慢性心力衰竭（chronic heart failure，CHF）是高患病率、高死亡率、高再住院率的心血管终末综合征，中药注射剂兼具中医辨证特色与快速起效优势，在CHF治疗中潜力显著。基于近10年研究，系统梳理30种中药注射剂的药效物质基础与作用特点，旨在填补该领域系统归纳的空白。按中医辨证将中药注射剂分为活血化瘀、益气养阴、温阳利水3类。活血化瘀类通过改善微循环、抑制心肌纤维化及炎症反应等发挥作用；益气养阴类聚焦调节心肌能量代谢与线粒体功能等；温阳利水类则通过调控肠道菌群、改善“肠-心轴”及抑制铁死亡等机制发挥作用。通过整合单味药与复方注射剂研究，揭示中药注射剂多成分、多靶点干预CHF复杂病理的优势，为CHF中西医结合临床治疗提供药效物质基础、作用机制及临床应用的系统证据，为精准辨证用药及创新治疗策略提供新思路。

Chronic heart failure (CHF) is a cardiovascular end syndrome with high prevalence, high mortality and high re-hospitalization rate, and traditional Chinese medicine (TCM) injections have significant potential in the treatment of CHF because of their combination of TCM evidence-based features and rapid onset of action. Based on ten years of research, this paper systematically investigates the pharmacodynamic material basis and action characteristics of 30 TCM injections to fill the gap of systematic summarization in this field. The study classified TCM injections into three categories according to TCM diagnosis: Activating blood and resolving stasis, replenishing qi and nourishing yin, and warming yang and excreting water. Activating blood and resolving stasis TCM injections can improve microcirculation and inhibit myocardial fibrosis and inflammation; replenishing qi and nourishing yin TCM injections focuses on regulating myocardial energy metabolism and mitochondrial function; warming yang and excreting water TCM injections can regulate intestinal bacterial flora, improve the “intestinal-cardiac axis” and inhibit iron death, etc. The study is the first to integrate single and compound TCM injections, revealing the advantages of TCM injections in multi-component and multi-target interventions in the complex pathology of CHF. It provides systematic evidence on the pharmacodynamic substances, mechanism of action, and clinical application for the clinical treatment of CHF using integrated Chinese and Western medicine, and provides new ideas for the precise identification of drugs and innovative treatment strategies.

R285

国家自然科学基金项目（82274412）；国家自然科学基金项目（82305092）；湖南省自然科学基金项目（2023JJ30453）；国家中医药管理局高水平中医药重点学科建设项目（ZYYZDXK-2023147）