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1.中国中医科学院 中药研究所,北京 100700
2.悦康药业集团股份有限公司,北京 100176
Received:16 December 2021,
Published Online:11 March 2022,
Published:05 May 2022
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杨秀娟,朱瑞萱,谢冉等.活心丸防治气虚血瘀证冠心病分子机制及方义和疗效解析[J].中国实验方剂学杂志,2022,28(09):205-213.
YANG Xiu-juan,ZHU Rui-xuan,XIE Ran,et al.Meaning, Efficacy and Mechanism of Huoxin Pills in Treating Coronary Heart Disease with Qi Deficiency and Blood Stasis Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(09):205-213.
杨秀娟,朱瑞萱,谢冉等.活心丸防治气虚血瘀证冠心病分子机制及方义和疗效解析[J].中国实验方剂学杂志,2022,28(09):205-213. DOI: 10.13422/j.cnki.syfjx.20220615.
YANG Xiu-juan,ZHU Rui-xuan,XIE Ran,et al.Meaning, Efficacy and Mechanism of Huoxin Pills in Treating Coronary Heart Disease with Qi Deficiency and Blood Stasis Syndrome[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(09):205-213. DOI: 10.13422/j.cnki.syfjx.20220615.
心血管病具有高发病率与高死亡率的临床特点,属于中医学中的“胸痹心痛”范畴。中医药对证防治心血管病疗效独特,且副作用小。活心丸属于国家基本用药品种,基于“阳微阴弦”的基本病机和心肌缺血缺氧的病理学基础组药成方,临床上主要用于冠心病心绞痛(气虚血瘀证)的防治。该药源于经典名方,由10种名贵中药材组成,临床疗效确切,主要通过增加心肌收缩力、提高心输出量、改善微循环、增加冠脉血流量、免疫调节及抗炎解毒、镇静安神等药理作用呈现其中医临床上益气活血、温通宣痹的功效,临床上主要应用于心阳不足、气虚血瘀所致的胸痹心痛,胸闷气短,心悸怔忡,畏寒肢冷等冠心病心绞痛者,尤其是老年(阳气虚弱)、既往心肌梗死者。该文基于已有的研究报道从冠心病基本病机角度阐释活心丸的方义,并对其作用靶点、作用部位和作用环节等进行分析和预测,从基础研究到临床循证医学研究释明其作用机制,为其进一步的临床合理高效使用提供数据支撑和科研实证。
Cardiovascular diseases, with high incidence and high mortality, belong to the category of "chest impediment and heart pain" in traditional Chinese medicine (TCM). Chinese medicines have unique effect on the prevention and treatment of cardiovascular diseases with little side effects. Huoxin pills, one of the National Essential Drugs, is formulated based on the basic pathogenesis of weak pulse at Yang and wiry pulse at Yin and the pathological basis of myocardial ischemia and hypoxia and used for treating angina pectoris of coronary heart disease (Qi deficiency and blood stasis syndrome). This medicine is derived from the classic famous prescription and is composed of ten precious Chinese medicinal herbs. It can replenish Qi, activate blood, and warm collaterals to diffuse impediment by enhancing myocardial contractility and cardiac output to improve micro-circulation and increase coronary blood flow, regulating immune functions, alleviating inflammation, detoxifying, and tranquilizing mind. Clinically, it is suitable for patients with angina pectoris caused by the lack of heart Yang, chest tightness, shortness of breath, palpitation, fear of cold for limbs and so on, especially for the elderly with Yang deficiency or the patients with a history of myocardial infarction. On the basis of the available research reports, this paper explains the formula meaning of Huoxin pills from the perspective of the basic pathogenesis of coronary heart disease and predicts its action targets, location and links. Furthermore, we expound the mechanism of action of Huoxin pills based on basic research and clinical evidence-based research, aiming to provide data support and evidence for the clinical application of this medicine.
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