Article(id=1304415574184977080, tenantId=1146029695717560320, journalId=1302319053441957962, issueId=1304415531491152712, articleNumber=null, orderNo=null, doi=10.7501/j.issn.0253-2670.2026.09.027, pmid=null, cstr=null, oa=null, hot=0, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1765555200000, receivedDateStr=2025-12-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1788926507754, onlineDateStr=2026-09-09, pubDate=null, pubDateStr=null, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1788926507754, onlineIssueDateStr=2026-09-09, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1788926507754, creator=13701087609, updateTime=1788926507754, updator=13701087609, issue=Issue{id=1304415531491152712, tenantId=1146029695717560320, journalId=1302319053441957962, year='2026', volume='57', issue='9', pageStart='3261', pageEnd='3684', issueExtLink='null', onlineDate='null', pubDate='1778515200000', pubDateStr='2026-05-12', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1788926497576, creator='13701087609', updateTime=1788926796984, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1304416787358049066, tenantId=1146029695717560320, journalId=1302319053441957962, issueId=1304415531491152712, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1304416787358049067, tenantId=1146029695717560320, journalId=1302319053441957962, issueId=1304415531491152712, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3588, endPage=3599, ext={EN=ArticleExt(id=1304415574969311932, articleId=1304415574184977080, tenantId=1146029695717560320, journalId=1302319053441957962, language=EN, title=Synergistic mechanism of “cardio-pulmonary-muscular-skeletal” functional axis and clinical evidence for traditional Chinese medicine formulae in improving exercise capacity in patients with cardiovascular disease, columnId=null, journalTitle=Chinese Traditional and Herbal Drugs, columnName=null, runingTitle=null, highlight=null, articleAbstract=Impaired exercise capacity is an independent risk factor for poor prognosis in patients with cardiovascular disease (CVD). The vicious cycle triggered by CVD, centered on cardiac dysfunction, progressively compromises pulmonary ventilation/gas exchange, skeletal muscle metabolism, and skeletal function, collectively leading to exercise intolerance. The “cardio-pulmonary-muscular-skeletal” functional axis theory is proposed to elucidate this multisystem deterioration. Within the framework, this review systematically discusses the mechanisms by which traditional Chinese medicine (TCM) interventions synergistically reverse exercise intolerance. These mechanisms include improving cardiac and vascular function, enhancing pulmonary ventilation and oxygenation, increasing muscle mass and metabolic function, and maintaining bone quality and mechanical function, thereby leveraging the multi-targeted and holistic regulatory advantages of TCM. Although the overall quality of clinical evidence remains moderate, a multidimensional evidence system centered on exercise tolerance has been established. This evidence confirms the consistent benefits of TCM formulas on core indicators across the functional axis. The functional axis theory provides an innovative framework for understanding the multisystemic underlying mechanisms of exercise capacity decline in CVD patients and for guiding holistic TCM-based interventions, highlighting the unique value of TCM in cardiac rehabilitation., authors=WANG Yimiao, LU Feng, authorsList=WANG Yimiao, LU Feng, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1304415574625379003, articleId=1304415574184977080, tenantId=1146029695717560320, journalId=1302319053441957962, language=CN, title=中药复方改善心血管疾病患者运动能力的“心-肺-肌-骨”功能轴协同机制及临床证据, columnId=1304140194685415572, journalTitle=中草药, columnName=综述, runingTitle=null, highlight=null, articleAbstract=运动能力下降是心血管疾病(cardiovascular disease,CVD)患者预后不良的独立危险因素。针对CVD引发以心功能不全为核心的恶性循环累及肺通气/氧合、骨骼肌代谢及骨骼力学功能,共同导致运动能力衰竭,提出“心-肺-肌-骨”功能轴协同理论,并以此为基础系统阐述中药干预通过改善心功能与血管功能、提升肺通气与氧合能力、增强肌肉质量与代谢功能、维持骨骼质量与力学功能等多重机制,发挥多靶点、整体调节优势以协同逆转运动能力下降的作用。临床证据整体质量总体偏低,但已形成以运动耐量为核心、覆盖功能轴各子系统的多维度证据体系,证实中药复方对功能轴核心指标的一致改善作用。该功能轴理论为阐释CVD患者运动能力下降的多系统深层机制,解析中药整体调节优势并优化干预策略提供了创新框架,体现了中医药在心脏康复领域的独特价值。, authors=王一淼1, 陆峰1, authorsList=王一淼, 陆峰, authorCompany=1 山东中医药大学第一临床医学院, 山东 济南 250000, correspAuthors=陆峰, authorNote=王一淼: 王一淼,硕士研究生,从事中医心病学研究。E-mail:2450714419@qq.com, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=/+aFlofeK5Oi08hNLGS8ww==, pdfFileSize=1143235, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=延边大学创新团队项目(012023051))}, authors=null, keywords=[Keyword(id=1304415575107723965, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=CN, orderNo=1, keyword=心血管疾病), Keyword(id=1304415575397130942, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=CN, orderNo=2, keyword=中药), Keyword(id=1304415575531348671, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=CN, orderNo=3, keyword=运动能力), Keyword(id=1304415575803978432, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=CN, orderNo=4, keyword=“心-肺-肌-骨”功能轴), Keyword(id=1304415575879475905, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=CN, orderNo=5, keyword=作用机制), Keyword(id=1304415575950779074, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=CN, orderNo=6, keyword=临床证据), Keyword(id=1304415576240186051, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=EN, orderNo=1, keyword=cardiovascular diseases), Keyword(id=1304415576298906308, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=EN, orderNo=2, keyword=traditional Chinese medicine), Keyword(id=1304415576357626565, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=EN, orderNo=3, keyword=exercise capacity), Keyword(id=1304415576680587974, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=EN, orderNo=4, keyword=“cardio-pulmonary-muscular-skeletal” functional axis), Keyword(id=1304415576743502535, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=EN, orderNo=5, keyword=mechanism of action), Keyword(id=1304415576806417096, tenantId=1146029695717560320, journalId=1302319053441957962, articleId=1304415574184977080, language=EN, orderNo=6, keyword=clinical evidence)], refs=null, funds=null, companyList=null, figs=null, attaches=null, journal=Journal(id=1302309778002903112, delFlag=0, nameCn=中草药, nameEn=Chinese Traditional and Herbal Drugs, nameHistory1=null, nameHistory2=null, issn=0253-2670, eissn=null, cn=12-1108/R, coden=null, periodic=3, language=CN, oaType=null, ccby=null, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=cGpSKCP11AF8PAOcTXYWfg==, journalPrice=null, startedYear=null, abbrevIsoEn=Chinese Traditional and Herbal Drugs, journalRemark=null, publicationField=null, createdTime=1788424446827, updatedTime=1788949289390, createdBy=18614031015, updatedBy=13041195026, firstLetterCn=Z, firstLetterEn=Z, subjectCode=Medical and Pharmaceutical Sciences, subjectName=null, subjectCodeEn=Medical and Pharmaceutical Sciences, subjectNameEn=null, picCn=cGpSKCP11AF8PAOcTXYWfg==, picEn=Xw//kxUC3ON4eHxev0QLhQ==, jcr=null, cjcr=null, exts=[JournalExt(id=1304511127375863983, language=CN, name=中草药, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1788949289411, updatedTime=1788949289411, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=https://www.tiprpress.com/zcy/author/login, submissionEditorUrl=https://www.tiprpress.com/zcy/editor/login, submissionReviewUrl=https://www.tiprpress.com/zcy/reviewer/login, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1304511127442972848, language=EN, name=Chinese Traditional and Herbal Drugs, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1788949289427, updatedTime=1788949289427, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=https://www.tiprpress.com/zcy/author/login, submissionEditorUrl=https://www.tiprpress.com/zcy/editor/login, submissionReviewUrl=https://www.tiprpress.com/zcy/reviewer/login, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1302319053441957962, websiteList=[Website(id=1302319176408912052, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1302319053441957962, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/zcy/CN, language=CN, createTime=1788426687576, createBy=18614031015, updateTime=1788427346252, updateBy=18614031015, name=中草药-中文, tplId=1146099689490845704, title=中草药, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1302322043651904087, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=articleTextType, value=kx, createTime=1788427371180, updateTime=1788427371180, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043593183828, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=banner, value=null, createTime=1788427371166, updateTime=1788427371166, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043672875610, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=grayFlag, value=0, createTime=1788427371185, updateTime=1788427371185, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043584795219, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=logo, value=https://castjournals.cast.org.cn/joweb/zcy/CN/file/pic?fileId=uiD1gpiRqR++OLOz4iKzDg==, createTime=1788427371164, updateTime=1788427371164, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043689652828, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=minRunFlag, value=0, createTime=1788427371189, updateTime=1788427371189, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043643515478, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/zcy/CN/file/pic, createTime=1788427371178, updateTime=1788427371178, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043681264219, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=silenceFlag, value=0, createTime=1788427371187, updateTime=1788427371187, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043601572437, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1788427371168, updateTime=1788427371168, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043660292696, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=themeColor, value=null, createTime=1788427371182, updateTime=1788427371182, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322043668681305, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176408912052, code=themeStyle, value=null, createTime=1788427371184, updateTime=1788427371184, creator=18614031015, updator=18614031015)]), Website(id=1302319176715096246, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1302319053441957962, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/zcy/EN, language=EN, createTime=1788426687649, createBy=18614031015, updateTime=1788427341161, updateBy=18614031015, name=中草药-英文, tplId=1146101810881728533, title=Chinese Traditional and Herbal Drugs, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1302322015206134340, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=articleTextType, value=kx, createTime=1788427364398, updateTime=1788427364398, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015185162817, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=banner, value=null, createTime=1788427364393, updateTime=1788427364393, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015227105863, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=grayFlag, value=0, createTime=1788427364403, updateTime=1788427364403, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015176774208, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=logo, value=https://castjournals.cast.org.cn/joweb/zcy/EN/file/pic?fileId=uiD1gpiRqR++OLOz4iKzDg==, createTime=1788427364391, updateTime=1788427364391, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015239688777, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=minRunFlag, value=0, createTime=1788427364406, updateTime=1788427364406, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015201940035, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/zcy/EN/file/pic, createTime=1788427364397, updateTime=1788427364397, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015235494472, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=silenceFlag, value=0, createTime=1788427364405, updateTime=1788427364405, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015193551426, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1788427364395, updateTime=1788427364395, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015214522949, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=themeColor, value=null, createTime=1788427364400, updateTime=1788427364400, creator=18614031015, updator=18614031015), WebsiteProps(id=1302322015218717254, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1302319176715096246, code=themeStyle, value=null, createTime=1788427364401, updateTime=1788427364401, creator=18614031015, updator=18614031015)])], journalTitle=中草药, weixinUrl=null, journalUrl=https://www.tiprpress.com/zcy, iacademicId=null, status=1, seqNo=null, journalTitleEn=Chinese Traditional and Herbal Drugs, journalPhotoCn=cGpSKCP11AF8PAOcTXYWfg==, journalPhotoEn=Xw//kxUC3ON4eHxev0QLhQ==, journalFirstLetter=Z, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false, interPubPlatform=, interPubPlatformUrl=null), detailUrlCn=https://castjournals.cast.org.cn/joweb/zcy/CN/10.7501/j.issn.0253-2670.2026.09.027, detailUrlEn=https://castjournals.cast.org.cn/joweb/zcy/EN/10.7501/j.issn.0253-2670.2026.09.027, pdfUrlCn=https://castjournals.cast.org.cn/joweb/zcy/CN/PDF/10.7501/j.issn.0253-2670.2026.09.027, pdfUrlEn=https://castjournals.cast.org.cn/joweb/zcy/EN/PDF/10.7501/j.issn.0253-2670.2026.09.027, aliStartDate=null, aliEndDate=null, collectionFlag=false, citedCount=null, citedUrl=null, previewStatus=0, delFlag=0, hasFullText=0, orderTime=1788926507754, fullTextJson=null, articleText=null, reference=Chong B, Jayabaskaran J, Jauhari S M, et al. Global burden of cardiovascular diseases:Projections from 2025 to 2050[J]. Eur J Prev Cardiol, 2025, 32(11):1001-1015. Hedman K, Lindow T, Cauwenberghs N, et al. Peak exercise SBP and future risk of cardiovascular disease and mortality[J]. J Hypertens, 2022, 40(2):300-309. Korpelainen R, LämsäJ, Kaikkonen K M, et al. Exercise capacity and mortality-a follow-up study of 3033 subjects referred to clinical exercise testing[J]. Ann Med, 2016,48(5):359-366. Forman D E, Arena R, Boxer R, et al. Prioritizing functional capacity as a principal end point for therapies oriented to older adults with cardiovascular disease:A scientific statement for healthcare professionals from the American heart association[J]. Circulation, 2017,135(16):e894-e918. Kotseva K, De Bacquer D, De Backer G, et al. Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries:Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry[J]. Eur J Prev Cardio, 2019,26(8):824-835. Kitzman D W, Whellan D J, Duncan P, et al. Physical rehabilitation for older patients hospitalized for heart failure[J]. N Engl J Med, 2021, 385(3):203-216. Salzano A, De Luca M, Israr M Z, et al. Exercise intolerance in heart failure with preserved ejection fraction[J]. Heart Fail Clin, 2021, 17(3):397-413. 张军月,张淇隆,卫靖靖,等.不同中成药联合指南导向药物治疗慢性心力衰竭的网状Meta分析[J].中草药, 2026, 57(6):2246-2264. Zhang M, Sun M Y, Yin H J, et al. The efficacy of Yiqi Huoxue therapy for chronic heart failure:A meta-analysis in accordance with PRISMA guideline[J]. Medicine,2022, 101(34):e30082. Zhang S S, Shen Y Q, Liu P L, et al. Yangxinshi tablet improves exercise capacity for patients with coronary heart disease:Results from a randomized, double-blind,placebo-controlled, and multicenter trial[J]. Rev Cardiovasc Med, 2022, 23(8):266. Carlström M, Weitzberg E, Lundberg J O. Nitric oxide signaling and regulation in the cardiovascular system:Recent advances[J]. Pharmacol Rev, 2024, 76(6):1038-1062. Smith C, Lin X Z, Parker L, et al. The role of bone in energy metabolism:A focus on osteocalcin[J]. Bone,2024, 188:117238. McCoy J, Bates M, Eggett C, et al. Pathophysiology of exercise intolerance in chronic diseases:The role of diminished cardiac performance in mitochondrial and heart failure patients[J]. Open Heart, 2017, 4(2):e000632. Visco V, Forte M, Giallauria F, et al. Epigenetic mechanisms underlying the beneficial effects of cardiac rehabilitation. An overview from the working groups of“cellular and molecular biology of the heart” and“cardiac rehabilitation and cardiovascular prevention” of the Italian Society of Cardiology(SIC)[J]. Int J Cardiol, 2025, 429:133166. Loncar G, Garfias-Veitl T, Valentova M, et al. Bone status in men with heart failure:Results from the studies investigating co-morbidities aggravating heart failure[J].Eur J Heart Fail, 2023, 25(5):714-723. Liu Y, Yao Q, Yu J B, et al. The bone-heart axis:A crucial dialogue in cardiovascular disease[J]. Metabolism, 2025,170:156332. Widmann L, Keranov S, Jafari L, et al. Fibroblast growth factor 23 as a biomarker of right ventricular dysfunction in pulmonary hypertension[J]. Clin Res Cardiol, 2023,112(10):1382-1393. Gosker H R, Wouters E F, van der Vusse G J, et al. Skeletal muscle dysfunction in chronic obstructive pulmonary disease and chronic heart failure:Underlying mechanisms and therapy perspectives 1 2 3[J]. Am J Clin Nutr, 2000,71(5):1033-1047. Chua J R, Tee M L. Association of sarcopenia with osteoporosis in patients with chronic obstructive pulmonary disease[J]. Osteoporos Sarcopenia, 2020, 6(3):129-132. Fushimi S, Nohno T, Katsuyama H. Chronic stress induces type 2b skeletal muscle atrophy via the inhibition of m TORC1 signaling in mice[J]. Med Sci, 2023, 11(1):19. Briot K. Bone and glucocorticoids[J]. Ann D'endocrinologie, 2018, 79(3):115-118. Zhang S F, Zhang Y N, Li B, et al. Physical inactivity induces the atrophy of skeletal muscle of rats through activating AMPK/FoxO3 signal pathway[J]. Eur Rev Med Pharmacol Sci, 2018, 22(1):199-209. Tashiro H, Takahashi K. Clinical impacts of interventions for physical activity and sedentary behavior on patients with chronic obstructive pulmonary disease[J]. J Clin Med, 2023, 12(4):1631. Pressman S D, Jenkins B N, Moskowitz J T. Positive affect and health:What do we know and where next should we go?[J]. Annu Rev Psychol, 2019, 70:627-650. Wang S, Wang L, Gu S K, et al. Effect of optimized new Shengmai Powder on exercise tolerance in rats with heart failure by regulating the ubiquitin-proteasome signaling pathway[J]. Front Cardiovasc Med, 2023, 10:1168341. Hou Y Z, He Z X, Han Y X, et al. Mechanism of new optimized Sheng-Mai-San Formula to regulate cardiomyocyte apoptosis through NMDAR pathway[J].Heliyon, 2023, 9(6):e16631. Zhang Z Y, Song Y W, Zhang X, et al. Optimized new Shengmai powder ameliorates myocardial fibrosis in rats with heart failure by inhibition of the MAPK signaling pathway[J]. J Ethnopharmacol, 2024, 319(Pt 1):117210. Ren W Q, Gao S, Zhang H M, et al. Decomposing the mechanism of Qishen Granules in the treatment of heart failure by a quantitative pathway analysis method[J].Molecules, 2018, 23(7):1829. Ma M J, Fan H, Dong Y D, et al. Kuoxin decoction alleviated left ventricular remodeling by inhibiting cardiomyocyte apoptosis through ASK1/JNK/Cx43signaling pathway in cTnTR141W transgenic mice and in vitro[J]. Drug Des Devel Ther, 2025, 19:6665-6686. Zhan Q Y, Peng W J, Wang S Q, et al. Heart failure with preserved ejection fraction:Pathogenesis, diagnosis,exercise, and medical therapies[J]. J Cardiovasc Transl Res, 2023, 16(2):310-326. Chen Y C, Cui L D, Wang C, et al. Ameliorative effects and mechanism of Buyang Huanwu Decoction on pulmonary vascular remodeling:Network and experimental analyses[J]. Oxid Med Cell Longev, 2021,2021:4576071. Li Q, Su L S, Zhou R J, et al. Efficacy and safety of Yangyin Shuxin Decoction-a Chinese herbal medicine formula for heart failure with preserved ejection fraction:A randomized controlled trial[J]. Evid Based Complement Alternat Med, 2022, 2022:1486366. Li Y, Li Y, Zhang Z J, et al. Efficacy and safety of Yangxinshi versus trimetazidine on exercise tolerance in patients with coronary heart disease after percutaneous coronary intervention:Multicenter, double-blind clinical trial[J]. Phytomedicine, 2024, 135:156198. Song H X, Liu C Y, Yang Z M, et al. Yangxinshi tablet protects against myocardial injury and increases skeletal muscle exercise capacity by regulating mitochondrial bioenergetics[J]. Phytomedicine, 2025, 145:156990. Wu R M, Jiang B, Li H, et al. Yang Xin Shi Tablet enhances adaptability to exercise training by relieving statin-induced skeletal muscle injury[J]. Chin Med J,2020, 133(18):2266-2268. Kondo T, Yamada S, Asai C, et al. Skeletal muscle pump function is associated with exercise capacity in patients with heart failure[J]. Circ J, 2018, 82(4):1033-1040. An Z C, Wu B, Mao W N, et al. Mechanisms and traditional Chinese medicine therapeutics for primary osteoporosis:An integrated perspective[J]. Front Endocrinol, 2025, 16:1638629. Ji W, Gong G Q, Liu Y H, et al. Icariin promotes osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)by activating PI3K-AKT-UTX/EZH2signaling in steroid-induced femoral head osteonecrosis[J]. J Orthop Surg Res, 2025, 20(1):290. Cao G, Hu S Q, Ning Y, et al. Traditional Chinese medicine in osteoporosis:From pathogenesis to potential activity[J]. Front Pharmacol, 2024, 15:1370900. Wang B Y, Chen Y F, Hsiao A W, et al. Ginkgolide B facilitates muscle regeneration via rejuvenating osteocalcinmediated bone-to-muscle modulation in aged mice[J]. J Cachexia Sarcopenia Muscle, 2023, 14(3):1349-1364. Li Y, Feng X, Chen B Y, et al. Retrospective analysis of exercise capacity in patients with coronary artery disease after percutaneous coronary intervention or coronary artery bypass graft[J]. Int J Nurs Sci, 2021, 8(3):257-263. Xiao J, Bingxin W U, Huanlin W U, et al. Effectiveness of Shenshu Guanxin Recipe Granules for improving exercise tolerance in patients with stable angina pectoris:A randomized, double-blind, placebo-controlled trial[J]. J Tradit Chin Med, 2023, 43(6):1227-1233. Zhang C X, Zheng Y G, Chen T, et al. The utility of traditional Chinese medicine(Shenmai)in the cardiac rehabilitation after coronary artery bypass grafting:A single-center randomized clinical trial[J]. Complementary Ther Med, 2019, 47:102203. Nie H Y, Li S Q, Liu M L, et al. Yiqi Fumai Injection as an adjuvant therapy in treating chronic heart failure:A metaanalysis of 33 randomized controlled trials[J]. Evid Based Complementary Altern Med, 2020, 2020:1876080. Wu Q Y, Zhang Q Y, Li Y, et al. A systematic review and meta-analysis of high-frequency prescription of Zhigancao Decoction combined with conventional western medicine in the treatment of chronic heart failure[J]. Evid Based Complementary Altern Med, 2021, 2021:7140044. Liu S P, Zhou J G, Jin Y, et al. Therapeutic efficacy of Shexiang Baoxin Pill combined with exercise in patients with heart failure with preserved ejection fraction:A single-center, double-blind, randomized controlled trial[J]. Chin J Integr Med, 2023, 29(2):99-107. Man Q S, Chen S J, Li X Y. Efficacy and safety of Qishen Yiqi Propping Pills combined with modern medicine for coronary heart disease with ischemic heart failure:A systematic review and meta-analysis[J]. Medicine, 2024,103(44):e39927. Mao J Y, Zhang J, Lam C S P, et al. Qishen Yiqi Dripping Pills for chronic ischaemic heart failure:Results of the CACT-IHF randomized clinical trial[J]. ESC Heart Fail,2020, 7(6):3881-3890. Wang X M, Dai G H, Guan H, et al. Clinical efficacy and safety of adjunctive treatment of chronic ischemic heart failure with Qishen Yiqi Dropping Pills:A systematic review and meta-analysis[J]. Front Cardiovasc Med,2023, 10:1271608. Visseren F L J, Mach F, Smulders Y M, et al. 2023 ESC Guidelines on cardiovascular disease prevention in clinical practice[J]. Eur Heart J, 2023,44(38), 3850-3876. Hu X Z, Zhou M, Weng J H. Eight trigrams Boxing combined with Wenyang Huoxue Recipe improves cardiopulmonary motor function and the quality of life of patients with coronary heart disease[J]. Int J Gen Med,2021, 14:7557-7566. Dhar I, Svingen G F, Pedersen E K, et al. Physical activity and risk of all-cause mortality in patients with stable angina pectoris:Effect modification by β-blocker treatment[J]. Int J Cardiol Cardiovasc Risk Prev, 2022,15:200150.)
中药复方改善心血管疾病患者运动能力的“心-肺-肌-骨”功能轴协同机制及临床证据
PDF下载
中草药
| 综述 2026,57(9): 3588-3599
收起
中草药
|综述
2026
, 57
(9) :
3588
-3599
中药复方改善心血管疾病患者运动能力的“心-肺-肌-骨”功能轴协同机制及临床证据
全屏
王一淼1, 陆峰1
作者信息
1 山东中医药大学第一临床医学院, 山东 济南 250000
通讯作者:
陆峰
作者简介:
王一淼: 王一淼,硕士研究生,从事中医心病学研究。E-mail:2450714419@qq.com
Synergistic mechanism of “cardio-pulmonary-muscular-skeletal” functional axis and clinical evidence for traditional Chinese medicine formulae in improving exercise capacity in patients with cardiovascular disease
Impaired exercise capacity is an independent risk factor for poor prognosis in patients with cardiovascular disease (CVD). The vicious cycle triggered by CVD, centered on cardiac dysfunction, progressively compromises pulmonary ventilation/gas exchange, skeletal muscle metabolism, and skeletal function, collectively leading to exercise intolerance. The “cardio-pulmonary-muscular-skeletal” functional axis theory is proposed to elucidate this multisystem deterioration. Within the framework, this review systematically discusses the mechanisms by which traditional Chinese medicine (TCM) interventions synergistically reverse exercise intolerance. These mechanisms include improving cardiac and vascular function, enhancing pulmonary ventilation and oxygenation, increasing muscle mass and metabolic function, and maintaining bone quality and mechanical function, thereby leveraging the multi-targeted and holistic regulatory advantages of TCM. Although the overall quality of clinical evidence remains moderate, a multidimensional evidence system centered on exercise tolerance has been established. This evidence confirms the consistent benefits of TCM formulas on core indicators across the functional axis. The functional axis theory provides an innovative framework for understanding the multisystemic underlying mechanisms of exercise capacity decline in CVD patients and for guiding holistic TCM-based interventions, highlighting the unique value of TCM in cardiac rehabilitation.
Key words
cardiovascular diseases
/
traditional Chinese medicine
/
exercise capacity
/
“cardio-pulmonary-muscular-skeletal” functional axis
/
mechanism of action
/
clinical evidence
WANG Yimiao, LU Feng.
Synergistic mechanism of “cardio-pulmonary-muscular-skeletal” functional axis and clinical evidence for traditional Chinese medicine formulae in improving exercise capacity in patients with cardiovascular disease[J].
Chinese Traditional and Herbal Drugs,
2026
, 57
(9)
: 3588
-3599
.
DOI: 10.7501/j.issn.0253-2670.2026.09.027
基金
收起
延边大学创新团队项目(012023051)
参考文献
收起
文献
收起
参考文献引证文献
排序方式:
Chong B, Jayabaskaran J, Jauhari S M, et al. Global burden of cardiovascular diseases:Projections from 2025 to 2050[J]. Eur J Prev Cardiol, 2025, 32(11):1001-1015. Hedman K, Lindow T, Cauwenberghs N, et al. Peak exercise SBP and future risk of cardiovascular disease and mortality[J]. J Hypertens, 2022, 40(2):300-309. Korpelainen R, LämsäJ, Kaikkonen K M, et al. Exercise capacity and mortality-a follow-up study of 3033 subjects referred to clinical exercise testing[J]. Ann Med, 2016,48(5):359-366. Forman D E, Arena R, Boxer R, et al. Prioritizing functional capacity as a principal end point for therapies oriented to older adults with cardiovascular disease:A scientific statement for healthcare professionals from the American heart association[J]. Circulation, 2017,135(16):e894-e918. Kotseva K, De Bacquer D, De Backer G, et al. Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries:Results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry[J]. Eur J Prev Cardio, 2019,26(8):824-835. Kitzman D W, Whellan D J, Duncan P, et al. Physical rehabilitation for older patients hospitalized for heart failure[J]. N Engl J Med, 2021, 385(3):203-216. Salzano A, De Luca M, Israr M Z, et al. Exercise intolerance in heart failure with preserved ejection fraction[J]. Heart Fail Clin, 2021, 17(3):397-413. 张军月,张淇隆,卫靖靖,等.不同中成药联合指南导向药物治疗慢性心力衰竭的网状Meta分析[J].中草药, 2026, 57(6):2246-2264. Zhang M, Sun M Y, Yin H J, et al. The efficacy of Yiqi Huoxue therapy for chronic heart failure:A meta-analysis in accordance with PRISMA guideline[J]. Medicine,2022, 101(34):e30082. Zhang S S, Shen Y Q, Liu P L, et al. Yangxinshi tablet improves exercise capacity for patients with coronary heart disease:Results from a randomized, double-blind,placebo-controlled, and multicenter trial[J]. Rev Cardiovasc Med, 2022, 23(8):266. Carlström M, Weitzberg E, Lundberg J O. Nitric oxide signaling and regulation in the cardiovascular system:Recent advances[J]. Pharmacol Rev, 2024, 76(6):1038-1062. Smith C, Lin X Z, Parker L, et al. The role of bone in energy metabolism:A focus on osteocalcin[J]. Bone,2024, 188:117238. McCoy J, Bates M, Eggett C, et al. Pathophysiology of exercise intolerance in chronic diseases:The role of diminished cardiac performance in mitochondrial and heart failure patients[J]. Open Heart, 2017, 4(2):e000632. Visco V, Forte M, Giallauria F, et al. Epigenetic mechanisms underlying the beneficial effects of cardiac rehabilitation. An overview from the working groups of“cellular and molecular biology of the heart” and“cardiac rehabilitation and cardiovascular prevention” of the Italian Society of Cardiology(SIC)[J]. Int J Cardiol, 2025, 429:133166. Loncar G, Garfias-Veitl T, Valentova M, et al. Bone status in men with heart failure:Results from the studies investigating co-morbidities aggravating heart failure[J].Eur J Heart Fail, 2023, 25(5):714-723. Liu Y, Yao Q, Yu J B, et al. The bone-heart axis:A crucial dialogue in cardiovascular disease[J]. Metabolism, 2025,170:156332. Widmann L, Keranov S, Jafari L, et al. Fibroblast growth factor 23 as a biomarker of right ventricular dysfunction in pulmonary hypertension[J]. Clin Res Cardiol, 2023,112(10):1382-1393. Gosker H R, Wouters E F, van der Vusse G J, et al. Skeletal muscle dysfunction in chronic obstructive pulmonary disease and chronic heart failure:Underlying mechanisms and therapy perspectives 1 2 3[J]. Am J Clin Nutr, 2000,71(5):1033-1047. Chua J R, Tee M L. Association of sarcopenia with osteoporosis in patients with chronic obstructive pulmonary disease[J]. Osteoporos Sarcopenia, 2020, 6(3):129-132. Fushimi S, Nohno T, Katsuyama H. Chronic stress induces type 2b skeletal muscle atrophy via the inhibition of m TORC1 signaling in mice[J]. Med Sci, 2023, 11(1):19. Briot K. Bone and glucocorticoids[J]. Ann D'endocrinologie, 2018, 79(3):115-118. Zhang S F, Zhang Y N, Li B, et al. Physical inactivity induces the atrophy of skeletal muscle of rats through activating AMPK/FoxO3 signal pathway[J]. Eur Rev Med Pharmacol Sci, 2018, 22(1):199-209. Tashiro H, Takahashi K. Clinical impacts of interventions for physical activity and sedentary behavior on patients with chronic obstructive pulmonary disease[J]. J Clin Med, 2023, 12(4):1631. Pressman S D, Jenkins B N, Moskowitz J T. Positive affect and health:What do we know and where next should we go?[J]. Annu Rev Psychol, 2019, 70:627-650. Wang S, Wang L, Gu S K, et al. Effect of optimized new Shengmai Powder on exercise tolerance in rats with heart failure by regulating the ubiquitin-proteasome signaling pathway[J]. Front Cardiovasc Med, 2023, 10:1168341. Hou Y Z, He Z X, Han Y X, et al. Mechanism of new optimized Sheng-Mai-San Formula to regulate cardiomyocyte apoptosis through NMDAR pathway[J].Heliyon, 2023, 9(6):e16631. Zhang Z Y, Song Y W, Zhang X, et al. Optimized new Shengmai powder ameliorates myocardial fibrosis in rats with heart failure by inhibition of the MAPK signaling pathway[J]. J Ethnopharmacol, 2024, 319(Pt 1):117210. Ren W Q, Gao S, Zhang H M, et al. Decomposing the mechanism of Qishen Granules in the treatment of heart failure by a quantitative pathway analysis method[J].Molecules, 2018, 23(7):1829. Ma M J, Fan H, Dong Y D, et al. Kuoxin decoction alleviated left ventricular remodeling by inhibiting cardiomyocyte apoptosis through ASK1/JNK/Cx43signaling pathway in cTnTR141W transgenic mice and in vitro[J]. Drug Des Devel Ther, 2025, 19:6665-6686. Zhan Q Y, Peng W J, Wang S Q, et al. Heart failure with preserved ejection fraction:Pathogenesis, diagnosis,exercise, and medical therapies[J]. J Cardiovasc Transl Res, 2023, 16(2):310-326. Chen Y C, Cui L D, Wang C, et al. Ameliorative effects and mechanism of Buyang Huanwu Decoction on pulmonary vascular remodeling:Network and experimental analyses[J]. Oxid Med Cell Longev, 2021,2021:4576071. Li Q, Su L S, Zhou R J, et al. Efficacy and safety of Yangyin Shuxin Decoction-a Chinese herbal medicine formula for heart failure with preserved ejection fraction:A randomized controlled trial[J]. Evid Based Complement Alternat Med, 2022, 2022:1486366. Li Y, Li Y, Zhang Z J, et al. Efficacy and safety of Yangxinshi versus trimetazidine on exercise tolerance in patients with coronary heart disease after percutaneous coronary intervention:Multicenter, double-blind clinical trial[J]. Phytomedicine, 2024, 135:156198. Song H X, Liu C Y, Yang Z M, et al. Yangxinshi tablet protects against myocardial injury and increases skeletal muscle exercise capacity by regulating mitochondrial bioenergetics[J]. Phytomedicine, 2025, 145:156990. Wu R M, Jiang B, Li H, et al. Yang Xin Shi Tablet enhances adaptability to exercise training by relieving statin-induced skeletal muscle injury[J]. Chin Med J,2020, 133(18):2266-2268. Kondo T, Yamada S, Asai C, et al. Skeletal muscle pump function is associated with exercise capacity in patients with heart failure[J]. Circ J, 2018, 82(4):1033-1040. An Z C, Wu B, Mao W N, et al. Mechanisms and traditional Chinese medicine therapeutics for primary osteoporosis:An integrated perspective[J]. Front Endocrinol, 2025, 16:1638629. Ji W, Gong G Q, Liu Y H, et al. Icariin promotes osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)by activating PI3K-AKT-UTX/EZH2signaling in steroid-induced femoral head osteonecrosis[J]. J Orthop Surg Res, 2025, 20(1):290. Cao G, Hu S Q, Ning Y, et al. Traditional Chinese medicine in osteoporosis:From pathogenesis to potential activity[J]. Front Pharmacol, 2024, 15:1370900. Wang B Y, Chen Y F, Hsiao A W, et al. Ginkgolide B facilitates muscle regeneration via rejuvenating osteocalcinmediated bone-to-muscle modulation in aged mice[J]. J Cachexia Sarcopenia Muscle, 2023, 14(3):1349-1364. Li Y, Feng X, Chen B Y, et al. Retrospective analysis of exercise capacity in patients with coronary artery disease after percutaneous coronary intervention or coronary artery bypass graft[J]. Int J Nurs Sci, 2021, 8(3):257-263. Xiao J, Bingxin W U, Huanlin W U, et al. Effectiveness of Shenshu Guanxin Recipe Granules for improving exercise tolerance in patients with stable angina pectoris:A randomized, double-blind, placebo-controlled trial[J]. J Tradit Chin Med, 2023, 43(6):1227-1233. Zhang C X, Zheng Y G, Chen T, et al. The utility of traditional Chinese medicine(Shenmai)in the cardiac rehabilitation after coronary artery bypass grafting:A single-center randomized clinical trial[J]. Complementary Ther Med, 2019, 47:102203. Nie H Y, Li S Q, Liu M L, et al. Yiqi Fumai Injection as an adjuvant therapy in treating chronic heart failure:A metaanalysis of 33 randomized controlled trials[J]. Evid Based Complementary Altern Med, 2020, 2020:1876080. Wu Q Y, Zhang Q Y, Li Y, et al. A systematic review and meta-analysis of high-frequency prescription of Zhigancao Decoction combined with conventional western medicine in the treatment of chronic heart failure[J]. Evid Based Complementary Altern Med, 2021, 2021:7140044. Liu S P, Zhou J G, Jin Y, et al. Therapeutic efficacy of Shexiang Baoxin Pill combined with exercise in patients with heart failure with preserved ejection fraction:A single-center, double-blind, randomized controlled trial[J]. Chin J Integr Med, 2023, 29(2):99-107. Man Q S, Chen S J, Li X Y. Efficacy and safety of Qishen Yiqi Propping Pills combined with modern medicine for coronary heart disease with ischemic heart failure:A systematic review and meta-analysis[J]. Medicine, 2024,103(44):e39927. Mao J Y, Zhang J, Lam C S P, et al. Qishen Yiqi Dripping Pills for chronic ischaemic heart failure:Results of the CACT-IHF randomized clinical trial[J]. ESC Heart Fail,2020, 7(6):3881-3890. Wang X M, Dai G H, Guan H, et al. Clinical efficacy and safety of adjunctive treatment of chronic ischemic heart failure with Qishen Yiqi Dropping Pills:A systematic review and meta-analysis[J]. Front Cardiovasc Med,2023, 10:1271608. Visseren F L J, Mach F, Smulders Y M, et al. 2023 ESC Guidelines on cardiovascular disease prevention in clinical practice[J]. Eur Heart J, 2023,44(38), 3850-3876. Hu X Z, Zhou M, Weng J H. Eight trigrams Boxing combined with Wenyang Huoxue Recipe improves cardiopulmonary motor function and the quality of life of patients with coronary heart disease[J]. Int J Gen Med,2021, 14:7557-7566. Dhar I, Svingen G F, Pedersen E K, et al. Physical activity and risk of all-cause mortality in patients with stable angina pectoris:Effect modification by β-blocker treatment[J]. Int J Cardiol Cardiovasc Risk Prev, 2022,15:200150.