心房颤动（房颤）是临床上最常见且危害严重的心律失常，其发生与复发与电重构、结构重构密切相关，其中以心房纤维化为核心的结构重构是关键环节。转化生长因子-β1(TGF-β1)/Smads同源物（Smads）信号通路是介导心脏纤维化、炎症反应及电重构的核心枢纽，在房颤的病理进程中扮演着至关重要的角色。目前，常规西医疗法在房颤的长期管理上面临复发率高与不良反应等挑战。中医药在防治房颤方面具有多靶点、整体调节的独特优势，其通过调控TGF-β1/Smads通路干预房颤已成为新的研究热点。系统综述TGF-β1/Smads信号通路在促进房颤心房纤维化、电重构及氧化应激等方面的作用机制，并重点归纳总结了单味中药、有效成分及中成药（复方）通过调控该通路抑制心肌纤维化、延缓房颤进程的最新实验研究成果，以期为研发防治房颤的现代中药提供坚实的理论依据。

Atrial fibrillation(AF) is the most common and serious clinical arrhythmia. Its onset and recurrence are closely related to electrical and structural remodeling, with atrial fibrosis-mediated structural remodeling being a key link. The transforming growth factor-β1(TGF-β1)/Smads signaling pathway serves as a central hub mediating cardiac fibrosis, inflammation, and electrical remodeling, playing a critical role in the pathology of AF. Currently, conventional western therapies face challenges in the long-term management of AF, such as high recurrence rates and side effects. Traditional Chinese medicine(TCM), with its unique advantages of multi-target and holistic regulation, has become a new research focus in intervening AF by modulating the TGF-β1/Smads pathway. This review systematically summarizes the mechanisms by which the TGF-β1/Smads pathway promotes atrial fibrosis, electrical remodeling, and oxidative stress in AF. It further highlights and synthesizes recent experimental research progress on how TCM monomers, active ingredients, and compound formulations inhibit myocardial fibrosis and delay AF progression by regulating this pathway. The aim is to provide a solid theoretical basis for developing modern TCM drugs for preventing and treating AF.

R285.5

首都卫生发展科研专项(首发2020-2-4203); 国家中医药管理局第二批全国西医学习中医优秀人才研修项目(国中医药人教函[2023]90号); 中央高水平中医医院临床科研业务费资助