经典方剂治疗心力衰竭的现代药理机制与临床应用新进展

Modern Pharmacological Mechanisms and New Clinical Application Progress of Classic Prescriptions in Treating Heart Failure

摘要: 心力衰竭是一种较为常见的循环系统疾病，严重威胁人类健康，尽管现代医学在其治疗上取得一定进展，但长期药物治疗存在诸多局限。中医药历经数千年实践，在心力衰竭治疗中逐渐凸显出独特优势。从现代药理机制来看，中药方剂作用于多个靶点和途径，通过调节神经内分泌系统，减少血管紧张素等缩血管物质生成，从而降低心脏后负荷，延缓心室重构进程，减轻心肌细胞氧化损伤，抑制心肌纤维化。在临床应用方面，经方真武汤、苓桂术甘汤等，常被用于阳虚水泛、水饮内停型心力衰竭患者，可显著改善患者水肿、呼吸困难等症状，与西药联合应用时，能减少西药用量及不良反应，提高患者生活质量。本文就经典方剂治疗心力衰竭的现代药理机制与临床应用新进展展开综述，以期为心力衰竭的临床治疗提供新思路与新方法，推动中医药在该领域的深入研究与广泛应用。

Abstract: Heart failure (HF), a common circulatory system disorder, poses a severe threat to human health. Although modern medicine has achieved certain progress in HF treatment, long-term pharmacological therapies exhibit multiple limitations. Traditional Chinese medicine (TCM), with thousands of years of clinical practice, has gradually demonstrated unique advantages in HF management. From the perspective of modern pharmacological mechanisms, TCM prescriptions act on multiple targets and pathways: they regulate the neuroendocrine system, reduce the production of vasoconstrictors such as angiotensin, thereby lowering cardiac afterload, delaying ventricular remodeling, alleviating myocardial oxidative damage, and inhibiting myocardial fibrosis. Clinically, classic prescriptions like Zhenwu Decoction and Lingguizhugan Decoction are frequently used for HF patients with yang deficiency and water retention or internal retention of fluid, significantly improving symptoms such as edema and dyspnea. When combined with Western medicine, these prescriptions can reduce the dosage and adverse reactions of Western drugs while enhancing patients’ quality of life. This review summarizes the modern pharmacological mechanisms and new clinical application progress of classic TCM prescriptions in HF treatment, aiming to provide novel insights and methods for clinical practice and promote further research and broad application of TCM in this field.