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1.湖南中医药大学,长沙 410208
2.安徽中医药大学,合肥 230013
3.重庆医科大学,重庆 400016
4.甘肃中医药大学 中医临床学院,兰州 730000
5.湖南中医药高等专科学校,湖南 株洲 412000
Received:16 November 2025,
Revised:2026-01-23,
Accepted:28 January 2026,
Online First:28 April 2026,
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LI Weijun, LI Leshi, LIU Donglin, et al. Pathogenesis and Treatment of Chronic Heart Failure with "Deficiency,Stasis, and Toxin" from Neutrophil Extracellular Traps[J/OL]. Chinese Journal of Experimental Traditional Medical Formulae, 2026, 1-9.
LI Weijun, LI Leshi, LIU Donglin, et al. Pathogenesis and Treatment of Chronic Heart Failure with "Deficiency,Stasis, and Toxin" from Neutrophil Extracellular Traps[J/OL]. Chinese Journal of Experimental Traditional Medical Formulae, 2026, 1-9. DOI: 10.13422/j.cnki.syfjx.20260216.
慢性心力衰竭(CHF)作为心血管系统的终末期阶段,病理机制复杂,涉及心肌细胞结构与功能改变,同时伴随体内炎症反应加剧、氧化应激水平升高及血管功能异常等多重病理环节。中性粒细胞胞外诱捕网(NETs)是中性粒细胞在特定刺激下释放的网状结构复合物,具备杀菌防御功能。最新研究揭示,NETs失衡可引发心肌组织损伤、触发炎症免疫反应及导致血液高凝状态,在CHF的发生发展进程中起着重要作用,故调控NETs状态有望成为CHF治疗的新靶点。中医理论认为“虚瘀毒”是CHF发生发展过程中的核心病机,其中“虚”为根本病因,前期多见,贯穿疾病始终,“瘀”是局部病理表现,为CHF中期主要病机,“毒”为标象,是CHF后期主要致病因素。NETs失衡的病理效应与中医“虚毒瘀”病机理论高度契合。将CHF中的NETs失衡现象与中医“虚瘀毒”病机理论相结合,心脏功能下降对应“虚”、炎症免疫反应对应“毒”、血液高凝状态对应“瘀”,从这一视角剖析NETs与CHF发病之间的内在联系。结合中医特点,辨证论治,审证求因,总结临床治疗方法并以分别列举代表方,补虚法(暖心康)、化瘀法(清心解瘀颗粒)以及祛毒法(痰瘀同治优化方),为CHF的中西医结合治疗提供全新的思路。
Chronic heart failure(CHF), representing the terminal stage of the cardiovascular system, involves complex pathological mechanisms. These encompass structural and functional alterations in cardiomyocytes, alongside multiple pathological processes such as heightened systemic inflammation, elevated oxidative stress levels, and vascular dysfunction. Neutrophil extracellular traps(NETs) are reticular structural complexes released by neutrophils in response to specific stimuli, serving a bactericidal defense function. Recent studies reveal that NET dysregulation can induce myocardial tissue damage, trigger inflammatory immune responses, and promote a hypercoagulable blood state, playing a significant role in the initiation and progression of CHF. Therefore, modulating NET status holds promise as a novel therapeutic target for CHF. Traditional Chinese medicine theory posits that "deficiency, stasis, and toxin" constitute the core pathogenesis in the initiation and development of CHF. Among these, "deficiency" represents the fundamental cause, predominantly observed in the early stage and persisting throughout the disease course. "Stasis" manifests as a localized pathological presentation, serving as the primary pathogenesis during the middle stage of CHF. "Toxin" signifies the manifestation and emerges as the principal pathogenic factor in the late stage of CHF. The pathological effects of NET imbalance align closely with the "deficiency, stasis, and toxin" pathogenesis theory in traditional Chinese medicine. The NET imbalance phenomenon observed in CHF was integrated with the "deficiency, stasis, and toxin" pathogenesis theory in traditional Chinese medicine. Declining cardiac function corresponds to "deficiency". Inflammatory immune responses correspond to "toxin". Hypercoagulable blood state corresponds to "stasis". The intrinsic connection between NETs and CHF pathogenesis was elucidated from this perspective. In line with traditional Chinese medicine characteristics, this paper emphasized treatment based on syndrome identification and etiology identification through syndrome analysis. Clinical therapeutic methods were summarized with representative formulas: Tonifying deficiency(Nuanxin Kang), resolving stasis(Qingxin Jieyu Granules), and eliminating toxins(optimized formula for phlegm-stasis concurrent treatment). This will provide a novel perspective for the integrated Chinese and Western medicine treatment of CHF.
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