摘要
心血管疾病是一类临床常见病,其患病率与死亡率不断递增,已成为影响公共卫生健康的重大问题.瓜蒌薤白半夏汤出自《金匮要略》,最早主治胸痹之重证,全方由瓜蒌、薤白、半夏、白酒组成,临床应用广泛,有行气解郁,通阳散结,祛痰宽胸的功效.近年来,临床研究证实瓜蒌薤白半夏汤原方加减、单独应用或与西药联用治疗高脂血症、冠状动脉粥样硬化性心脏病、高血压病、心力衰竭、心律失常等心血管疾病效果显著,可有效改善疾病症状、降低患者再住院风险.基础研究表明,其作用机制包括改善血管内皮功能、抗炎、抗氧化应激、抗凋亡、抑制心室重构、调节线粒体功能、改善血液流变学、调节自噬作用、调节神经递质等.通过总结近年来相关文献,就瓜蒌薤白半夏汤组方探析、临床应用及作用机制等三方面进行文献回顾和系统综述,希望为该方治疗心血管疾病的作用机制及临床应用提供理论依据,为后续的深入研究提供思路和参考.
Abstract
Cardiovascular diseases(CVD),a group of common diseases in clinical practice,are witnessing a steady rise in both incidence and mortality rates,posing a challenge to public health.Gualou Xiebai Banxiatang,originating from Synopsis of the Golden Chamber(《金匮要略》),was initially used to treat severe cases of chest impediment.The formula consists of Trichosanthis Fructus,Allii Macrostemonis Bulbus,Pinelliae Rhizoma,and Baijiu.It has a wide range of clinical applications,with therapeutic effects including moving Qi to relieve depression,activating Yang to dissipate mass,and expelling phlegm to alleviate chest congestion.In recent years,clinical research has confirmed that Gualou Xiebai Banxiatang,with or without modification,used alone or in combination with Western medicine,has definite effects in the treatment of CVD such as hyperlipidemia,coronary atherosclerotic heart disease,hypertension,heart failure,and arrhythmia.It can alleviate disease symptoms and reduce the risk of re-hospitalization.Basic research indicates that the mechanisms of Gualou Xiebai Banxiatang include improving endothelial functions,exhibiting anti-inflammatory properties,countering oxidative stress,preventing apoptosis,inhibiting ventricular remodeling,regulating mitochondrial functions,improving hemorheology,and modulating autophagy and neurotransmitters.This article reviews relevant articles in recent years with focuses on the compatibility,clinical application,and mechanism of Gualou Xiebai Banxiatang.This review is expected to provide a theoretical basis for the mechanism research and clinical application of this formula in treating CVD and to offer ideas and reference for in-depth research.
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