1.河北中医药大学,石家庄 050200
2.河北省中医院,石家庄 050032
3.河北省中药组方制剂技术创新中心,石家庄 050200
4.河北省高校中药开发与产业化应用技术研发中心,石家庄 050200
高卉,在读博士,主治医师,从事心血管中药药理的研究,E-mail:549820235@qq.com
郭秋红,教授,博士生导师,从事心血管中药药理的研究,E-mail:qiuhong70105@163.com
收稿:2024-07-22,
录用:2024-10-22,
网络出版:2024-11-07,
纸质出版:2025-04-05
移动端阅览
高卉,杨泽祺,高凡等.升陷汤对慢性心力衰竭大鼠心肌微血管损伤的保护作用[J].中国实验方剂学杂志,2025,31(07):35-42.
GAO Hui,YANG Zeqi,GAO Fan,et al.Protective Effect of Shengxiantang on Myocardial Microvascular Injury in Rats with Chronic Heart Failure[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(07):35-42.
高卉,杨泽祺,高凡等.升陷汤对慢性心力衰竭大鼠心肌微血管损伤的保护作用[J].中国实验方剂学杂志,2025,31(07):35-42. DOI: 10.13422/j.cnki.syfjx.20241837.
GAO Hui,YANG Zeqi,GAO Fan,et al.Protective Effect of Shengxiantang on Myocardial Microvascular Injury in Rats with Chronic Heart Failure[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(07):35-42. DOI: 10.13422/j.cnki.syfjx.20241837.
目的
2
探讨升陷汤对慢性心力衰竭(CHF)大鼠心功能及心肌微血管损伤的保护作用。
方法
2
采用主动脉弓缩窄术(TAC)制备CHF大鼠模型,72只SD大鼠随机选取8只为假手术组,只开胸不结扎主动脉弓,将造模成功的40只大鼠随机分为模型组,升陷汤低、中、高剂量组(5.1、10.2、20.4 g·kg
-1
),盐酸曲美他嗪组(6.3 mg·kg
-1
),每组各8只。造模后4周开始给药,给药组分别予相应药物灌胃,假手术组和模型组予等量蒸馏水,连续给药8周。超声心动图检测大鼠心功能;酶联免疫吸附测定法(ELISA)检测一氧化氮(NO)、内皮素(ET-1)、血管内皮生长因子(VEGF)、血管性血友病因子(vWF)水平;透射电镜观察微血管超微结构变化;免疫组化法检测心肌组织ATP合成酶亚基(ATP5D)、F-肌动蛋白(F-actin)蛋白表达水平;蛋白免疫印迹法(Western blot)检测心肌组织闭合蛋白(Occludin)、密封蛋白(Claudin)、血管内皮钙黏蛋白(VE-Cadherin)、闭锁小带蛋白1(ZO-1)蛋白表达水平;免疫荧光染色测定微血管密度。
结果
2
与假手术组比较,模型组大鼠射血分数(EF)、左心室缩短分数(FS)显著降低(
P
<
0.01),左室舒张内径(LVIDd)、左室收缩内径(LVIDs)、左室舒张末期后壁厚度(LVPWd)、左室收缩末期后壁厚度(LVPWs)、左
室舒张末期容积(LVVOLd)、左室收缩末期容积(LVVOLs)显著升高(
P
<
0.01),NO、VEGF水平显著降低(
P
<
0.01),ET-1、vWF水平显著升高(
P
<
0.01),电镜下微血管基底膜不完整,紧密连接模糊,ATP5D、F-actin蛋白及Occludin、Claudin、ZO-1、VE-Cadherin蛋白表达水平明显降低(
P
<
0.05,
P
<
0.01),微血管相对密度显著降低(
P
<
0.01)。经升陷汤干预后,CHF大鼠EF、FS显著升高(
P
<
0.01),LVIDd、LVIDs、LVPWd、LVPWs、LVVOLd、LVVOLs显著下降(
P
<
0.01),NO、VEGF水平显著升高(
P
<
0.01),ET-1、vWF水平显著下降(
P
<
0.01),电镜下微血管基底膜相对完整,紧密连接相对连续,ATP5D、F-actin及Occludin、Claudin、ZO-1、VE-Cadherin表达水平明显上升(
P
<
0.05,
P
<
0.01),微血管相对密度显著升高(
P
<
0.01)。
结论
2
升陷汤能有效改善CHF大鼠心功能,减轻微血管内皮损伤,加强内皮细胞间连接,提高微血管密度,从而保护心肌微血管损伤。
Objective
2
To explore the protective effect of Shengxiantang on cardiac function and myocardial microvascular injury in rats with chronic heart failure (CHF).
Methods
2
The CHF rat model was prepared by aortic arch constriction (TAC). Of the 72 SD rats, 8 were randomly selected as the sham operation group, where the chest was opened without ligating the aortic arch. The 40 successfully modeled rats were randomly divided into the model group, the Shengxiantang low-, medium-, and high-dose groups (5.1, 10.2, 20.4 g·kg
-1
), and the trimetazidine group (6.3 mg·kg
-1
), with 8 rats in each group. Drug administration began 4 weeks after modeling. The administration groups received the corresponding drugs by gavage, while the sham operation and model groups were given the same amount of distilled water for 8 consecutive weeks. Echocardiography was used to assess cardiac function. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of nitric oxide (NO), endothelin (ET-1), vascular endothelial growth factor (VEGF), and von Willebrand factor (vWF). Ultrastructural changes of mi
crovessels were observed by transmission electron microscopy. Immunohistochemistry was used to detect the expression levels of ATP synthase subunit (ATP5D) and F-actin in myocardial tissue. Western blot was used to detect the expression levels of occludin, claudin, vascular endothelial cadherin (VE-Cadherin), and zonula occludens-1 (ZO-1). Microvessel density was measured by immunofluorescence staining.
Results
2
Compared with the sham operation group, the ejection fraction (EF) and left ventricular shortening fraction (FS) in the model group were significantly decreased (
P
<
0.01), while the left ventricular diastolic diameter (LVIDd), left ventricular systolic diameter (LVIDs), left ventricular end-diastolic posterior wall thickness (LVPWd), left ventricular end-systolic posterior wall thickness (LVPWs), left ventricular end-diastolic volume (LVVOLd), and left ventricular end-systolic volume (LVVOLs) were significantly increased (
P
<
0.01). The levels of NO and VEGF were significantly decreased (
P
<
0.01), while the levels of ET-1 and vWF were significantly increased (
P
<
0.01). Under electron microscopy, the microvascular basement membrane was incomplete and the tight junctions were blurred. The expression levels of ATP5D, F-actin, occludin, claudin, ZO-1, and VE-Cadherin were significantly decreased (
P
<
0.05,
P
<
0.01), and the relative density of microvessels was significantly reduced (
P
<
0.05,
P
<
0.01). After intervention with Shengxiantang, the EF and FS of CHF rats significantly increased (
P
<
0.01), while the LVIDd, LVIDs, LVPWd, LVPWs, LVVOLd, and LVVOLs significantly decreased (
P
<
0.01). The levels of NO and VEGF significantly increased (
P
<
0.01), while the levels of ET-1 and vWF significantly decreased (
P
<
0.01). Under electron microscopy, the microvascul
ar basement membrane was relatively complete and the tight junctions were more continuous. The expression levels of ATP5D, F-actin, occludin, claudin, ZO-1, and VE-Cadherin significantly increased (
P
<
0.05,
P
<
0.01), and the relative density of microvessels significantly increased (
P
<
0.01).
Conclusion
2
Shengxiantang can effectively improve the cardiac function of CHF rats, reduce microvascular endothelial injury, strengthen the connection between endothelial cells, and increase microvessel density, thereby protecting myocardial microvascular injury.
王艳丽 , 王艳萍 , 马金波 , 等 . 芪苈强心胶囊辅治扩张型心肌病合并慢性心力衰竭的疗效及对神经内分泌因子、炎性因子及心室重构的影响 [J]. 解放军医药杂志 , 2021 , 33 ( 2 ): 84 - 88 .
WANG Y L , WANG Y P , MA J B , et al . Effect of Qiliqiangxin capsule on dilated cardiomyopathy with chronic heart failure and its influence on neuroendocrine factors,inflammatory factors and ventricular remodeli [J]. Med Pharm J Chin PLA , 2021 , 33 ( 2 ): 84 - 88 .
ANDRES E , TALHA S , HAJJAM M , et al . Experimentation of 2.0 telemedicine in elderly patients with chronic heart failure:A study prospective in 175 patients [J]. Eur J Int Med , 2018 , doi: 10.1016/j.ejim.2018.02.022 http://dx.doi.org/10.1016/j.ejim.2018.02.022 .
HE Y , ZHANG B , ZHU F , et al . Transesophageal echocardiography measures left atrial appendage volume and function and predicts recurrence of paroxysmal atrial fibrillation after radiofrequency catheter ablation [J]. Echocardiography , 2018 , 35 ( 7 ): 985 - 990 .
刘博通 , 李泉 , 韩晶岩 . 微血管屏障损伤引起的微血管渗漏及中医固摄理论和方药的机理 [J]. 中国病理生理杂志 , 2021 , 37 ( 9 ): 1679 - 1692 .
LIU B T , LI Q , HAN J Y . Microvascular leakage caused by microvascular barrier injury,and mechanisms of TCM fixation theory and prescription [J]. Chin J Pathophysiol , 2021 , 37 ( 9 ): 1679 - 1692 .
SABBAH H N . Targeting the mitochondria in heart failure:A translational perspective [J]. JACC Basic Transl Sci , 2020 , 5 ( 1 ): 88 - 106 .
KUMAR V , SANTHOSH KUMAR T R , KARTHA C C . Mitochondrial membrane transporters and metabolic switch in heart failure [J]. Heart Fail Rev , 2019 , 24 ( 2 ): 255 - 267 .
任訾娟 , 徐健 . 房颤患者射频消融的临床疗效及术后早期复发的危险因素 [J]. 山东医药 , 2018 , 58 ( 33 ): 21 - 24 .
REN Z J , XU J . Clinical efficacy of radiofrequency ablation for atrial fibrillation patients and risk factors for early recurrence of atrial tachyarrhythmia after ablation [J]. Shandong Med J , 2018 , 58 ( 33 ): 21 - 24 .
张锡纯 . 医学衷中参西录:上 [M]. 北京 : 中医古籍出版社 , 2016 : 404 .
ZHANG X C . Records of tradition Chinese and western medicine in combination:Volume 1 [M]. Beijing : Chinese Ancient Medical Books Publishing House , 2016 : 404 .
姚磊 . 升陷汤干预慢性心衰患者临床疗效及其抗心肌细胞凋亡机制研究 [D]. 上海 : 上海中医药大学 , 2020 .
YAO L . Clinical efficacy of Sheng-xian decoction in patients with chronic heart failure and its anti-apoptotic mechanism [D]. Shanghai : Shanghai University of Traditional Chinese Medicine , 2020 .
ZHANG F , ZHAN Q , DONG X , et al . Shengxiantang in chronic heart failure treatment and synergistic property of platycodonis radix:A metabolomic approach and its application [J]. Mol Bio Syst , 2014 , 10 ( 8 ): 2055 - 2063 .
董红彦 , 张少强 , 钟燕春 , 等 . 基于网络药理学研究升陷汤治疗心力衰竭的作用机制 [J]. 中医药导报 , 2020 , 26 ( 13 ): 114 - 118 .
DONG H Y , ZHANG S Q , ZHONG Y C , et al . Study on the mechanism of treating heart failure with Shengxiantang based on network pharmacology [J]. Guid J Tradit Chin Med Pharm , 2020 , 26 ( 13 ): 114 - 118 .
WEI X , ZHANG A , YANG W , et al . Depletion of β 3 -adrenergic receptor re lieves pressure overload-induced cardiac hypertrophy and heart failure via enhancing innate immune response [J]. Biomed Pharmacother , 2021 , 143 : 112194 .
LU H I , CHUNG S Y , CHEN Y L , et al . Exendin-4 therapy still offered an additional benefit on reducing transverse aortic constriction-induced cardiac hypertrophy-caused myocardial damage in DPP-4 deficient rats [J]. Am J Transl Res , 2016 , 8 ( 2 ): 778 - 798 .
钟森杰 , 熊霞军 , 胡志希 , 等 . 基于“方证对应”理论探讨主动脉弓缩窄致心力衰竭大鼠模型的中医证型与代谢标志物 [J]. 中国实验方剂学杂志 , 2022 , 28 ( 9 ): 117 - 124 .
ZHONG S J , XIONG X J , HU Z X , et al . Exploration on syndrome types and metabolic markers of rat model with heart failure caused by transverse aortic constriction based on theory of correspondence of prescription and syndrome [J]. Chin J Exp Tradit Med Form , 2022 , 28 ( 9 ): 117 - 124 .
徐叔云 , 卞如濂 , 陈修 , 等 . 药理实验方法学 [M]. 3版 . 北京 : 人民卫生出版社 , 2002 .
XU S Y , BIAN R L , CHEN X , et al . Experimental methodology of pharmacology [M]. 3 rd edition . BeiJing : People's Medical Publishing House , 2002 .
ZIAEIAN B , FONAROW G C . Epidemiology and etiology of heart failure [J]. Nat Rev Cardiol , 2016 , 13 : 368 - 378 .
赵宇 , 袁向东 , 张远妮 , 等 . 基于结构方程模型的心力衰竭患者住院费用影响因素分析 [J]. 卫生软科学 , 2021 , 35 ( 12 ): 46 - 49,60 .
ZHAO Y , YUAN X D , ZHANG Y N , et al . Analysis of influencing factors of hospitalization expenses of patients with heart failure based on structural equation model [J]. Soft Sci Health , 2021 , 35 ( 12 ): 46 - 49,60 .
YANG Z Q , HAN Y Y , GAO F , et al . Shengxiantang protects against chronic heart failure in a rat model via energy regulation mechanisms [J]. BMC Complement Med Ther , 2023 , 23 ( 1 ): 200 .
ZANG Y , WAN J , ZHANG Z , et al . An updated role of astragalo-side Ⅳ in heart failure [J]. Biomed Pharmacother , 2020 , 126 : 110012 .
CUI L Y , MA J , ZHANG X X , et al . Astragaloside Ⅳ protects cardiac function in rats with congestive heart failure with preserved ejection fraction and its influence on myocardial microvascular inflammatory factors [J]. J Emerg Tradit Chin Med , 2022 , 31 ( 1 ): 53 - 57 .
韩晶岩 . 心气虚血瘀的科学内涵和芪参益气滴丸补气活血的作用机理 [J]. 世界科学技术—中医药现代化 , 2019 , 21 ( 2 ): 139 - 147 .
HAN J Y . The scientific connotation of heart qi deficiency and blood stasis and the mechanism of Qishen Yiqi Dropping Pills in tonifying Qi and activating blood circulation [J]. World Sci Technol Mod Tradit Chin Med , 2019 , 21 ( 2 ): 139 - 147 .
张军芳 . 芪苈强心胶囊对心力衰竭微血管损伤、心室重构及代谢重构的影响 [D]. 石家庄 : 河北医科大学 , 2013 .
ZHANG J F . Effect of Qili Qiangxin capsule on microvascular injury, ventricular remodeling and metabolic remodeling in heart failure [D]. Shijiazhuang : Hebei Medical University , 2013 .
CHEN Y Y , LIU Q S , PENG W X , et al . Effect of Yiqi Huayu decoction on microvascular injury,ventricular remodeling and metabolic remodeling in treatment of chronic heart failure patient [J]. Chin J Gener Pract , 2020 , 9 ( 18 ): 1504 - 1507 .
MITSOS S , KATSANOS K , KOLETSIS E , et al . Therapeutic angiogenesis for myocardial ischemia revisited:Basic bio-logical concepts and focus on latest clinical trials [J]. An-giogenesis , 2012 , 15 ( 1 ): 1 - 22 .
方瑾 , 黄鹤 . 内皮功能障碍在心力衰竭中的作用 [J]. 心脏杂志 , 2021 , 33 ( 2 ): 195 - 198 .
FANG J , HUANG H . Role of endothelial dysfunction in heart failure [J]. Chin Heart J , 2021 , 33 ( 2 ): 195 - 198 .
WOLF P , BECK-SICKINGER A G . The ring size of monocyclic ET-1 controls selectivity and signaling efficiency at both endothelin receptor subtypes [J]. J Pept Sci , 2021 , 27 ( 7 ): e3325 .
DU H , LI X , ZHAO W , et al . The Difference between sacubitril valsartan and valsartan on vascular endothelial function, APN, MMP-9, and BNP levels in patients with hypertension and chronic heart failure [J]. J Healthc Eng , 2022 , doi: 10.1155/2022/9494981 http://dx.doi.org/10.1155/2022/9494981 .
ZUCHI C , TRITTO I , CARLUCCIO E , et al . Role of endothelial dysfunction in heart failure [J]. Heart Fail Rev , 2020 , 25 ( 1 ): 21 - 30 .
HAN J Y , LI Q , PAN C S , et al . Effects and mechanisms of QiShenYiQi pills and major ingredients on myocardial microcirculatory disturbance,cardiac injury and fibrosis induced by ischemia-reperfusion [J]. Pharmacol Res , 2019 , 147 : 104386 .
0
浏览量
227
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621
