中医技术治疗心肌肥厚炎症损伤作用机制的研究进展
Research Progress on the Mechanism of TCM Technology in the Treatment of Myocardial Hypertrophy and Inflammatory Injury
DOI: 10.12677/acm.2025.1541219, PDF,   
作者: 师向森：黑龙江中医药大学研究生学院，黑龙江 哈尔滨；聂 宏*：黑龙江中医药大学附属第一医院营养科，黑龙江 哈尔滨
关键词: 心肌肥厚；炎症；中医技术；机制；Myocardial Hypertrophy； Inflammation； TCM Technology； Mechanism
摘要: 心肌肥厚是为维持正常的心输出量的一种代偿性反应，其具体发病机制目前尚未明确，但有报告显示心肌肥厚发病率逐年增高且严重影响患者的机体功能和生活质量。因此，对于心肌肥厚的改善和治疗成了重中之重的问题，亟待解决。炎症是心肌肥厚的发病机制之一，且贯穿心肌代偿的整个过程。针灸作为重要的治疗手段，对于调节改善炎症状态疗效显著。本文就针刺治疗心肌肥厚的可能机制进行了综述，为相关治疗提供了理论依据。
Abstract: Myocardial hypertrophy is a compensatory response to the maintenance of normal cardiac output, and its specific pathogenesis is not yet clear, but it has been reported that the incidence of myocardial hypertrophy is increasing year by year and seriously affects the function and quality of life of patients. Therefore, the improvement and treatment of myocardial hypertrophy has become a top priority and needs to be solved urgently. Inflammation is one of the pathogeneses of myocardial hypertrophy and runs through the entire process of myocardial compensation. As an important treatment method, acupuncture has a significant effect on regulating and improving inflammatory states. This article reviews the possible mechanisms of acupuncture in the treatment of myocardial hypertrophy, and provides a theoretical basis for related treatments.
文章引用：师向森, 聂宏. 中医技术治疗心肌肥厚炎症损伤作用机制的研究进展[J]. 临床医学进展, 2025, 15(4): 2605-2612. https://doi.org/10.12677/acm.2025.1541219

参考文献

[1] Giamouzis, G., Dimos, A., Xanthopoulos, A., Skoularigis, J. and Triposkiadis, F. (2021) Left Ventricular Hypertrophy and Sudden Cardiac Death. Heart Failure Reviews, 27, 711-724. [Google Scholar] [CrossRef] [PubMed]
[2] 张德玉, 王菲, 高岩岩. 线粒体翻译延伸因子Ts对心肌肥大的作用及机制[J]. 青岛大学学报(医学版), 2023, 59(3): 401-406.
[3] Oldfield, C.J., Duhamel, T.A. and Dhalla, N.S. (2020) Mechanisms for the Transition from Physiological to Pathological Cardiac Hypertrophy. Canadian Journal of Physiology and Pharmacology, 98, 74-84. [Google Scholar] [CrossRef] [PubMed]
[4] 宋潇君, 张亚娟, 周新丽. 肥胖相关性心肌肥厚的分子机制研究进展[J]. 老年医学研究, 2023, 4(2): 64-69.
[5] 何德全, 陈友权, 王世祥. 丹参酮ⅡA通过调节PI3K/AKT通路对异丙肾上腺素诱导的大鼠心肌肥厚及纤维化的影响[J]. 中国循证心血管医学杂志, 2022, 14(7): 811-815.
[6] 《中国心血管健康与疾病报告2022》编写组. 《中国心血管健康与疾病报告2022》要点解读[J]. 中国心血管杂志, 2023, 28(4): 297-312.
[7] Frieler, R.A. and Mortensen, R.M. (2015) Immune Cell and Other Noncardiomyocyte Regulation of Cardiac Hypertrophy and Remodeling. Circulation, 131, 1019-1030. [Google Scholar] [CrossRef] [PubMed]
[8] 吴青青. OX40通过影响CD4+T淋巴细胞功能参与调节心肌重构[D]: [博士学位论文]. 武汉: 武汉大学, 2016.
[9] 张淼, 王文君, 祝鹏宇, 郭颖, 李书霖. 针刺内关穴对心肌肥厚小鼠心肌组织超微结构的影响[J]. 上海针灸杂志, 2016, 35(5): 588-591.
[10] Kamo, T., Akazawa, H. and Komuro, I. (2015) Cardiac Nonmyocytes in the Hub of Cardiac Hypertrophy. Circulation Research, 117, 89-98. [Google Scholar] [CrossRef] [PubMed]
[11] Kim, P.K. and Deutschman, C.S. (2000) Inflammatory Responses and Mediators. Surgical Clinics of North America, 80, 885-894. [Google Scholar] [CrossRef] [PubMed]
[12] Kadomoto, S., Izumi, K. and Mizokami, A. (2021) Macrophage Polarity and Disease Control. International Journal of Molecular Sciences, 23, Article 144. [Google Scholar] [CrossRef] [PubMed]
[13] Shapouri‐Moghaddam, A., Mohammadian, S., Vazini, H., Taghadosi, M., Esmaeili, S., Mardani, F., et al. (2018) Macrophage Plasticity, Polarization, and Function in Health and Disease. Journal of Cellular Physiology, 233, 6425-6440. [Google Scholar] [CrossRef] [PubMed]
[14] Liu, L., Zhao, Q., Kong, M., Mao, L., Yang, Y. and Xu, Y. (2021) Myocardin-Related Transcription Factor a Regulates Integrin Beta 2 Transcription to Promote Macrophage Infiltration and Cardiac Hypertrophy in Mice. Cardiovascular Research, 118, 844-858. [Google Scholar] [CrossRef] [PubMed]
[15] Lafuse, W.P., Wozniak, D.J. and Rajaram, M.V.S. (2020) Role of Cardiac Macrophages on Cardiac Inflammation, Fibrosis and Tissue Repair. Cells, 10, Article 51. [Google Scholar] [CrossRef] [PubMed]
[16] Opal, S.M. and DePalo, V.A. (2000) Anti-Inflammatory Cytokines. Chest, 117, 1162-1172. [Google Scholar] [CrossRef] [PubMed]
[17] 王瑞琦, 李礼, 孟维媛, 等. 针刺预处理心脑同护的机制和优势探讨[J]. 针灸临床杂志, 2023, 39(8): 104-111.
[18] 李书霖. 针刺内关穴逆转ISO诱导小鼠心肌肥厚的研究[D]: [博士学位论文]. 哈尔滨: 黑龙江中医药大学, 2016.
[19] 巴特, 王泽然, 孙楷航, 等. 免疫-炎症反应在针刺治疗高血压中的机制探析[J]. 针灸临床杂志, 2023, 39(10): 96-101.
[20] 吴松, 王华, 李佳, 等. 电针不同穴位对心肌肥厚模型大鼠炎症细胞因子的比较研究[J]. 中华中医药学刊, 2012, 30(2): 260-262.
[21] 苏杭. 基于“心与小肠相表里”研究原络配穴电针减轻急性胰腺炎大鼠心肌损伤的机理[D]: [硕士学位论文]. 成都: 成都中医药大学, 2018.
[22] 王文君. 针刺预处理内关穴对ISO诱导心肌肥厚小鼠心肌组织病理学及超微结构的影响[D]: [硕士学位论文]. 哈尔滨: 黑龙江中医药大学, 2016.
[23] 治丁铭, 刘岩, 赵鸿飞, 等. 针刺对大鼠心肌组织细胞因子的影响[J]. 中国老年学杂志, 2016, 36(1): 19-21.
[24] 李佳莘, 朱晓雨, 鲁美丽, 等. 电针与黄芪甲苷结合对大鼠心肌纤维化的影响[J]. 针刺研究, 2017, 42(6): 477-481
[25] Hayden, M.S. and Ghosh, S. (2008) Shared Principles in NF-κB Signaling. Cell, 132, 344-362. [Google Scholar] [CrossRef] [PubMed]
[26] Yu, H., Lin, L., Zhang, Z., Zhang, H. and Hu, H. (2020) Targeting NF-κB Pathway for the Therapy of Diseases: Mechanism and Clinical Study. Signal Transduction and Targeted Therapy, 5, Article No. 209. [Google Scholar] [CrossRef] [PubMed]
[27] Chen, Y., Yang, B., Stanton, C., Ross, R.P., Zhao, J., Zhang, H., et al. (2021) Bifidobacterium pseudocatenulatum Ameliorates DSS-Induced Colitis by Maintaining Intestinal Mechanical Barrier, Blocking Proinflammatory Cytokines, Inhibiting TLR4/NF-κB Signaling, and Altering Gut Microbiota. Journal of Agricultural and Food Chemistry, 69, 1496-1512. [Google Scholar] [CrossRef] [PubMed]
[28] 游琼, 吴铿, 涂焰明, 等. 柚皮苷调控心肌核因子NF-κB炎症信号通路对糖尿病心肌病大鼠防治作用[J]. 中国免疫学杂志, 2013, 29(2): 121-124.
[29] 耿欢, 罗振东, 孙芳园, 等. 电针足三里减轻脓毒症模型大鼠心肌损伤的作用机制[J]. 中国组织工程研究, 2022, 26(35): 5614-5619.
[30] 王军蒙, 袁璟, 蔡云, 等. 电针对急性心肌缺血模型小鼠心肌组织中炎性反应的影响[J]. 中国针灸, 2018, 38(5): 513-518.
[31] 吴嘉宏, 孙珂, 卢圣锋, 等. 电针预处理对急性心肌缺血大鼠心肌瞬时受体电位亚型1/降钙素基因相关肽信号及核因子-κB亚型p65蛋白表达的影响[J]. 针刺研究, 2021, 46(1): 58-63.
[32] 朱怡, 李毅, 张楠, 等. 电针预处理对心肌缺血再灌注损伤大鼠“内关”穴区Toll样受体4、髓样分化因子88及核转录因子-κB基因表达的影响[J]. 针刺研究, 2018, 43(5): 302-306, 329.
[33] Franchi, L., Eigenbrod, T., Muñoz-Planillo, R. and Nuñez, G. (2009) The Inflammasome: A Caspase-1-Activation Platform That Regulates Immune Responses and Disease Pathogenesis. Nature Immunology, 10, 241-247. [Google Scholar] [CrossRef] [PubMed]
[34] Fu, J. and Wu, H. (2023) Structural Mechanisms of NLRP3 Inflammasome Assembly and Activation. Annual Review of Immunology, 41, 301-316. [Google Scholar] [CrossRef] [PubMed]
[35] Zheng, Y., Xu, L., Dong, N. and Li, F. (2022) NLRP3 Inflammasome: The Rising Star in Cardiovascular Diseases. Frontiers in Cardiovascular Medicine, 9, Article 927061. [Google Scholar] [CrossRef] [PubMed]
[36] 蔡昀潞. NF-κB/NLRP3信号通路在针刺高血压合并肥胖大鼠心肌细胞炎症中的作用[D]: [硕士学位论文]. 沈阳: 辽宁中医药大学, 2022.
[37] 张涛. 电针预处理对心肌缺血小鼠NLRP3炎性体活化和巨噬细胞极化的影响[D]: [硕士学位论文]. 南京: 南京中医药大学, 2021.
[38] 曹济民. 自主神经、炎症与心脏疾病[C]//中国生理学会. 2019中国生理学会学术年会暨张锡钧基金第十五届全国青年优秀生理学学术论文交流会及第十三届全国青年生理学工作者学术会议论文摘要. 2019: 108-109.
[39] Woodburn, S.C., Bollinger, J.L. and Wohleb, E.S. (2021) The Semantics of Microglia Activation: Neuroinflammation, Homeostasis, and Stress. Journal of Neuroinflammation, 18, Article No. 258. [Google Scholar] [CrossRef] [PubMed]
[40] Xia, W., Xu, M., Yu, X., Du, M., Li, X., Yang, T., et al. (2020) Antihypertensive Effects of Exercise Involve Reshaping of Gut Microbiota and Improvement of Gut-Brain Axis in Spontaneously Hypertensive Rat. Gut Microbes, 13, 1-24. [Google Scholar] [CrossRef] [PubMed]
[41] Li, N., Guo, Y., Gong, Y., Zhang, Y., Fan, W., Yao, K., et al. (2021) The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation. Journal of Inflammation Research, 14, 7191-7224. [Google Scholar] [CrossRef] [PubMed]
[42] Wang, M., Pan, W., Xu, Y., Zhang, J., Wan, J. and Jiang, H. (2022) Microglia-Mediated Neuroinflammation: A Potential Target for the Treatment of Cardiovascular Diseases. Journal of Inflammation Research, 15, 3083-3094. [Google Scholar] [CrossRef] [PubMed]
[43] Wang, L., Yang, J., Lin, L., Huang, J., Wang, X., Su, X., et al. (2020) Acupuncture Attenuates Inflammation in Microglia of Vascular Dementia Rats by Inhibiting miR-93-Mediated TLR4/Myd88/NF-κB Signaling Pathway. Oxidative Medicine and Cellular Longevity, 2020, Article ID: 8253904. [Google Scholar] [CrossRef] [PubMed]
[44] Sun, L., Yong, Y., Wei, P., Wang, Y., Li, H., Zhou, Y., et al. (2021) Electroacupuncture Ameliorates Postoperative Cognitive Dysfunction and Associated Neuroinflammation via NLRP3 Signal Inhibition in Aged Mice. CNS Neuroscience & Therapeutics, 28, 390-400. [Google Scholar] [CrossRef] [PubMed]
[45] 王喜文, 郑佳, 汤漾, 等. 肠道菌群及其代谢产物对心肌纤维化影响与治疗的研究进展[J]. 微生物学报, 2023, 63(9): 3464-3481.
[46] Li, N., Durgan, D.J. and Wehrens, X.H.T. (2021) Gut Microbiota: A Key Regulator of Ageing-Associated Atrial Fibrillation? Cardiovascular Research, 118, 657-659. [Google Scholar] [CrossRef] [PubMed]
[47] Nogal, A., Valdes, A.M. and Menni, C. (2021) The Role of Short-Chain Fatty Acids in the Interplay between Gut Microbiota and Diet in Cardio-Metabolic Health. Gut Microbes, 13, Article 1897212. [Google Scholar] [CrossRef] [PubMed]
[48] Katsimichas, T., Ohtani, T., Motooka, D., Tsukamoto, Y., Kioka, H., Nakamoto, K., et al. (2018) Non-Ischemic Heart Failure with Reduced Ejection Fraction Is Associated with Altered Intestinal Microbiota. Circulation Journal, 82, 1640-1650. [Google Scholar] [CrossRef] [PubMed]
[49] 赵晟羽, 刘敉霖, 闫纪蓉, 等. 心力衰竭与肠道菌群及其代谢产物的研究进展[J]. 中西医结合心脑血管病杂志, 2023, 21(23): 4358-4362.
[50] Bai, H., Gu, R., Chen, L., Qian, Y., Yu, M., Xu, S., et al. (2021) Electroacupuncture Interventions Alleviates Myocardial Ischemia Reperfusion Injury through Regulating Gut Microbiota in Rats. Microvascular Research, 138, Article 104235. [Google Scholar] [CrossRef] [PubMed]
[51] 殷瑀. 针刺内关穴对异丙肾上腺素诱导心肌肥厚小鼠心脏保护作用的研究[D]: [硕士学位论文]. 哈尔滨: 黑龙江中医药大学, 2019.
[52] Lu, S., Wang, J., Yuan, J., Yang, W., Chen, L., Zhang, T., et al. (2021) Electroacupuncture Improves Cardiac Function and Reduces Infarct Size by Modulating Cardiac Autonomic Remodeling in a Mouse Model of Myocardial Ischemia. Acupuncture in Medicine, 39, 681-690. [Google Scholar] [CrossRef] [PubMed]
[53] 王辰庚, 兰闻禹, 赵鑫宇, 等. 针刺“内关”穴治疗心肌肥厚作用机制的研究进展[J]. 中国医药导报, 2024, 21(5): 28-31, 60.

为你推荐