文献类型：期刊文献

中文题名：中药调控巨噬细胞极化防治射血分数保留型心力衰竭研究进展

英文题名：Research Progress in Traditional Chinese Medicine Regulation of Macrophage Polarization for the Prevention and Treatment of Heart Failure with Preserved Ejection Fraction

作者：段礽妙[1];苏莹[1];翟芳芳[1];蒙占权[2]

第一作者：段礽妙

机构：[1]甘肃中医药大学中西医结合学院,甘肃兰州730000;[2]甘肃中医药大学附属医院,甘肃兰州730000

第一机构：甘肃中医药大学中西医结合学院

年份：2026

卷号：28

期号：5

起止页码：1062

中文期刊名：中国现代中药

外文期刊名：Modern Chinese Medicine

基金：兰州市科技计划项目(2024-9-95);甘肃省科技计划项目(21JR7RA583)。

语种：中文

中文关键词：巨噬细胞极化;射血分数保留型心力衰竭;心力衰竭;中药

外文关键词：macrophage polarization;heart failure with preserved ejection fraction;heart failure;traditional Chinese medicine

摘要：射血分数保留型心力衰竭(HFpEF)是临床常见心力衰竭类型,是以心室舒张性功能受损为特征的临床综合征。其因异质性高、进行性加重、合并症多、病死率高等特点,给患者带来沉重负担。其发病机制与心肌炎症、心脏纤维化、线粒体功能障碍等多种因素相关,而巨噬细胞极化失衡是关键驱动因素。巨噬细胞具有经典活化型巨噬细胞(M1型)与替代活化型巨噬细胞(M2型)2种表型,HFpEF状态下,M1/M2表型失衡可诱发心肌炎症、促进纤维化与心脏重塑、扰乱电传导稳态,进而加剧HFpEF病理进程。研究表明,中药能够多成分、多靶点调控巨噬细胞极化平衡。本文总结了巨噬细胞极化在HFpEF发生发展中的作用机制,系统归纳了中药通过调控巨噬细胞极化、平衡M1/M2表型,靶向干预转化生长因子-β1(TGF-β1)/Smads、磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)等关键信号通路,进而发挥抗炎、抗纤维化、改善心脏功能的核心作用,为中医药防治HFpEF提供了新思路与理论支撑。
Heart failure with preserved ejection fraction(HFpEF)is a clinically prevalent form of heart failure,characterized by impaired ventricular diastolic function.Its high heterogeneity,progressive worsening,multiple comorbidities,and high mortality rate impose a heavy burden on patients.Its pathogenesis involves multiple mechanisms including myocardial inflammation,cardiac fibrosis,and mitochondrial dysfunction,with dysregulated macrophage polarization serving as a key driver.Macrophages exhibit two phenotypes:classically activated macrophages(M1 type)and alternatively activated macrophages(M2 type).In HFpEF,M1/M2 imbalance induces myocardial inflammation,promotes fibrosis and cardiac remodeling,and disrupts electrical conduction homeostasis,thereby exacerbating the pathological progression of HFpEF.Research indicates that traditional Chinese medicine(TCM)can modulate macrophage polarization balance through multi-component,multi-target mechanisms.This article summarizes the mechanisms of macrophage polarization in the pathogenesis of HFpEF.It systematically outlines how TCM exerts its core anti-inflammatory,antifibrotic,and cardiac function-improving effects by regulating macrophage polarization and balancing M1/M2 phenotypes via the transforming growth factor-β1/Smad(TGF-β1/Smads)signaling pathway and the phosphoinositide 3-kinase/protein kinase B(PI3K/Akt)signaling pathway.This provides novel insights and theoretical support for the application of TCM in the prevention and treatment of HFpEF.