小柴胡汤是《伤寒杂病论》中的一首经典方剂,是和解法的基础方,后世将其广泛用于治疗妇科疾病。本研究旨在通过文献检索,探讨小柴胡汤在治疗妇科疾病方面的有效性及其应用的最新进展。文章综述了小柴胡汤在治疗妇科痛证、血证、带下证、块证等相关疾病方面的临床研究和实践经验。小柴胡汤通过其疏肝利胆、健运脾胃、和解枢机的作用,有效改善了女性痛经、盆腔炎性疾病、月经不调、妇科肿瘤、围绝经期综合征等妇科疾病症状。作为临床常用的妇科学方剂,小柴胡汤亟需进一步的发扬与创新,以期更有效地应用于未来的临床实践。
Xiaochaihu Decoction,as a classic prescription in the Treatise on Cold Pathogenic and Miscellaneous Diseases,laid the foundation for reconciliation.It has a wide range of applications in the treatment of gynecological diseases.Through a literature search,this study aimed to explore the effectiveness of Xiaochaihu Decoction in the treatment of gynecological diseases and the latest progress of its application.This article reviews the clinical research and practical experience of Xiaochaihu Decoction in the treatment of gynecological pain,bleeding,leucorrhea disease,tumors and other related diseases.Xiaochaihu Decoction has effectively improved the symptoms of gynecological diseases such as dysmenorrhea,pelvic inflammatory disease,menstrual irregularities,gynecological tumors,and perimenopausal syndrome through its role of soothing the liver and promoting bile flow,strengthening the spleen and stomach,and harmonizing and releasing the pivot.As a commonly used gynecological prescription in clinical practice,Xiaochaihu Decoction urgently needs to be further developed and innovated to be more effectively applied to clinical practice in the future.
目的 探讨术前静注艾司氯胺酮在腹腔镜结直肠癌根治术患者中的应用效果。方法 前瞻性分析2024年1月—2025年4月在厦门市中医院行腹腔镜结直肠癌根治术患者的临床资料,根据随机数字表法将患者分为两组:对照组40例,术前5 min予5 mL生理盐水;观察组40例,术前5 min予以0.25 mg/kg艾司氯胺酮(以生理盐水配置成5 mL)。比较围术期指标、炎症因子、负性情绪、疼痛情况、不良反应。结果 观察组的手术时间、麻醉时间、术中出血量分别为(213.54±64.22)min、(240.67±81.26)min、(141.31±45.03)mL,与对照组的(210.43±65.71)min、(244.25±81.33)min、(137.64±42.75)mL比较,差异均无统计学意义(t=0.214、0.197、0.374,P均>0.05),而观察组丙泊酚、瑞芬太尼用量分别为(1 075.52±134.37)mg、(1 267.18±242.26)μg,虽然低于对照组的(1?126.64±150.21)mg、(1 352.50±295.14)μg,但差异也无统计学意义(t=1.604、1.413,P均>0.05);观察组在术后24 h的肿瘤坏死因子-α、白介素-6、C反应蛋白水平分别为(54.52±9.64)pg/mL、(40.08±7.75)pg/mL、(30.38±6.93)mg/L,均低于对照组的(77.31±10.86)pg/mL、(56.35±9.47)pg/mL、(43.73±7.61)mg/L(t=9.926、8.409、8.203,P均<0.05);术后1 d的焦虑、抑郁自评量表评分及术后1 h、6 h、12 h、24 h咳嗽时的疼痛视觉模拟量表评分分别为(51.92±4.41)分、(53.96±4.47)分、(3.59±1.14)分、(3.06±1.01)分、(2.89±0.91)分、(2.57±0.76)分,均低于对照组的(55.06±5.12)分、(57.21±5.19)分、(4.27±1.36)分、(3.68±1.18)分、(3.41±1.06)分、(2.96±0.92)分(t=2.939、3.001、2.423、2.525、2.329、2.067,P均<0.05),但两组术后48 h咳嗽时疼痛视觉模拟量表评分比较差异无统计学意义(P>0.05);两组术后不良反应发生率也无显著差异(P<0.05)。结论 在腹腔镜结直肠癌根治术术前静注艾司氯胺酮可有效降低术后炎症反应水平,减轻术后疼痛,缓解术后负性情绪,且不会增加患者术后不良反应发生率。
Objective To explore the application effect of preoperative intravenous injection of esketamine in patients undergoing laproscopic radical resection of colorectal cancer.Methods The clinical data of patient who underwent laparoscopic radical resection of colorectal cancer in Xiamen Hospital of Traditional Chinese Medicine from January 2024 to April 2025 were retrospectively analyzed.The patients were divided into two groups according to the random number table method:40 cases in the control group were given 5 mL saline,five minutes before operation,40 cases in the observation group were treated with 0.25 mg / kg esketamine(in 5 mL saline)five minutes before operation.The perioperative indicators,inflammatory factors,negative emotions,pain and adverse reactions were compared between two groups.Results The operation time,anesthesia time and intraoperative blood loss of the observation group were(213.54±64.22)min,(240.67±81.26)min and(141.31±45.03)mL,respectively,which were not significantly different from those of the control group(210.43±65.71)min,(244.25±81.33)min and(137.64±42.75)mL(t=0.214,0.197,0.374,all P>0.05).The dosage of propofol and remifentanil in the observation group were(1 075.52±134.37)mg and(1 267.18±242.26)μg,respectively,which were lower than those in the control group of (1126.64±150.21)mg and(1352.50±295.14)μg,but the difference was not statistically significant(t=1.604,1.413,P>0.05).The levels of tumor necrosis factor-α,interleukin-6 and C-reactive protein in the observation group at 24 h after operation were(54.52±9.64)pg / mL,(40.08±7.75)pg / mL and(30.38±6.93)mg / L,respectively,which were lower than those in the control group of (77.31±10.86)pg / ml,(56.35±9.47)pg / mL and 43.73±7.61)mg / L(t=9.926,8.409,8.203,all P<0.05).The scores of Anxiety and Depression Self-Rating Scale at 1 day after operation and the scores of pain visual analogue scale at 1 h,6 h,12 h and 24 h after operation were(51.92±4.41),(53.96±4.47),(3.59±1.14),(3.06±1.01),(2.89±0.91) and(2.57±0.76),respectively,which were lower than those of the control group(55.06±5.12),(57.21±5.19),(4.27±1.36),(3.68±1.18),(3.41±1.06) and(2.96±0.92)(t=2.939,3.001,2.423,2.525,2.329,2.067,P<0.05).However,no significant difference was observed in cough-related VAS scores between the groups at 48 h postoperatively(P>0.05).Adverse event rates showed no significance in two groups(P>0.05).Conclusions Preoperative administration of esketamine in laparoscopic colorectal cancer surgery can attenuate postoperative inflammation,decrease pain,mitigate negative emotions,without increasing the incidence of postoperative adverse reactions.
目的 探讨清咳平喘颗粒联合乙酰半胱氨酸对痰热闭肺型大叶性肺炎(LP)患儿的治疗效果。方法 回顾性选取我院收治的118例痰热闭肺型LP患儿(选例时间:2023年1月~2025年11月)为研究对象,根据治疗方案分为参照组(59例,采用乙酰半胱氨酸治疗)、联合组(59例,采用清咳平喘颗粒联合乙酰半胱氨酸治疗)。对比两组临床疗效、不良反应及治疗前、后肺功能[潮气量(VT)、达峰时间比(TPTEF/TE)、吸呼比(Ti/Te)、达峰容积比(VPEF/VE)]、中医证候、免疫功能、炎症因子[白细胞介素-8(IL-8)、趋化因子配体3(CCL3)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)]水平。结果 联合组总有效率为96.61%,高于参照组的83.05%(P<0.05);与参照组相比,治疗后联合组各中医证候积分均较低(P<0.05);联合组治疗后VT、TPTEF/TE、Ti/Te、VPEF/VE水平均较参照组高(P<0.05);联合组治疗后CD8+水平较参照组低,CD3+、CD4+、CD4+/CD8+水平较参照组高(P<0.05);治疗后联合组血清IL-8、CCL3、TNF-α、HMGB1水平均较参照组低(P<0.05);不良反应发生情况组间比较,无明显差异(P>0.05)。结论 清咳平喘颗粒联合乙酰半胱氨酸可提高痰热闭肺型LP患儿治疗效果,减轻临床症状,改善肺功能、免疫功能,降低机体炎症反应程度。
Objective To explore the therapeutic efficacy of Qingke Pingchuan granules combined with acetylcysteine on children with lobar pneumonia (LP) of phlegm-heat obstructing lung type. Methods A total of 118 children with LP of phlegm-heat obstructing lung type admitted to our hospital from January 2023 to November 2025 were retrospectively selected as the research subjects. According to different treatment regimens, they were divided into the control group (59 cases, treated with acetylcysteine) and the combined group (59 cases, treated with Qingke Pingchuan granules combined with acetylcysteine). The clinical efficacy, adverse reactions, as well as the levels of pulmonary function indicators [tidal volume (VT), time to peak tidal expiratory flow ratio (TPTEF/TE), inspiration-expiration ratio (Ti/Te), volume to peak tidal expiratory flow ratio (VPEF/VE)], traditional Chinese medicine (TCM) syndrome scores, immune function and inflammatory factors [interleukin-8 (IL-8), C-C motif chemokine ligand 3 (CCL3), tumor necrosis factor-α (TNF-α), high mobility group box 1 protein (HMGB1)] before and after treatment were compared between the two groups. Results The total effective rate of the combined group was 96.61%, which was higher than 83.05% of the control group (P<0.05). After treatment, the TCM syndrome scores of the combined group were lower than those of the control group (P<0.05). The levels of VT, TPTEF/TE, Ti/Te and VPEF/VE in the combined group were higher than those in the control group after treatment (P<0.05). After treatment, the level of CD8? in the combined group was lower, while the levels of CD3?, CD4? and CD4?/CD8? were higher than those in the control group (P<0.05). The serum levels of IL-8, CCL3, TNF-α and HMGB1 in the combined group were significantly lower than those in the control group after treatment (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of Qingke Pingchuan granules and acetylcysteine can enhance the therapeutic efficacy on children with LP of phlegm-heat obstructing lung type, relieve clinical symptoms, improve pulmonary function and immune function, and reduce systemic inflammatory response.
目的 探讨动态社交行为技巧练习联合生物反馈对学龄注意缺陷多动障碍(ADHD)患儿临床症状和社会功能的影响。方法 回顾性选取我院2021年1月~2024年3月收治的81例学龄ADHD患儿作为研究对象,按照治疗方法不同分为对照组(40例)、观察组(41例),对照组接受生物反馈治疗,观察组接受动态社交行为技巧练习联合生物反馈治疗。比较两组临床疗效、临床症状、社会功能、脑电波频率[β波、θ波、感觉运动节律(SMR)波]。结果 观察组总有效率90.24%较对照组的72.50%高(P<0.05);治疗后观察组对抗性行为、多动-冲动、注意力不集中评分均低于对照组(P<0.05);治疗后观察组家庭、学习与学校、生活技能、自我管理、社交活动及风险活动评分均低于对照组(P<0.05);治疗后观察组β波、SMR波均高于对照组,θ波低于对照组(P<0.05)。结论 动态社交行为技巧练习联合生物反馈对学龄ADHD患儿临床疗效确切,可进一步改善患儿临床症状、社会功能。
Objective To explore the effect of dynamic social behavior skills training combined with biofeedback on clinical symptoms and social function in school-age children with attention deficit hyperactivity disorder (ADHD). Methods A total of 81 school-age children with ADHD admitted to our hospital from January 2021 to March 2024 were retrospectively selected as the research objects. According to different treatment methods, they were divided into control group (40 cases) and observation group (41 cases). The control group received biofeedback therapy, and the observation group received dynamic social behavior skills training combined with biofeedback therapy. The clinical efficacy, clinical symptoms, social function, brain wave frequency [β wave, θ wave, sensorimotor rhythm ( SMR ) wave] were compared between the two groups. Results The total effective rate of the observation group was 90.24% higher than that of the control group (72.50%) (P<0.05). After treatment, the scores of antagonistic behavior, hyperactivity-impulsion and inattention in the observation group were lower than those in the control group (P<0.05). After treatment, the scores of family, learning and school, life skills, self-management, social activities and risk activities in the observation group were lower than those in the control group (P<0.05). After treatment, the β wave and SMR wave in the observation group were higher than those in the control group, and the θ wave was lower than that in the control group (P<0.05). Conclusion Dynamic social behavior skill training combined with biofeedback has definite clinical efficacy in school-age children with ADHD, which can further improve their clinical symptoms and social functioning.
目的 探讨改良后本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面的变化。方法 2018年9月-2019年9月选取四川大学华西医院2017级临床医学和口腔医学五年制本科生共30名,以及3名授课教师作为研究对象,将既往版、现行版以及改良版教学质量评价量表应用课堂,并采用问卷调查方法对其进行分析评估。评估经改良后的教学质量评价表在及时性、有效性和易用性方面的变化差异。结果 共计向研究对象发放99份教学质量评价量表和33份调查问卷,回收率为100%。针对授课教师能及时获取教学质量反馈,教师认为课后评教工具的最佳评价时机为课后当天晚上12点前(33.3%)或课后24小时内(66.7%),高于课后立即评价(0%)和期末评价(0%)。对三个版本教学评价表问卷调查结果显示,改良版教学评价量表的时效性、有效性和易用性为优的比例分别为86.67%,60%和76.67%,均高于现行版的43.33%,60%和46.67%,同时均高于既往版的23.33%,23.33%和36.67%,差异有统计学意义(P<0.05)。结论 改良后的本科生临床医学课堂教学评价量表在时效性、有效性和易用性方面均得以显著提高。通过不断优化量表设计和评价指标,可以提高教学质量评价的科学性和准确性。
Objective: To investigate the changes in timeliness, validity, and usability of the modified classroom teaching evaluation scale for undergraduate clinical medical education. Methods: From September 2018 to September 2019, a cohort comprising 30 fifth-year undergraduate students majoring in clinical medicine and stomatology from West China Hospital, Sichuan University, along with three faculty instructors, was enrolled. Three versions of teaching evaluation scales (historical, current, and modified) were implemented in classroom settings, followed by questionnaire-based comparative analyses. The revised scale was systematically assessed for improvements in feedback timeliness, measurement validity, and operational usability. Results: A total of 99 evaluation forms and 33 questionnaires were distributed, with a 100% response rate. Regarding timely feedback acquisition, faculty preferred receiving evaluations by midnight on the teaching day (33.3%) or within 24 hours post-class (66.7%), outperforming immediate
摘要 目的 分析固定(FB)和活动平台(MB)单髁置换术(UKA)在膝关节内侧间室骨关节炎早期阶段的临床效果与影像学差异,以指导临床假体选择。 方法 本研究回顾性纳入41例确诊为单侧膝关节内侧间室骨关节炎的患者,按照假体类型分为两组:FB组(20例,使用春立XG假体)和MB组(21例,使用春立XK假体)。分别在术前、术后及随访终点统计膝关节屈伸活动范围(ROM)、VAS 疼痛评分、美国特种外科医院膝关节评分(HSS );测量并比较股胫角(FTA)、胫骨假体内外翻角(TCVA)、胫骨假体后倾角(TCPSA);记录围手术期指标及并发症情况。 结果 两组患者术后ROM、VAS、HSS 评分均较术前显著改善(P均<0.0001);末次随访时固定平台组 VAS 评分显著低于活动平台组(P<0.05),而两组间的ROM、HSS 评分无统计学差异(均 P>0.05)。两组术后 FTA、TCVA、TCPSA 均恢复至理想范围,组间均无统计学差异(均 P>0.05)。固定平台组手术时间更短(P<0.05),两组均无严重并发症,假体生存率均为 100%。 结论 活动平台与固定平台单髁置换术均可显著改善膝关节内侧间室骨关节炎患者疼痛、活动度及功能,下肢力线恢复效果相当;固定平台假体在疼痛控制与手术便捷性方面更具优势,临床可根据患者情况与术者经验个体化选择。 关键词 单髁置换术;活动平台假体;固定平台假体;骨关节炎;并发症
Abstract Objective To investigate the early clinical outcomes and radiological differences between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA), and to provide evidence for clinical prosthesis selection. Methods Clinical data of 41 patients with unilateral medial compartment knee OA were retrospectively analyzed. The FB group comprised 20 patients (using Chunli XG prosthesis), and the MB group comprised 21 patients (using Chunli XK prosthesis). Knee range of motion (ROM), Visual Analogue Scale (VAS) pain score, and Hospital for Special Surgery (HSS) knee score were compared between the two groups preoperatively, postoperatively, and at the final follow-up. Femorotibial angle (FTA), tibial component valgus angle (TCVA), and tibial component posterior slope angle (TCPSA) were measured and compared. Perioperative indicators and complications were recorded. Results Postoperative ROM, VAS, and HSS scores significantly improved compared with preoperative values in both groups (all P < 0.0001). At the final follow-up, the VAS score in the FB group was significantly lower than that in the MB group (P < 0.05), while no significant differences were observed in ROM or HSS scores between the two groups (all P > 0.05). Postoperative FTA, TCVA, and TCPSA values returned to the ideal range in both groups, with no significant intergroup differences (all P > 0.05). The FB group had a significantly shorter operative time (P < 0.05). No severe complications occurred in either group, and the prosthesis survival rate was 100% in both groups. Conclusion Both FB-UKA and MB-UKA significantly improve pain, range of motion, and function in patients with medial compartment knee OA, with comparable efficacy in restoring lower limb alignment. The FB prosthesis offers advantages in pain control and surgical convenience. Clinical selection may be individualized based on patient characteristics and surgeon experience. Keywords Unicompartmental knee arthroplasty; Mobile-bearing prosthesis; Fixed-bearing prosthesis; Osteoarthritis; Complications
目的 探讨固定平台(FB)与活动平台(MB)单髁置换术(UKA)治疗膝关节内侧间室骨关节炎(OA)的早期临床疗效及影像学差异,为临床假体选择提供依据。 方法 回顾性分析41 例单侧膝关节内侧间室骨关节炎患者临床资料,其中 FB 组 20例(采用春立XG假体),MB 组 21 例(采用春立XK假体)。比较两组患者术前、术后和末次随访的膝关节活动度(ROM)、疼痛视觉模拟评分(VAS)、美国特种外科医院膝关节评分(HSS);测量并比较股胫角(FTA)、胫骨假体内外翻角(TCVA)、胫骨假体后倾角(TCPSA);记录围手术期指标及并发症情况。 结果 两组患者术后ROM、VAS、HSS 评分均较术前显著改善(P均<0.0001);末次随访时固定平台组 VAS 评分显著低于活动平台组(P<0.05),ROM、HSS 评分两组差异无统计学意义(均 P>0.05)。两组术后 FTA、TCVA、TCPSA 均恢复至理想范围,组间差异均无统计学意义(均 P>0.05)。固定平台组手术时间更短(P<0.05),两组均无严重并发症,假体生存率均为 100%。 结论 固定平台与活动平台单髁置换术均可显著改善膝关节内侧间室骨关节炎患者疼痛、活动度及功能,下肢力线恢复效果相当;固定平台假体在疼痛控制与手术便捷性方面更具优势,临床可根据患者情况与术者经验个体化选择。 关键词 单髁置换术;活动平台假体;固定平台假体;骨关节炎;并发症
Abstract Objective To investigate the early clinical outcomes and radiological differences between fixed-bearing (FB) and mobile-bearing (MB) unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment knee osteoarthritis (OA), and to provide evidence for clinical prosthesis selection. Methods Clinical data of 41 patients with unilateral medial compartment knee OA were retrospectively analyzed. The FB group comprised 20 patients (using Chunli XG prosthesis), and the MB group comprised 21 patients (using Chunli XK prosthesis). Knee range of motion (ROM), Visual Analogue Scale (VAS) pain score, and Hospital for Special Surgery (HSS) knee score were compared between the two groups preoperatively, postoperatively, and at the final follow-up. Femorotibial angle (FTA), tibial component valgus angle (TCVA), and tibial component posterior slope angle (TCPSA) were measured and compared. Perioperative indicators and complications were recorded. Results Postoperative ROM, VAS, and HSS scores significantly improved compared with preoperative values in both groups (all P < 0.0001). At the final follow-up, the VAS score in the FB group was significantly lower than that in the MB group (P < 0.05), while no significant differences were observed in ROM or HSS scores between the two groups (all P > 0.05). Postoperative FTA, TCVA, and TCPSA values returned to the ideal range in both groups, with no significant intergroup differences (all P > 0.05). The FB group had a significantly shorter operative time (P < 0.05). No severe complications occurred in either group, and the prosthesis survival rate was 100% in both groups. Conclusion Both FB-UKA and MB-UKA significantly improve pain, range of motion, and function in patients with medial compartment knee OA, with comparable efficacy in restoring lower limb alignment. The FB prosthesis offers advantages in pain control and surgical convenience. Clinical selection may be individualized based on patient characteristics and surgeon experience. Keywords Unicompartmental knee arthroplasty; Mobile-bearing prosthesis; Fixed-bearing prosthesis; Osteoarthritis; Complications
目的 探讨婴儿胆汁淤积症为表现的钠牛磺胆酸共转运多肽(NTCP)缺陷病临床特点,提高临床医生对疾病的认识。方法:回顾总结分析12例因婴儿胆汁淤积症于2018年1月-2024年12月广州医科大学附属妇女儿童医疗中心就诊并经基因检测确诊为NTCP基因缺陷病患儿的临床特征、肝功能特点、基因结果及预后转归。结果:12例患儿基因组测序结果均存在SLC10A1基因纯合突变:c.800C>T(p.Ser267Phe),就诊中位年龄2.1月,临床表现为黄疸伴大便颜色浅;肝功能表现为顽固的高胆汁酸血症及以直接胆红素升高为主的高胆红素血症,ALT、AST水平升高者10例,伴肝肿大者5例,脾肿大者4例,经治疗后黄疸消退中位时间5个月,3例患儿行胆道冲洗及肝活检,所有患儿生长发育均无异常。 结论 NTCP 缺陷病在婴儿期可表现为胆汁淤积症,肝功能异常除高胆汁酸血症外,以直接胆红素升高为主的高胆红素血症为典型表现;本病预后良好,早期行基因检测可避免有创或过度检查
To explore the clinical features of sodium taurocholate cotransporting polypeptide (NTCP) defective disease manifested by infantile cholestasis and to improve clinicians' understanding of the disease.Methods A retrospective summary and analysis were conducted of the clinical features, liver function features, genetic findings, and prognosis of 12 children who were diagnosed with NTCP gene deficiency disease by genetic testing at The Women's and Children's Medical Center Affiliated to Guangzhou Medical University between January 2018 and December 2024 as a result of infantile cholestasis. Results 12 children were diagnosed with NTCP gene defects at a median age of 2.1 months, and all of them had a pure mutation in the SLC10A1 gene (c.800C>T(p.Ser267Phe)) by genome sequencing. Intractable hyperbilirubinemia and hyperbilirubinemia with primarily elevated direct bilirubin, elevated ALT and AST levels in 10 cases, hepatomegaly in 5 cases, splenomegaly in 5 cases, and elevated bile levels in the liver were among th
扩张型心肌病(DCM)以左心室或双心室扩大并伴心肌收缩功能下降为主要特征,左心室逆重构(LVRR)可反映治疗后心室结构和功能恢复,并与患者预后改善相关。近年来,中医药联合常规西医治疗DCM的研究逐渐增多,部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示,中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复,从而促进LVRR。然而,现有研究对LVRR的判定标准尚未统一,相关临床证据仍需进一步规范和验证。鉴于此,本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述,以期为DCM的中西医结合治疗及后续临床研究设计提供参考。
Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.
扩张型心肌病(DCM)以左心室或双心室扩大并伴心肌收缩功能下降为主要特征,左心室逆重构(LVRR)可反映治疗后心室结构和功能恢复,并与患者预后改善相关。近年来,中医药联合常规西医治疗DCM的研究逐渐增多,部分研究显示其可改善左心室射血分数、左心室内径或容积、BNP或NT-proBNP、6min步行距离及生活质量等LVRR相关指标。现有证据提示,中医药可能通过改善心肌细胞损伤与能量代谢、减轻心肌纤维化与细胞外基质重塑、调节神经内分泌激活与心室负荷等环节参与DCM患者左心室结构重塑改善和收缩功能恢复,从而促进LVRR。然而,现有研究对LVRR的判定标准尚未统一,相关临床证据仍需进一步规范和验证。鉴于此,本文旨在围绕DCM-LVRR的概念、评价指标、中医药临床证据及可能机制进行叙述性综述,以期为DCM的中西医结合治疗及后续临床研究设计提供参考。
Dilated cardiomyopathy (DCM) is mainly characterized by left ventricular or biventricular dilatation accompanied by impaired myocardial systolic function. Left ventricular reverse remodeling (LVRR) reflects the recovery of ventricular structure and function after treatment and is associated with improved prognosis. In recent years, studies on traditional Chinese medicine (TCM) combined with conventional Western medical therapy for DCM have gradually increased. Some studies have shown that such combined treatment may improve LVRR-related indicators, including left ventricular ejection fraction, left ventricular diameter or volume, BNP or NT-proBNP, 6-minute walking distance, and quality of life. Current evidence suggests that TCM may contribute to left ventricular structural remodeling and systolic functional recovery in patients with DCM by alleviating myocardial cell injury, improving energy metabolism, attenuating myocardial fibrosis and extracellular matrix remodeling, and modulating neuroendocrine activation and ventricular load, thereby promoting LVRR. However, the criteria for defining LVRR remain inconsistent across existing studies, and the relevant clinical evidence requires further standardization and validation. Therefore, this narrative review aims to summarize the concept, evaluation indicators, clinical evidence of TCM, and potential mechanisms related to DCM-LVRR, with the aim of providing a reference for integrated Chinese and Western medical treatment of DCM and the design of future clinical studies.