Heilongjiang University of Chinese Medicine, Harbin, 150006, China.
The Second Cardiology Department of the Affiliated Second Hospital of Heilongjiang University of Chinese Medicine, Harbin, 150001, China.
Heart Lung. 2025 Jan-Feb;69:111-126. doi: 10.1016/j.hrtlng.2024.09.017. Epub 2024 Oct 8.
Chronic Pulmonary Heart Disease (CPHD) significantly impacts global health, especially among middle-aged and older adults. In China, the Traditional Chinese Medicine (TCM) technique of Resolving Phlegm and Activating Blood (RPAB) is widely used to treat CPHD, although high-quality evidence supporting its efficacy remains limited.
The purpose of this study was to rigorously assess the clinical efficacy of RPAB for CPHD and elucidate the mechanisms underlying its primary herbal components.
Through a detailed search of literature in both Chinese and English and strict inclusion and exclusion criteria, 18 randomized controlled trials (RCTs) were selected for meta-analysis. We identified RPAB's core herbal combinations using association rule analysis. This method statistically analyzes the frequency and correlation of herbal medicine usage. We then analyzed the chemical components of these combinations and investigated their potential intervention mechanisms on CPHD through network pharmacology.
The combination of RPAB with Western medicine was superior to Western medicine alone in improving blood gas analysis and pulmonary function and reducing plasma viscosity in CPHD patients. The core herbal combination identified was Astragalus membranaceus (Fisch.) Bunge, Ligusticum chuanxiong Hort. ex S. H. Qiu & al., and Stellaria alsine Grimm (ALS). This combination targeted 588 therapeutic and 27 core targets. It influenced ten core compounds across 34 pathways, primarily through the chemokine signaling pathway and the JAK-STAT signaling pathway.
RPAB with Western medicine significantly improves CPHD treatment outcomes. The study highlights the therapeutic potential of the ALS combination, which operates through multiple pathways to remodel pulmonary arteries, decrease inflammation, and lessen oxidative stress. These insights support the clinical application of RPAB in CPHD treatment and open new avenues for research and therapeutic development.
慢性肺源性心脏病（CPHD）对全球健康有重大影响，尤其在中老年人群中。在中国，中医的化痰活血法（RPAB）被广泛用于治疗 CPHD，但支持其疗效的高质量证据仍然有限。
本研究旨在严格评估 RPAB 治疗 CPHD 的临床疗效，并阐明其主要草药成分的作用机制。
通过对中文和英文文献进行详细检索，并严格设定纳入和排除标准，我们选择了 18 项随机对照试验（RCT）进行荟萃分析。我们使用关联规则分析确定了 RPAB 的核心草药组合。该方法统计分析了草药使用的频率和相关性。然后，我们分析了这些组合的化学成分，并通过网络药理学研究了它们对 CPHD 的潜在干预机制。
与单纯西药治疗相比，RPAB 联合西药在改善 CPHD 患者血气分析和肺功能、降低血浆黏度方面更具优势。确定的核心草药组合为黄芪、川芎和繁缕（ALS）。该组合针对 588 个治疗靶点和 27 个核心靶点。它影响了 34 条通路中的 10 个核心化合物，主要通过趋化因子信号通路和 JAK-STAT 信号通路。
RPAB 联合西药可显著改善 CPHD 的治疗效果。本研究强调了 ALS 组合的治疗潜力，它通过多种途径重塑肺动脉、减轻炎症和减少氧化应激。这些发现为 RPAB 在 CPHD 治疗中的临床应用提供了支持，并为研究和治疗开发开辟了新的途径。
