| 引用本文:杨盈天1，王师菡2，唐菁菁2，吕乾瑜2，李俊佳2.心房颤动心房重构的发生机制及温阳活血法抑制心房重构上游靶点的研究[J].世界中医药,2022,(23):. |
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| 心房颤动心房重构的发生机制及温阳活血法抑制心房重构上游靶点的研究 |
| Mechanism of Atrial Remodeling in Atrial Fibrillation and the Upstream Targets of Yang-warming and Blood-activating Therapy for Inhibiting Atrial Remodeling |
| 投稿时间：2021-03-18 |
| DOI：10.3969/j.issn.1673-7202.2022.23.026 |
| 中文关键词: 心房颤动 心房重构 机制 电重构 结构重构 温阳活血法 靶点 中医药 |
| English Keywords:Atrial fibrillation Atrial remodeling Mechanism Electrical remodeling Structural remodeling Therapy for warming yang and activating blood Target Traditional Chinese medicine |
| 基金项目:国家自然科学基金项目（81473465）——基于HIF-1对Angptl4的调控探讨痰瘀同治抗低氧诱导动脉硬化的路径；首都临床诊疗技术研究及示范应用项目（Z191100006619025）——基于医院-体育馆-社区三位一体的冠心病康复方案的完善和评估 |
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| 中文摘要: |
| 心房颤动（AF）是临床常见的一种心律失常，具有较高的发病率和致死率。心房重构被认为是AF发生、进展和持续的主要因素，主要包括电重构和结构重构，与电重构比较，结构重构不易逆转，因此有效地抑制心房重构对于预防AF的发展和持续非常重要。AF的主要上游靶点包括L型钙通道（LTCC）、心房缝隙连接蛋白、肾素-血管紧张素-醛固酮系统（RAAS）、基质金属蛋白酶（MMP）系统以及氧化应激和炎症反应等。现代医学治疗方法包括药物疗法和非药物疗法，但仍存在一定的不良反应，而中医药整体观念、辨证论治的学术思想，在提高临床疗效、改善心脏电生理及结构功能方面具有明显的优势。阳虚血瘀证作为AF的主要证型，对心房重构有促进作用。运用温阳活血法治疗阳虚血瘀型AF不仅能够减少心房颤动的发生频率和持续时间，还能抑制其心房重构的上游环节从而逆转重构，防止复发，改善预后。 |
| English Summary: |
| Atrial fibrillation(AF) is a common arrhythmia and is associated with significant morbidity and mortality.Atrial remodeling is important for the occurrence，progression，and persistence of AF，mainly including electrical and structural remodeling.Structural remodeling is often more difficult to be reversed than electrical remodeling.Therefore，effective inhibition of atrial remodeling is very important to prevent the development and persistence of AF.The main upstream targets of AF include L-type calcium channel(LTCC)，atrial connexin，renin-angiotensin-aldosterone system(RAAS)，matrix metalloproteinases(MMPs)，oxidative stress and inflammatory responses.The modern therapies comprise drug therapy and non-drug therapy，which，however，have some side effects and adverse reactions.Traditional Chinese medicine，with holistic concept and syndrome differentiation-based treatment，has remarkable advantages in improving clinical efficacy，cardiac electrophysiology and structural function.As a major syndrome of AF，yang deficiency and blood stasis can enhance atrial remodeling.For AF with the syndrome of yang deficiency and blood stasis，the yang-warming and blood-activating therapy can not only reduce the occurrence frequency and duration of AF but also inhibit the upstream link of atrial remodeling，thus reversing remodeling，preventing recurrence，and improving prognosis. |
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