射血分数保留型心力衰竭和肠道菌群中西医研究进展
Research Advances on Heart Failure with Preserved Ejection Fraction and Gut Microbiota in Traditional Chinese and Western Medicine
DOI: 10.12677/jcpm.2025.43346, PDF,   
作者: 张虎啸, 张 纯, 张雯慧：黑龙江中医药大学研究生院，黑龙江 哈尔滨；窦金金*：黑龙江中医药大学附属第四医院心内一，黑龙江 哈尔滨
关键词: 心力衰竭；射血分数保留型；中西医；中药；肠道菌群；Heart Failure； Heart Failure with Preserved Ejection Fraction (HFpEF)； Integrated Chinese-Western Medicine； Traditional Chinese Medicine； Gut Microbiota
摘要: 射血分数保留型心力衰竭(HFpEF)是一种以心脏舒张功能障碍为核心的复杂疾病，其发病与NO-sGC-cGMP-PKG通路失调、慢性炎症及代谢紊乱密切相关。近年研究发现，HFpEF患者存在显著肠道菌群紊乱，表现为产短链脂肪酸菌属(如丁酸球菌)丰度降低，促炎菌属(如肠球菌)增殖，伴随菌群代谢产物SCFAs减少、TMAO升高等特征，通过“肠–心轴”加剧全身炎症和心肌纤维化。中西医在菌群调节机制上均可通过恢复菌群稳态、调节肠屏障、缓解全身炎症等改善HFpEF病理进程。本文就中西医对HFpEF当前研究及治疗手段进行综述，以期为后续HFpEF中西医结合治疗及机制探索提供思路。
Abstract: Heart failure with preserved ejection fraction (HFpEF) is a complex disorder characterized by diastolic dysfunction, closely associated with dysregulation of the NO-sGC-cGMP-PKG signaling pathway, chronic inflammation, and metabolic disturbances. Recent studies have identified significant gut microbiota dysbiosis in HFpEF patients, marked by reduced abundance of short-chain fatty acid (SCFA)-producing genera (e.g., Faecalibacterium), proliferation of pro-inflammatory bacteria (e.g., Enterococcus), decreased SCFA levels, and elevated trimethylamine N-oxide (TMAO). These alterations exacerbate systemic inflammation and myocardial fibrosis through the gut-heart axis. Both Traditional Chinese Medicine (TCM) and Western medicine demonstrate therapeutic potential by restoring microbial homeostasis, modulating intestinal barrier function, and alleviating systemic inflammation to mitigate HFpEF progression. This review synthesizes current research and therapeutic strategies targeting HFpEF in TCM and Western medicine, aiming to provide insights for future integrative treatment approaches and mechanistic exploration.
文章引用：张虎啸, 张纯, 张雯慧, 窦金金. 射血分数保留型心力衰竭和肠道菌群中西医研究进展[J]. 临床个性化医学, 2025, 4(3): 295-306. https://doi.org/10.12677/jcpm.2025.43346

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