心肌纖維化是以細(xì)胞外基質(zhì)（ECM）中膠原纖維過(guò)量積聚、代謝失衡、膠原成分比例失調(diào)且排列紊亂為特征的一種疾病，心力衰竭會(huì)導(dǎo)致心肌纖維化發(fā)生，心肌纖維化反過(guò)來(lái)又會(huì)導(dǎo)致心肌僵硬度增加，心室肌順應(yīng)性下降，纖維化程度越嚴(yán)重，心力衰竭癥狀會(huì)越重，心肌纖維化是造成心力衰竭的重要原因，是心血管疾病發(fā)生發(fā)展的獨(dú)立危險(xiǎn)因素。臨床上改善心肌纖維化的中藥類制劑主要有益氣養(yǎng)陰類、益氣活血類、益氣溫陽(yáng)利水類3種，此類制劑可以通過(guò)調(diào)控轉(zhuǎn)化生長(zhǎng)因子β（TGF-β）信號(hào)通路、減少膠原沉積、改善線粒體能量途徑、減少氧化應(yīng)激損傷以及調(diào)節(jié)炎癥反應(yīng)等減緩或逆轉(zhuǎn)心肌纖維化進(jìn)程，對(duì)此類中藥制劑改善心肌纖維化的藥理作用及機(jī)制進(jìn)行歸納總結(jié)，為改善心肌纖維化的新藥研發(fā)及臨床合理用藥提供依據(jù)。

Myocardial fibrosis (MF) is a disease characterized by excessive accumulation of collagen fibers, metabolic imbalance, imbalance in the proportion of collagen components and disordered arrangement in the extracellular matrix (ECM), heart failure will lead to myocardial fibrosis, which in turn will lead to an increase in myocardial stiffness, a decrease in ventricular muscle compliance, and the more severe the degree of fibrosis, the more severe the symptoms of heart failure, myocardial fibrosis is an important cause of heart failure, and is an independent risk factor for the occurrence and development of cardiovascular diseases. Clinically, there are three kinds of traditional Chinese medicine preparations for improving MF: invigorating qi and nourishing yin, invigorating qi and promoting blood circulation, invigorating qi and warming yang and promoting diuresis. These preparations can slow down or reverse the process of MF by regulating transforming growth factor β (TGF-β) signal pathway, reducing collagen deposition, improving mitochondrial energy pathway, reducing oxidative stress damage and regulating inflammatory reaction. This paper summarizes the pharmacological effects and mechanisms of these traditional Chinese medicine preparations for improving MF, and provides a basis for improving new drug research and clinical rational drug use.

R285.5

天津市制造業(yè)高質(zhì)量發(fā)展專項(xiàng)資金—天津天士力之驕藥業(yè)有限公司技術(shù)中心創(chuàng)新能力建設(shè)（ZZY20232088）