益气扶正治法对血液超滤治疗慢性心力衰竭代谢机制的研究

The ultrafiltration makes mechanical diuretic come true. It not only can reduce the volume load of heart-failure patients, inhibit the sympathetic nervous system and the renin - angiotensin system, but also can reduce the excitatory effects of the neuroendocrine axis. However we found that it used for heart failure has pathological mechanisms of rectifying XIE and harming ZHENG which can be avoid by TCM intervention that can tonify ZHENG(Reduce the adverse effects of ultrafiltration ) and rectify XIE(reduce sodium and water retention). This research proposed very important treatment principles which based on"ultrafiltration used for heart failure has pathological mechanisms of rectifying XIE and harming ZHENG " ,by analyzing the metabolic mechanisms used etabolomics technology that made heart-failure patients who used ultrafiltration treatment as study boject, the renin - angiotensin system and the way of cytokines as the starting point, combined TCM intervention of tonifying qi and strengthening the body resistance，to provide an objective basis of pathophysiological mechanisms of TCM therapeutic principle.

血液超滤可以实现机械性利尿，能够减少心衰患者的容量负荷，抑制交感神经系统和肾素-血管紧张素系统，减少神经内分泌轴的兴奋作用，但血液超滤治疗心衰存在祛邪伤正的病理机制，而中医药干预能够达到扶正（减少UF治疗的不良反应）和祛邪（减少钠水储留）的目的。本研究针对"血液超滤治疗心衰存在祛邪伤正的病理机制"这一关键治则问题，以血液超滤治疗的心衰患者为研究对象，拟以肾素-血管紧张素系统及细胞因子途径为切入点，引入代谢组学技术，研究血液超滤治疗心衰的祛邪伤正的病理机制，结合益气扶正中药干预，分析血液超滤治疗心力衰竭祛邪伤正的代谢机制，为揭示心衰中医不同治则治法的病理生理机制提供客观依据。

血液超滤可以实现机械性利尿，能够减少心衰患者的容量负荷，抑制交感神经系统和肾素-血管紧张素系统，减少神经内分泌轴的兴奋作用，但血液超滤治疗心衰存在祛邪伤正的病理机制，而中医药干预能够达到扶正（减少UF治疗的不良反应）和祛邪（减少钠水储留）的目的。我们分析了血液超滤治疗心衰患者的中医证候特点与治则治法的关系，建立了心衰血液超滤治疗患者尿及血清样品的代谢组学测试和模式，研究了益气扶正中药对血液超滤治疗心衰患者的神经内分泌及细胞因子调控机制和代谢组学，并获得了一系列成果，为同类研究提供示范和参考。培养了2名硕士研究生，已发表6篇相关学术文章，尚有3-4篇相关文章待发表。