心肌纤维化是以细胞外基质（ECM）中胶原纤维过量积聚、代谢失衡、胶原成分比例失调且排列紊乱为特征的一种疾病，心力衰竭会导致心肌纤维化发生，心肌纤维化反过来又会导致心肌僵硬度增加，心室肌顺应性下降，纤维化程度越严重，心力衰竭症状会越重，心肌纤维化是造成心力衰竭的重要原因，是心血管疾病发生发展的独立危险因素。临床上改善心肌纤维化的中药类制剂主要有益气养阴类、益气活血类、益气温阳利水类3种，此类制剂可以通过调控转化生长因子β（TGF-β）信号通路、减少胶原沉积、改善线粒体能量途径、减少氧化应激损伤以及调节炎症反应等减缓或逆转心肌纤维化进程，对此类中药制剂改善心肌纤维化的药理作用及机制进行归纳总结，为改善心肌纤维化的新药研发及临床合理用药提供依据。

Myocardial fibrosis (MF) is a disease characterized by excessive accumulation of collagen fibers, metabolic imbalance, imbalance in the proportion of collagen components and disordered arrangement in the extracellular matrix (ECM), heart failure will lead to myocardial fibrosis, which in turn will lead to an increase in myocardial stiffness, a decrease in ventricular muscle compliance, and the more severe the degree of fibrosis, the more severe the symptoms of heart failure, myocardial fibrosis is an important cause of heart failure, and is an independent risk factor for the occurrence and development of cardiovascular diseases. Clinically, there are three kinds of traditional Chinese medicine preparations for improving MF: invigorating qi and nourishing yin, invigorating qi and promoting blood circulation, invigorating qi and warming yang and promoting diuresis. These preparations can slow down or reverse the process of MF by regulating transforming growth factor β (TGF-β) signal pathway, reducing collagen deposition, improving mitochondrial energy pathway, reducing oxidative stress damage and regulating inflammatory reaction. This paper summarizes the pharmacological effects and mechanisms of these traditional Chinese medicine preparations for improving MF, and provides a basis for improving new drug research and clinical rational drug use.

R285.5

天津市制造业高质量发展专项资金—天津天士力之骄药业有限公司技术中心创新能力建设（ZZY20232088）