Kev tshawb fawb soj ntsuam kev nce qib ntawm ischemic plawv tsis ua hauj lwm thiab kev cia siab ntawm cov tshuaj suav tshuaj
Mar 15, 2022
Hu rau: Audrey Hu Whatsapp / hp: 0086 13880143964 Email:audrey.hu@wecistanche.com
Qhov tseem ceeb
Raws li feem ntau hom ntawmplawv tsis ua hauj lwm, qhov mob ntawmischemic plawv tsis ua hauj lwmyog nce xyoo los ntawm xyoo. Txawm hais tias cov kws kho mob muab qhov tseem ceeb rau txoj kev tshawb fawb ntawm ischemic plawv tsis ua hauj lwm, kev kho mob thiab kev kuaj mob ntawm ischemic plawv tsis ua hauj lwm tseem tseem tsis muaj kev cuam tshuam thiab cuam tshuam. Hauv tsab xov xwm no, peb yuav piav qhia qee qhov kev tshawb fawb soj ntsuam ntawm ischemic plawv tsis ua haujlwm nyob rau xyoo tas los no, suav nrog kev kuaj mob thiab kev kho mob. Peb kuj tseem yuav qhia txog kev nce qib thiab qhov tshwj xeeb zeem muag ntawm Cov Tshuaj Kho Mob Suav hauv kev kho tus kab mob no.
Abstract
Raws li ib qho ntawm feem ntau hom ntawmplawv tsis ua hauj lwm, kev kuaj mob, thiab kev kho mob ntawm Ischemic plawv tsis ua hauj lwm yog lub ntsiab tseem ceeb ntawm lub tsev kho mob. Nyob rau hauv xyoo tas los no, cov kev tshawb fawb ntawm biomarkers tau muab kev txhawb nqa rau kev kuaj mob, kev ntsuas kev ntsuas, thiab stratification. Kev siv tshuaj kho mob tshiab thiab kev txhim kho cov kev kho mob tsis yog tshuaj tau coj ntau txoj kev xaiv hauv kev kho cov pa. Nyob rau tib lub sijhawm, nyob rau hauv kev taw qhia ntawm Traditional Chinese Medicine Syndrome sib txawv txoj kev xav, Kev Kho Mob Suav Tshuaj tseem ua lub luag haujlwm tseem ceeb thiab qhia nws txoj kev cia siab dav.
Ntsiab lus: Ischemic Heart Failure, Diagnosis, Treatment, Traditional Chinese Medicine
Cov teebmeem ntawm cistanche: Tiv thaiv ISCHEMIA INJURY
Keeb kwm
Lub plawv tsis ua hauj lwm(HF) yog theem kawg ntawm kab mob plawv. Lub systolic thiab (lossis) diastolic tsis ua haujlwm ntawm lub plawv ua rau muaj zog intracardiac siab thiab txo qis ntawm lub plawv. HF feem ntau tshwm sim hauv cov tsos mob ua ke ntawm pulmonary congestion thiab vena cava congestion. Lub ntiaj teb no tshwm sim ntawm lub plawv tsis ua hauj lwm tseem loj hlob txhua txhua xyoo. Hauv cov teb chaws tsim kho, qhov feem pua ntawm cov neeg laus muaj tus kab mob yog 1 feem pua -2 feem pua. Lub hli 12-hli tag nrho-ua rau kev tuag ntawm cov neeg mob hauv tsev kho mob yog 17 feem pua thiab 12- hli rehospitalization tus nqi yog 44 feem pua [1]. HF yog ib qho tseem ceeb rau kev tuag ntawm cov neeg mob uas muaj kab mob plawv.
Ischemic plawv tsis ua hauj lwm(IHF) yog hom HF tshaj plaws hauv ntiaj teb [2]. Hauv 2016 ESC cov lus qhia, IHF tau muab cais ua HF nrog rau sab laug ventricular ejection feem (LVEF) < 40="" feem="" pua="" nrog="" kev="" hloov="" mus="" sij="" hawm="" ntev="" myocardial="" ischemic.="" kab="" lus="" no="" yuav="" tham="" txog="" kev="" nce="" qib="" ntawm="" kev="" tshawb="" fawb="" soj="" ntsuam="" thiab="" kev="" cia="" siab="" ntawm="" tcm="" hauv="" cov="" ntsiab="" lus="" ntawm="" cov="" ntsiab="" lus="" tseem="" ceeb="" ntawm="">
Eua ffects ntawm cistanche: Tiv thaiv lub plawv tsis ua hauj lwm
Biomarkers
B-type natriuretic peptide (BNP)
BNP raws li ib tug natural hormone synthesized los ntawm lub plawv myocytes tau zoo tswj lub plawv muaj nuj nqi thiab yuav siv tau raws li ib tug quantitative marker ntawm HF. Ntau qhov kev tshawb fawb tau taw qhia tias BNP thiab nws cov precursor NT-proBNP tau nce siab hauv cov neeg mob IHF raws li qhov ntsuas ntawm lub plawv kev ntxhov siab [3,4], uas qhia tias BNP, NT-proBNP yog qhov tseem ceeb los txhawb kev kuaj mob ntawm IHF. Txawm li cas los xij, raws li kev sim tsis ntev los no ua los ntawm Zheng li al, qib NT-proBNP thaum ntxov tau pom tias yog qhov txo qis hauv cov neeg mob uas mob IHF, thiab NT-proBNP qib hauv cov neeg mob IHF tau qis dua cov neeg mob uas tsis yog IHF [5 ]. Kev tsim kho ntxiv yog xav tau los tshawb txog cov laj thawj ntawm qhov tsis sib xws nrog cov ntawv tshaj tawm dhau los, tab sis ob qho tib si qhia tau hais tias BNP qib tuaj yeem pab txo qis tus nqi ntawm kev kuaj mob tsis zoo ntawm ischemic etiology.
Lub plawv troponin (cTn)
cTn yog ib qho kev tswj hwm cov protein ntawm myocardial nqaij contraction, suav nrog cTnT, cTnI, thiab cTnC, feem. Nws cov concentration yog qhov zoo sib xws nrog cov naj npawb ntawm myocardial cell necrosis. Vim tias qhov kev tshawb pom qis ntawm cov pa cTNT, qhov siab-rhiab heev plawv troponin (hs-cTn) tuaj yeem siv rau kev tshawb nrhiav. Cov kev tshawb fawb tau ua pov thawj tias qib hs-cTn hauv cov neeg mob IHF siab dua qhov tsis yog-ischemic [6], yog li hs-cTn tuaj yeem siv rau hauv kev kho mob ua tus cim rau kev kuaj mob ntawm IHF. Kev loj hlob txawv qhov sib txawv-15 (GDF-15) GDF-15 yog tus yam ntxwv tseem ceeb hauv kev teb rau kev raug mob ntxhov siab. Qib ntawm cov ntshav qab zib GDF-15 tuaj yeem nce ntxiv hauv cov neeg mob HF [7]. Kev soj ntsuam kuaj pom pom tias cov ntshav GDF-15 qib hauv cov neeg mob uas muaj ischemic cardiomyopathy tau nce siab dua li cov neeg mob uas muaj mob cardiomyopathy [8]. Qhov tshwm sim qhia tau hais tias theem ntawm GDF-15 tuaj yeem muab cov ntaub ntawv siv rau kev txiav txim rau qhov ua rau HF, uas yooj yim rau kev kuaj mob ntxov ntawm IHF.
Cystatin C
Cystatin C yog cov protein uas feem ntau yog siv los ua cov cim ntawm lub raum ua haujlwm. Kev sim tshuaj ntsuam xyuas tau ua pov thawj tias cystatin C qib tuaj yeem cuam tshuam me me lossis subclinical lub raum tsis ua haujlwm hauv cov neeg mob IHF thiab tuaj yeem siv los ntsuas glomerular filtration function thaum ntxov [9]. Yog li, serum cystatin C muaj qhov kev kuaj mob siv tus nqi hauv kev ntsuas qhov kev ntsuas luv luv ntawm IHF.
Eua ffects ntawm cistanche ntxiv: txhim kho kev tiv thaiv
Western tshuaj kho mob
Tshuaj
Cov tshuaj ntawm IHF yog qhov pib zoo ib yam li lwm hom kev kho HF raws li kev kho mob (Table 1), tab sis muaj cov ntsiab lus tshwj xeeb raws li lub plawv tsis ua hauj lwm nrog txo ejection feem (HFrEF) hauv kev xaiv thiab siv.
-receptor blocker -receptor blocker tau lees paub tias yog tus neeg sawv cev ntxiv rau angiotensin-hloov enzyme inhibitor (ACEI) thiab tuaj yeem siv rau cov neeg mob HFrEF uas tseem muaj cov tsos mob tom qab ACEI. Cov kev tshawb fawb tau qhia tias vim hais tias -receptor blocker tuaj yeem ua rau lub plawv dhia qeeb thiab txhim kho arrhythmia, kev siv cov -receptor blockers hauv HFrEF cov neeg mob nrog lub qhov ntswg atherosclerosis tuaj yeem txo qhov kev tuag tag nrho [10].
Aldosterone receptor antagonists Spironolactone thiab eplerenone yog thawj thiab thib ob tiam aldosterone receptor, antagonists. Kev tshawb fawb soj ntsuam los ntawm Zannad thiab al tau qhia tias eplerenone lossis spironolactone tuaj yeem siv los kho txhua tus neeg mob HFrEF, suav nrog cov neeg mob IHF, nrog rau cov neeg mob HF uas siv ACEI thiab -receptor blocker tab sis tseem muaj cov tsos mob thiab nws LVEF tsawg dua 35 feem pua. . Kev siv cov aldosterone receptor antagonist tau txo qis tus nqi kho mob thiab kev tuag [11].
Angiotensin receptor enkephalinase inhibitor (ARNI) Cov npe tshuaj nrov, uas tau kawm nyob rau xyoo tas los no, yog ib qho chaw tshiab uas khi rau angiotensin receptor blocker (valsartan) thiab enkephalinase inhibitor (Shakuba) los ua ntawm ob lub hom phiaj. ARNI tuaj yeem siv rau qhov chaw ntawm ACEI lossis ARB txhawm rau txo qis kev mob thiab kev tuag ntawm cov neeg mob uas muaj peev xwm zam tau ACEI lossis ARB lossis tag nrho HFrEF [12]. Kev nyab xeeb mus ntev ntawm cov tshuaj tseem yuav tsum tau lees paub.
Cov tshuaj inotropic zoo tuaj yeem txhim kho myocardial contraction thiab myocardial perfusion, txhim kho kev ua haujlwm plawv thiab txo qis kev tuag. Cov txiaj ntsig ntawm COSMIC-HF txoj kev tshawb fawb tau taw qhia tias lub plawv myosin activator, raws li cov tshuaj inotropic tshiab, tuaj yeem txhim kho LVEF, txo lub plawv dhia thiab NT-pro BNP qib hauv cov neeg mob HFrEF, thiab muaj kev nyab xeeb thiab ua siab ntev [13]. Nws tuaj yeem muab qhov kev xaiv tshiab rau kev kho mob ntawm IHF yav tom ntej.
Lwm yam Trimetazidine, ib qho tshuaj nquag siv rau kev kho mob ntawm IHF, tuaj yeem txhim kho myocardial contractility thiab txhim kho sab laug ventricular muaj nuj nqi. Kev tshawb fawb tam sim no tau lees paub tias trimetazidine tsuas yog siv tau rau hauv kev kho mob ntawm IHF, thiab tsis muaj kev cuam tshuam loj rau cov txiaj ntsig ntawm cov tsis-IHF [14].
Revascularization
Coronary artery bypass grafting (CABG) CABG yog ib qho kev pabcuam tseem ceeb los txo qis myocardial ischemia thiab kab mob plawv, thiab nws cov txiaj ntsig tau lees paub los ntawm kev tshawb fawb thoob ntiaj teb. Kev tshawb fawb STICH yog kev tswj xyuas rau cov neeg mob uas muaj IHF hnyav, qhia tias cov txiaj ntsig ntawm lub cev ntawm CABG suav nrog kev txo qis ntawm ischemic lub plawv mob [15]. Tswj kev sim ua los ntawm O'Connor li al. tau qhia tias kev siv CABG rau revascularization piv nrog cov tshuaj kho mob tuaj yeem txhim kho cov 1-, 5-, thiab 10- xyoo ciaj sia taus ntawm IHF [16]. Tus nqi ntawm CABG hauv kev kho IHF yuav tsum muaj kev txhawj xeeb ntau dua.
Percutaneous coronary intervention (PCI)
PCI tuaj yeem ua tiav lossis tsis tiav revascularization ntawm cov neeg mob uas muaj kab mob ntau hauv IHF. Txoj kev tshawb fawb soj ntsuam tau qhia tias pawg PCI tau muaj txiaj ntsig zoo hauv qhov tshwm sim ntawm cov xwm txheej tsis zoo ntawm lub plawv thiab lub sijhawm pw hauv tsev kho mob hauv 30 hnub piv nrog pawg CABG [17]. Tam sim no, tsis muaj pov thawj tseeb ntxiv rau kev tshawb fawb soj ntsuam ntawm PCI rau IHF, tab sis nws tseem yuav yog ib qho ntawm cov kev tshawb fawb qhia txog kev kho mob rov qab rau IHF yav tom ntej.
Cistanche tshuaj ntsuab
Kev kho noob caj noob ces
Tam sim no, kev kho noob tseem nyob rau theem nrog ntau tus kws tshawb fawb soj ntsuam. Txawm hais tias kev siv cov kev paub hauv kev kho noob tsis txaus, kev nyab xeeb kev kho mob yog qhov zoo [18]. CUPID txoj kev tshawb fawb tau qhia tias cov koob tshuaj AAV1 lossis SERCA2a cov tshuaj kho mob siab tshaj plaws tau qis tshaj qhov kev tuag lig thiab 82 feem pua txo qis hauv ntau yam kev mob plawv, xws li myocardial ischemia, ua rau HF, thiab kev tuag [19]. Nyob rau hauv lub neej yav tom ntej, kev kho noob yuav ua lub luag haujlwm tseem ceeb hauv kev kho IHF.
Kev kho TCM Cov tshuaj suav tshuaj suav hais tias IHF yog kab mob thib ob ntawm cov ntshav stasis vim tsis muaj qi thiab ntshav, cov ntshav tsis zoo, thiab kev puas tsuaj ntawm cov hlab plawv los ntawm kev cuam tshuam ntawm cov kab mob co toxins [20].Nyob rau xyoo tas los no, kev sim ntawm Suav. Cov tshuaj rau IHF tau siv dav hauv Suav teb. Ib txoj kev tshawb fawb hla ntu tau raug npaj, raws li kev loj hlob ntawm tus kab mob, IHF feem ntau tshwm sim raws li qi deficiency, ntshav stasis, tsis txaus Yang, dej ntws, thiab yin deficiency [21]. Hauv qab no yog ib qho kev taw qhia rau kev tshawb fawb soj ntsuam ntawm TCM kev kho mob ntawm IHF ua ke nrog kev sib txawv thiab kev kho mob.
Qi tsis txaus thiab ntshav stasis IHF pib nrog kev puas tsuaj ntawm cov hlab plawv vim tsis muaj qi thiab ntshav, tom qab ntawd cov hlab ntshav txhaws ua rau lub hauv siab txhaws thiab mob. Nws pib manifests lub pathological yam ntxwv ntawm qi deficiency thiab ntshav stasis nrog rau intermingled deficiency thiab tshaj. Qishen Yiqi dripping pills yog ib hom tshuaj suav patent, uas yog tsim los ntawm cov khoom xyaw nquag ntawm astragalus, salvia, pseudo-ginseng, thiab rosewood. Nws muaj cov txiaj ntsig ntawm kev muaj txiaj ntsig qi thiab ua kom lub siab muaj zog thiab ua kom ntshav analgesia. Cov neeg mob IHF uas siv cov tshuaj no los kho qi deficiency thiab ntshav stasis syndrome tuaj yeem txhim kho ntau yam txiaj ntsig suav nrog 6-feeb taug kev, qib BNP, thiab lwm yam [22]. Qishen Yiqi cov tshuaj dripping kuj tuaj yeem txhim kho txoj haujlwm sab laug ventricular thiab tiv thaiv cardiomyocytes [23]. Cov tshuaj tiv thaiv lub plawv thiab Dan Hong txhaj tshuaj tseem ua lub luag haujlwm tseem ceeb hauv kev kho mob ntawm IHF nrog qi deficiency thiab ntshav stasis syndrome [24,25].
Lub plawv-lub raum yang deficiency
Qian Jin Fang tau hais tias lub siab yog hluav taws, lub raum yog dej, thiab dej thiab hluav taws yuav tsum muaj txiaj ntsig zoo. Yog li, cov txheej txheem pathological ntawm IHF feem ntau cuam tshuam nrog rau lub raum dhau ntawm lub plawv [21]. Shenfu txhaj yog ib qho sib xyaw ua los ntawm kev rho tawm cov khoom xyaw zoo los ntawm cov ginseng liab thiab aconite los ntawm cov cuab yeej siv niaj hnub no. Nws muaj lub luag haujlwm ntawm kev txhawb nqa qi thiab rov kho yang, thiab ua kom sov yang los hloov qi. Kev sib xyaw ntawm Shenfu txhaj tshuaj thiab cov tshuaj sab hnub poob hauv kev kho mob ntawm IHF nrog lub plawv-mob raum yang deficiency syndrome tuaj yeem txhim kho myocardial contractility, txo qis myocardial oxygen noj, tiv thaiv myocardium thiab rov ua haujlwm vascular, thiab txhim kho cov nyhuv kho ntawm IHF [26]. Tsis tas li ntawd, Qiliqiangxin capsule kuj tau txais txiaj ntsig zoo hauv kev sim tshuaj [27].
Kev tsis txaus ntawm qi thiab tuav cov kua dej Cov neeg mob lub siab Yang raug puas ntsoog, ua rau lub cev tsis muaj peev xwm los txhawb cov ntshav ncig thiab txhaws cov hlab ntsha, kom lub cev ua kua dej stagnates thiab overflows, los yog rushes mus rau lub plawv [28]. ling GUI zhu gan decoction muaj xya tshuaj suav tshuaj: astragalus, Poria cocos, dawb atractylodes rhizome, codonopsis pilosula, cassia twig, salvia, thiab licorice. Nws muaj lub luag haujlwm ntawm kev ntxiv qi thiab ua kom sov yang, nrog rau kev ua kom ntshav thiab txhawb kev tso zis. lingguizhugan decoction ua ke nrog cov tshuaj sab hnub poob hauv kev kho mob ntawm cov neeg mob IHF nrog cov kua dej ntau dhau mus rau lub plawv tuaj yeem txhim kho tag nrho cov txiaj ntsig zoo ntawm kev kho mob thiab kev ua haujlwm ntawm lub plawv. Nws kuj tseem tuaj yeem txo cov qib NT-proBNP, lub sijhawm pw hauv tsev kho mob, thiab rov mus pw hauv tsev kho mob [29].Nyob hauv tsev kho mob, hloov Yangxin decoction ua ke nrog cov tshuaj sab hnub poob kuj siv los kho IHF nrog kev tuav cov kua dej thiab tau ua tiav cov txiaj ntsig zoo [30] .
Eua ffects ntawm cistanche: IMPROVE KIDNEY FUNCTION
Deficiency ntawm qi thiab yin
Cov neeg mob IHF muaj kev mob ntev ntev, uas ua rau poob ntshav plawv, qi, thiab yin. Nyob rau theem tom ntej, nws tuaj yeem tshwm sim raws li qhov tsis txaus ntawm qi thiab yin. Sheng Mai txhaj tshuaj feem ntau suav nrog ginseng, ophiopogon japonicus, thiab Schisandra, uas tuaj yeem ntxiv qi thiab tshem tawm cov ntshav stasis, nrog rau kev noj zaub mov yin thiab lub cev kua. Ua ke nrog cov tshuaj Western, nws tuaj yeem nthuav dav cov hlab ntsha hauv cov hlab ntsha, txhim kho cov ntshav siab thiab cov hlab ntsha peripheral, ua kom cov hlab plawv thiab myocardial contractility, thiab txo qis kev noj cov pa oxygen ntawm myocardial. Yog li ua kom luv luv txoj kev kho mob thiab txhim kho tag nrho cov txiaj ntsig zoo [31]. Tsis tas li ntawd, kev tshawb fawb soj ntsuam ntawm Sen-Mei txhaj tshuaj hauv kev kho mob ntawm IHF kuj tau mus txog qhov kev xav tau [20].
Kev sib tham thiab xaus Nrog kev nkag siab tob ntawm IHF, tib neeg tau ntxiv dag zog rau kev kawm txog cov txiaj ntsig biochemical. Txawm hais tias nws tseem nyuaj rau kev sib txawv ntawm ischemic thiab tsis yog ischemic ua rau, nws yog qhov pab tau los txhim kho cov kev kho mob thiab kev kwv yees. Kev siv tshuaj kho mob ntawm kev kho mob sab hnub poob yog qhov tseem ceeb ntawm kev tshawb fawb. Tib neeg tau ua kom zoo dua kev siv tshuaj HF ib txwm siv, tsim cov tshuaj tshiab xws li ARNI kom hloov mus rau qhov chaw kho mob sib txawv, thiab ntxiv dag zog rau cov phiaj xwm kev kho mob ntawm IHF. Ntxiv nrog rau kev kho tshuaj, kev tshawb fawb txog kev kho mob rau IHF kuj tseem qhia tau tias muaj peev xwm zoo, thiab cov ntawv thov no xav tau kev txhawb nqa ntxiv los ntawm cov ntaub ntawv kho mob.
Nyob rau hauv kev kho mob ntawm TCM, qhov ntau thiab zoo ntawm kev tshawb fawb ntawm decoctions yog me me, thaum lub qhov ncauj npaj muaj ntau yam, tab sis cov nyhuv tsis zoo txaus. Kev txhaj tshuaj TCM yog qhov tsim nyog rau kev kho mob ntawm IHF vim nws qhov xwm txheej, hom meej, thiab daim ntawv ntau npaum li cas. Feem ntau ntawm lawv tuaj yeem ua tiav cov txiaj ntsig zoo thiab muaj kev lees paub kev kho mob siab. Nyob rau hauv ib lo lus, kev kho mob ntawm IHF nrog cov tshuaj suav tshuaj suav hais tias yog tsom rau kev sib txawv ntawm tus mob tag nrho. Nws muaj kev cia siab dav hauv kev txhawb nqa kev rov qab los ntawm ntau yam kabmob, txo cov kev siv tshuaj sib xyaw ua ke, thiab txo cov kev tsis zoo. Txawm li cas los xij, nws tseem tsis tau tsim cov qauv meej thiab xav tau cov ntaub ntawv pov thawj kho mob zoo dua los txhawb kev txhim kho cov kev kho mob.
Eua ffects ntawm cistanche: BOOSTS IMMUNE SYSTEM
Cov ntaub ntawv
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