Research progress in the intervention of myocardial fibrosis by regulating signal pathways with traditional Chinese medicine

doi:10.12092/j.issn.1009-2501.2026.03.009

Abstract

Abstract:

Myocardial fibrosis is a heart disease characterized by abnormal cardiac structure and function, primarily manifested by pathological deposition of the extracellular matrix in myocardial cells. The pathogenesis of this disease is complex and involves multiple biological pathways, which have not yet been fully elucidated. Currently, traditional Chinese medicine (TCM) can intervene in the treatment of myocardial fibrosis by regulating signaling pathways such as TGF-β, MAPKs, PI3K/Akt, Wnt, AMPK, NF-κB, JAK/STAT, and Notch. This article deeply analyzes the potential mechanisms and clinical applications of traditional Chinese compound formulas, single Chinese herbs, and other TCM therapies in the treatment of myocardial fibrosis, providing a scientific basis for optimizing treatment protocols for myocardial fibrosis. By regulating relevant signaling pathways, TCM has shown unique advantages and broad application prospects in the prevention and treatment of myocardial fibrosis.

Key words: myocardial fibrosis, traditional Chinese medicine, signal pathway, mechanism of action, research progress

CLC Number:

Yuanyuan HUANG, Lingzhun WANG. Research progress in the intervention of myocardial fibrosis by regulating signal pathways with traditional Chinese medicine[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(3): 372-381.

Figures/Tables 1

References 90

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中医辨证	中药复方	作用途径	调控机制
气虚血瘀证	益气活血组方^[37-38]	降低Notch1、Notch3蛋白表达，抑制p38 MAPK的磷酸化	改善心室重构、抗炎、抗凋亡等
	补阳还五汤^[39-40]	抑制TGF-β1/Smads、PI3K/Akt	抗纤维化、改善心肌重构、心功能等
	麝香保心丸^[41,42]	激活PI3K/Akt，抑制TGF-β1/Smads	抗纤维化、促进心脏微血管新生、减轻胶原沉积等
气阴两虚血瘀证	生脉散^[47]	抑制TGF-β1/Smad3	抗纤维化、抗炎、减轻胶原沉积等
	心阴片^[48]	抑制MAP3K/JNK，抑制巨噬细胞	抗纤维化、抗炎、改善心肌重构
	参竹心康汤^[49]	调节miRNA-21、PTEN/PI3K/Akt	抗纤维化、减轻胶原沉积等
阳气亏虚血瘀证	真武汤^[51-53]	激活TGF-β/JNK，调节PI3K/Akt/mTOR，调节TLR4/NF-κB	抗纤维化、抗炎、抑制自噬等
	苓桂术甘汤^[54–56]	调节Wnt/β-catenin，抑制NF-κB，激活Sirt3/AMPK	抗纤维化、保护线粒体、减轻氧化应激损伤等
	鹿红方^[57–59]	激活gp130/JAK2/STAT3，抑制p38MAPK、PI3K/Akt/Bax	抗纤维化、减轻氧化应激损伤、抑制细胞凋亡等
瘀毒互结证	解毒通络方^[62-63]	抑制TGF-β1/Smad2/3、ROCK、 NF-κB	抗纤维化、减少氧化应激反应、减轻胶原沉积等
	四妙勇安汤^[64-65]	激活AMPK，抑制Akt/mTOR、TGF-β/Smad3，抑制NF-κB，上调JNK	抗纤维化、改善心功能、抗炎、抑制过度自噬、抗氧化等
痰瘀交阻证	瓜蒌薤白半夏汤^[67-68]	激活PI3K、mTOR、HIF-1α/VEGF，调控AMPK/PGC-1α	改善血氧供应、心肌细胞功能、抑制线粒体功能障碍等
	半夏白术天麻汤^[69-70]	抑制MAPK/ ERK，调控AngII/TGF-β1/Smad	抗纤维化、改善心肌重塑、减轻胶原沉积等

中医辨证	中药复方	作用途径	调控机制
气虚血瘀证	益气活血组方^[37-38]	降低Notch1、Notch3蛋白表达，抑制p38 MAPK的磷酸化	改善心室重构、抗炎、抗凋亡等
	补阳还五汤^[39-40]	抑制TGF-β1/Smads、PI3K/Akt	抗纤维化、改善心肌重构、心功能等
	麝香保心丸^[41,42]	激活PI3K/Akt，抑制TGF-β1/Smads	抗纤维化、促进心脏微血管新生、减轻胶原沉积等
气阴两虚血瘀证	生脉散^[47]	抑制TGF-β1/Smad3	抗纤维化、抗炎、减轻胶原沉积等
	心阴片^[48]	抑制MAP3K/JNK，抑制巨噬细胞	抗纤维化、抗炎、改善心肌重构
	参竹心康汤^[49]	调节miRNA-21、PTEN/PI3K/Akt	抗纤维化、减轻胶原沉积等
阳气亏虚血瘀证	真武汤^[51-53]	激活TGF-β/JNK，调节PI3K/Akt/mTOR，调节TLR4/NF-κB	抗纤维化、抗炎、抑制自噬等
	苓桂术甘汤^[54–56]	调节Wnt/β-catenin，抑制NF-κB，激活Sirt3/AMPK	抗纤维化、保护线粒体、减轻氧化应激损伤等
	鹿红方^[57–59]	激活gp130/JAK2/STAT3，抑制p38MAPK、PI3K/Akt/Bax	抗纤维化、减轻氧化应激损伤、抑制细胞凋亡等
瘀毒互结证	解毒通络方^[62-63]	抑制TGF-β1/Smad2/3、ROCK、 NF-κB	抗纤维化、减少氧化应激反应、减轻胶原沉积等
	四妙勇安汤^[64-65]	激活AMPK，抑制Akt/mTOR、TGF-β/Smad3，抑制NF-κB，上调JNK	抗纤维化、改善心功能、抗炎、抑制过度自噬、抗氧化等
痰瘀交阻证	瓜蒌薤白半夏汤^[67-68]	激活PI3K、mTOR、HIF-1α/VEGF，调控AMPK/PGC-1α	改善血氧供应、心肌细胞功能、抑制线粒体功能障碍等
	半夏白术天麻汤^[69-70]	抑制MAPK/ ERK，调控AngII/TGF-β1/Smad	抗纤维化、改善心肌重塑、减轻胶原沉积等

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