因子水平，改善血液动力学指标和运动耐量，安全性高，特别是对孕妇。至于冠心病，TCM 和抗血小板药物的联合使用可能会促进彼此的吸收。然而，在疗效剂量下，它们之间的药代动力学机制相互作用风险较低。整合医学可以降低 N 端脑利钠肽前体的水平，延缓心脏重构，改善心力衰竭患者的心功能和生活质量，安全性高。
