冠心病通常是指冠状动脉粥样硬化性心脏病,主要由冠状动脉血管发生粥样硬化性病变而导致血管腔狭窄或阻塞,进而引发心肌组织缺血、缺氧或坏死的心脏病,并且随着患者病情的加重,心脏功能会持续降低,最终引发慢性心力衰竭症状,对患者的生活质量和生命安全均造成负面影响[1].既往,西医对于该疾病的治疗多从强心、利尿和扩张血管的方面入手,以改善患者短期内血流动力学,延缓心室重构为目的,达到提高患者生活质量,降低住院率和病死率的长期作用[2].近年来,随着血管紧张素受体-脑啡肽酶抑制剂在临床的广泛应用,慢性心力衰竭的治疗达到一个重要的新里程碑式的阶段;但上述策略在临床实践的过程中仍或多或少存在一定局限性,部分患者在治疗后依旧存在心衰急性发作或者在出院的情况,不利于患者的预后转归[3].然而随着现代中医对冠心病慢性心力衰竭患者研究的不断深入,对其认知的不断提高,使得中医药在该疾病的治疗上可以取得令人满意的效果,其中以中药方剂在临床应用最为频繁,可以发挥随证加减的作用[4].现本文以芪附强心汤为例,观察该方剂在冠心病慢性心力衰竭患者中的应用进展.

Objective: In traditional Chinese medicine, the herbal pair, Radix Achyranthis Bidentatae (RAB) and Eucommiae Cortex (EC), is widely used to treat osteoporosis. Herein, we determined whether this herbal pair can be used to ameliorate glucocorticoid (GC)-induced osteoporosis (GIOP) and find its optimal dosage in zebrafish. Methods: The characteristics of the aqueous extract of RAB and EC were separately characterized using high-performance liquid chromatography. Osteoporosis was induced in 5-day post-fertilization zebrafish larvae by exposing them to 10 mu mol/L dexamethasone (Dex) for 96 h. Seven combinations of different ratios of RAB and EC were co-administered. Treatment efficacy was determined by calculating zebrafish vertebral area and sum brightness, via alizarin red staining, and by detecting alkaline phosphatase (ALP) activity. Multiple regression analysis was conducted to test the optimal dosage ratio. Results: According to the Chinese Pharmacopoeia (2015), beta-ecdysone (beta-Ecd) is a major bioactive marker in RAB extract, while pinoresinol diglucoside (PDG) is the major marker in EC extract. Both of beta-Ecd and PDG content values aligned with the Chinese Pharmacopoeia standards. Treatment with 10 mu mol/L Dex reduced zebrafish vertebral area, sum brightness, and ALP activity, but RAB and EC attenuated these effects. Combining 50 mu g/mL RAB and 50 mu g/mL EC was optimal for preventing GIOP in zebrafish. Reverse transcription-quantitative polymerase chain reaction was used to evaluate the mRNA expression of osteogenesis-related genes. A treatment of 10 mu mol/L Dex decreased runt-related transcription factor 2 (Runx2), osteogenic protein-1 (OP-1), bone gamma-carboxyglutamic acid-containing protein (BGLAP), and beta-catenin levels. This effect was counteracted by RAB and EC co-treatment (P < 0.05). Additionally, the effect of using the two herbal extracts together was better than single-herb treatments separately. These results demonstrated that RAB and EC preserve osteoblast function in the presence of GC. The best mass ratio was 1:1. Conclusion: RAB and EC herbal pair could ameliorate GC-induced effects in zebrafish, with 1:1 as the optimal dosage ratio. (C) 2022 Shanghai Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. Published by Elsevier B.V. All rights reserved.

心衰是当今社会严重危害人类健康的一种复杂的临床综合征,其致病原因和作用机制复杂,为了更加深入地探索其发病机制和干预途径,需要选择和建立适合的动物模型.通过查阅近几年国内外文献,本文综述了常见的心衰动物模型建模方法及优缺点比较.各种模型有其自身的特点和优势,为今后在心衰模型选择方面提供参考.