持续性心房颤动合并慢性心力衰竭的中西医研究进展
Research Progress on Persistent Atrial Fibrillation Complicated with Chronic Heart Failure in Traditional Chinese and Western Medicine
DOI: 10.12677/acm.2025.15113342, PDF,   
作者: 宋兹超：黑龙江中医药大学研究生院，黑龙江 哈尔滨；耿乃志*, 彭彩亮：黑龙江中医药大学附属第一医院心血管病三科，黑龙江 哈尔滨
关键词: 持续性心房颤动；慢性心力衰竭；中西医治疗；Persistent Atrial Fibrillation； Chronic Heart Failure； Integrated Traditional Chinese and Western Medicine Treatment
摘要: 本文全面综述了持续性心房颤动合并慢性心力衰竭的相关研究，涵盖基础理论、诊断技术、治疗策略、技术进展以及争议点与未来展望等方面。在基础理论部分，阐述了持续性心房颤动的病理机制、慢性心力衰竭的病理生理学以及二者的机制联系；诊断技术介绍了现代诊断方法及中西医结合的临床应用；治疗策略探讨了西医、中医及中西医结合治疗的进展与效果；技术进展聚焦于介入治疗技术和中西医结合治疗的新技术探索；争议点与未来展望则剖析了治疗中的争议及未来研究方向。通过综合多方面研究，为该领域的进一步探索和临床实践提供全面参考。
Abstract: This article provides a comprehensive review of the research related to persistent atrial fibrillation combined with chronic heart failure, covering aspects such as basic theories, diagnostic techniques, treatment strategies, technological advancements, as well as controversial points and future prospects. In the basic theory section, it elaborates on the pathological mechanisms of persistent atrial fibrillation, the pathophysiology of chronic heart failure, and the connection between their mechanisms. The diagnostic techniques section introduces modern diagnostic methods and the clinical application of integrated traditional Chinese and Western medicine. The treatment strategies section discusses the progress and effects of Western medicine, traditional Chinese medicine, and integrated traditional Chinese and Western medicine treatments. The technological advancements section focuses on interventional treatment technologies and the exploration of new integrated traditional Chinese and Western medicine treatment techniques. The controversial points and future prospects section analyzes the controversies in treatment and future research directions. Through a comprehensive review of multiple aspects, it provides a comprehensive reference for further exploration and clinical practice in this field.
文章引用：宋兹超, 耿乃志, 彭彩亮. 持续性心房颤动合并慢性心力衰竭的中西医研究进展[J]. 临床医学进展, 2025, 15(11): 2241-2250. https://doi.org/10.12677/acm.2025.15113342

参考文献

[1] Du, X., Guo, L., Xia, S., Du, J., Anderson, C., Arima, H., et al. (2021) Atrial Fibrillation Prevalence, Awareness and Management in a Nationwide Survey of Adults in China. Heart, 107, 535-541. [Google Scholar] [CrossRef] [PubMed]
[2] Packer, D.L., Mark, D.B., Robb, R.A., et al. (2019) Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest among Patients with Atrial Fibrillation: The CABANA Randomized Clinical Trial. JAMA, 321, 1261-1274.
[3] Marrouche, N.F., Brachmann, J., Andresen, D., Siebels, J., Boersma, L., Jordaens, L., et al. (2018) Catheter Ablation for Atrial Fibrillation with Heart Failure. New England Journal of Medicine, 378, 417-427. [Google Scholar] [CrossRef] [PubMed]
[4] 中华医学会心血管病学分会, 中国医师协会心血管内科医师分会, 中国医师协会心力衰竭专业委员会, 等. 中国心力衰竭诊断和治疗指南2024 [J]. 中华心血管病杂志, 2024, 52(3): 235-275.
[5] Gurses, K.M., Yalcin, M.U., et al. (2015) Effects of Persistent Atrial Fibrillation on Serum Galectin-3 Levels. American Journal of Cardiology, 115, 647-651.
[6] Tsai, F., Chang, G., Hsu, Y., Lin, Y., Lee, Y., Chen, W., et al. (2016) Proinflammatory Gene Expression in Patients Undergoing Mitral Valve Surgery and Maze Ablation for Atrial Fibrillation. The Journal of Thoracic and Cardiovascular Surgery, 151, 1673-1682.e5. [Google Scholar] [CrossRef] [PubMed]
[7] Haissaguerre, M., Shah, A.J., Cochet, H., Hocini, M., Dubois, R., Efimov, I., et al. (2016) Intermittent Drivers Anchoring to Structural Heterogeneities as a Major Pathophysiological Mechanism of Human Persistent Atrial Fibrillation. The Journal of Physiology, 594, 2387-2398. [Google Scholar] [CrossRef] [PubMed]
[8] Zuo, K., Yin, X., Li, K., Zhang, J., Wang, P., Jiao, J., et al. (2020) Different Types of Atrial Fibrillation Share Patterns of Gut Microbiota Dysbiosis. mSphere, 5, e00071-20. [Google Scholar] [CrossRef] [PubMed]
[9] Rigolli, M., Rossi, A., Quintana, M., Klein, A.L., Yu, C., Ghio, S., et al. (2015) The Prognostic Impact of Diastolic Dysfunction in Patients with Chronic Heart Failure and Post-Acute Myocardial Infarction: Can Age-Stratified E/A Ratio Alone Predict Survival? International Journal of Cardiology, 181, 362-368. [Google Scholar] [CrossRef] [PubMed]
[10] Breidthardt, T., Cox, E.F., Squire, I., Odudu, A., Omar, N.F., Eldehni, M.T., et al. (2015) The Pathophysiology of the Chronic Cardiorenal Syndrome: A Magnetic Resonance Imaging Study. European Radiology, 25, 1684-1691. [Google Scholar] [CrossRef] [PubMed]
[11] Ohuchi, H., Negishi, J., Hayama, Y., Sasaki, O., Taniguchi, Y., Noritake, K., et al. (2015) Hyperuricemia Reflects Global Fontan Pathophysiology and Associates with Morbidity and Mortality in Patients after the Fontan Operation. International Journal of Cardiology, 184, 623-630. [Google Scholar] [CrossRef] [PubMed]
[12] Norum, H.M., Gullestad, L., Abraityte, A., Broch, K., Aakhus, S., Aukrust, P., et al. (2016) Increased Serum Levels of the Notch Ligand DLL1 Are Associated with Diastolic Dysfunction, Reduced Exercise Capacity, and Adverse Outcome in Chronic Heart Failure. Journal of Cardiac Failure, 22, 218-223. [Google Scholar] [CrossRef] [PubMed]
[13] Tsigkas, G., Apostolos, A., Despotopoulos, S., Vasilagkos, G., Kallergis, E., Leventopoulos, G., et al. (2021) Heart Failure and Atrial Fibrillation: New Concepts in Pathophysiology, Management, and Future Directions. Heart Failure Reviews, 27, 1201-1210. [Google Scholar] [CrossRef] [PubMed]
[14] Younes, H., Noujaim, C., Mekhael, M., Chouman, N., Assaf, A., Kreidieh, O., et al. (2023) Atrial Fibrillation Ablation as First-Line Therapy for Patients with Heart Failure with Reduced Ejection Fraction (HFrEF): Evaluating the Impact on Patient Survival. Expert Review of Cardiovascular Therapy, 21, 111-121. [Google Scholar] [CrossRef] [PubMed]
[15] Dixit, S., Stein, P.K., Dewland, T.A., Dukes, J.W., Vittinghoff, E., Heckbert, S.R., et al. (2016) Consumption of Caffeinated Products and Cardiac Ectopy. Journal of the American Heart Association, 5, e002503. [Google Scholar] [CrossRef] [PubMed]
[16] Gao, K., Zhao, H., Gao, J., Wen, B., Jia, C., Wang, Z., et al. (2017) Mechanism of Chinese Medicine Herbs Effects on Chronic Heart Failure Based on Metabolic Profiling. Frontiers in Pharmacology, 8, Article 864. [Google Scholar] [CrossRef] [PubMed]
[17] Zhang, Y.G., Tan, R.R., et al. (2018) New Method for Evaluating Pharmacodynamics of Traditional Chinese Medicine Compounds Based on Its Moderate Regulation and Principle of Balanced Adjustment of Immunity under Pan-Immunomic. China Journal of Chinese Materia Medica, 43, 3229-3234.
[18] Vamos, M. and Hohnloser, S.H. (2016) Amiodarone and Dronedarone: An Update. Trends in Cardiovascular Medicine, 26, 597-602.
[19] Hassan Virk, H.U., Qureshi, W.T., Makkar, N., Bastawrose, J., Souvaliotis, N., Aziz, J., et al. (2017) Short‐ and Long‐Term Clinical Predictors of Pharmacological Cardioversion of Persistent Atrial Fibrillation by Dofetilide: A Retrospective Cohort Study of 160 Patients. Clinical Cardiology, 40, 474-479. [Google Scholar] [CrossRef] [PubMed]
[20] Chierchia, G.B., Mugnai, G., et al. (2016) Incidence of Real-Time Recordings of Pulmonary Vein Potentials Using the Third-Generation Short-Tip Cryoballoon. Europace, 18, 1158-1163.
[21] Mugnai, G., de Asmundis, C., Hünük, B., Ströker, E., Moran, D., Hacioglu, E., et al. (2016) Improved Visualisation of Real-Time Recordings during Third Generation Cryoballoon Ablation: A Comparison between the Novel Short-Tip and the Second Generation Device. Journal of Interventional Cardiac Electrophysiology, 46, 307-314. [Google Scholar] [CrossRef] [PubMed]
[22] 陈婷, 陈颖, 范秀花, 等. 炙甘草汤联合美托洛尔治疗持续性心房颤动临床研究[J]. 辽宁中医药大学学报, 2018, 20(3): 163-166.
[23] 田晓婕, 顾宁, 何小丽, 等. 稳心律合剂干预心房颤动的临床研究[J]. 中西医结合心脑血管病杂志, 2018, 16(4): 458-460.
[24] 李军, 陈光, 王阶, 等. 中医药是心脏康复的新动力[J]. 中医杂志, 2018, 59(17): 1460-1464.
[25] 林小娟. 八段锦对心房纤颤经导管射频消融术后患者的临床疗效研究[D]: [硕士学位论文]. 福州: 福建中医药大学, 2020.
[26] 章文春, 钟志兵, 吉娜薇, 等. 健身气功: 易筋经对中老年人规范负荷下心率变异性的影响[J]. 中国老年学杂志, 2010, 30(4): 448-449.
[27] McMurray, J.J.V., et al. (2019) Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. The New England Journal of Medicine, 381, 1995-2008.
[28] Packer, M., et al. (2020) Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. The New England Journal of Medicine, 383, 1413-1424.
[29] Bassi, N.S., Ziaeian, B., Yancy, C.W. and Fonarow, G.C. (2020) Association of Optimal Implementation of Sodium-Glucose Cotransporter 2 Inhibitor Therapy with Outcome for Patients with Heart Failure. JAMA Cardiology, 5, 948-951. [Google Scholar] [CrossRef] [PubMed]
[30] Zhou, J., Jiang, K., Ding, X., Fu, M., Wang, S., Zhu, L., et al. (2015) Qiliqiangxin Inhibits Angiotensin II‐Induced Transdifferentiation of Rat Cardiac Fibroblasts through Suppressing Interleukin‐6. Journal of Cellular and Molecular Medicine, 19, 1114-1121. [Google Scholar] [CrossRef] [PubMed]
[31] 中国医师协会中西医结合医师分会心血管病专业委员会, 国家中医心血管病临床医学研究中心. 麝香保心丸治疗冠心病专家共识[J]. 中国中西医结合杂志, 2022, 42(7): 782-790.
[32] Lu, L., Sun, X., Chen, C., Qin, Y. and Guo, X. (2018) Shexiang Baoxin Pill, Derived from the Traditional Chinese Medicine, Provides Protective Roles against Cardiovascular Diseases. Frontiers in Pharmacology, 9, Article 1161. [Google Scholar] [CrossRef] [PubMed]
[33] Guo, H., Zhu, M., Yu, R., Li, X. and Zhao, Q. (2023) Efficacy of Chinese Traditional Patent Medicines for Heart Failure with Preserved Ejection Fraction: A Bayesian Network Meta-Analysis of 64 Randomized Controlled Trials. Frontiers in Cardiovascular Medicine, 10, Article 1255940. [Google Scholar] [CrossRef] [PubMed]
[34] 国家卫生计生委合理用药专家委员会, 中国药师协会. 心力衰竭合理用药指南(第2版) [J]. 中国医学前沿杂志(电子版), 2019, 11(7): 1-78.
[35] Wei, H., Wu, H., Yu, W., Yan, X. and Zhang, X. (2015) Shenfu Decoction as Adjuvant Therapy for Improving Quality of Life and Hepatic Dysfunction in Patients with Symptomatic Chronic Heart Failure. Journal of Ethnopharmacology, 169, 347-355. [Google Scholar] [CrossRef] [PubMed]
[36] Yao, W., Cheang, I., Liao, S., Zhou, Y., Zhou, F., Xu, D., et al. (2020) Study Protocol for a Randomized Controlled Trial: Qiliqiangxin in Heart Failure: Assessment of Reduction in Mortality (Quest). BMC Complementary Medicine and Therapies, 20, Article No. 38. [Google Scholar] [CrossRef] [PubMed]
[37] Wang, Y., Wang, J., Lv, W., Chen, H., Yang, Q., Zhang, Y., et al. (2024) Clinical Intervention Effect of Xuefu Zhuyu Decoction on Chronic Heart Failure Complicated with Depression. World Journal of Psychiatry, 14, 857-865. [Google Scholar] [CrossRef] [PubMed]
[38] Essebag, V., Boersma, L., Petru, J., et al. (2025) Acute Procedural Results of Pulsed Field Cryoablation for Persistent Atrial Fibrillation: Multicenter First-in-Human PARALELL Trial. Journal of Cardiovascular Electrophysiology, 36, 1411-1415.
[39] Ghannam, M., Jame, S., et al. (2021) Catheter Ablation of the Left and Right Atrial Appendages without Isolation in Persistent Atrial Fibrillation. Heart Rhythm, 18, 694-701.
[40] Kiuchi, K., Fukuzawa, K., Takami, M., Watanabe, Y., Izawa, Y., Shigeru, M., et al. (2021) Feasibility of Catheter Ablation in Patients with Persistent Atrial Fibrillation Guided by Fragmented Late‐Gadolinium Enhancement Areas. Journal of Cardiovascular Electrophysiology, 32, 1014-1023. [Google Scholar] [CrossRef] [PubMed]
[41] Yan, S., Liu, R., Jin, H., Liu, X., Ye, J., Shan, L., et al. (2015) “Omics” in Pharmaceutical Research: Overview, Applications, Challenges, and Future Perspectives. Chinese Journal of Natural Medicines, 13, 3-21. [Google Scholar] [CrossRef] [PubMed]
[42] Zhao, T.Y., Chen, B., Pan, X.F., Guo, Y.M. and Guo, Y. (2016) Enlightenment of Big-Data Era on Clinical Research of TCM and Acupuncture. Chinese Acupuncture & Moxibustion, 35, 938-942.
[43] Terricabras, M., Piccini, J.P. and Verma, A. (2019) Ablation of Persistent Atrial Fibrillation: Challenges and Solutions. Journal of Cardiovascular Electrophysiology, 31, 1809-1821. [Google Scholar] [CrossRef] [PubMed]
[44] Lai, H., Wu, B., Tao, Y., Ding, H., Liu, Y., Zhu, Z., et al. (2024) Exploring New Frontiers: A Rare Case of Catheter Ablation for Persistent Atrial Fibrillation in a Patient with Cor Triatriatum Sinister Guided by Intracardiac Echocardiography. Journal of Cardiothoracic Surgery, 19, Article No. 355. [Google Scholar] [CrossRef] [PubMed]
[45] Wang, H., Zhang, J., et al. (2020) Distribution of Traditional Chinese Medicine Syndromes in Type 2 Diabetes Mellitus with Chronic Heart Failure: A Clinical Study. Medicine, 99, e21091.
[46] Wang, H., Zhang, J., et al. (2020) Combination and Distribution Characteristics of Syndromes Related to Traditional Chinese Medicine in Patients with Chronic Heart Failure: Protocol for a Clinical Study. Medicine, 99, e21852.
[47] Liu, C., Hou, Y., Wang, X., Zhao, Z., Liu, Z., Zhai, J., et al. (2015) Clinical Assessment of Shenfu Injection Loading in the Treatment of Patients with Exacerbation of Chronic Heart Failure Due to Coronary Heart Disease: Study Protocol for a Randomized Controlled Trial. Trials, 16, Article No. 222. [Google Scholar] [CrossRef] [PubMed]
[48] Guo, L.J., Yuan, H., et al. (2020) A Multi-Center, Randomized, Double-Blind, Placebo-Parallel Controlled Trial for the Efficacy and Safety of Shenfuqiangxin Pills in the Treatment of Chronic Heart Failure (Heart-Kidney Yang Deficiency Syndrome). Medicine, 99, e20271.

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