【目的】 观察保元汤对慢性心力衰竭模型大鼠的治疗作用及机制。【方法】 将SD大鼠随机分为空白组、模型组、保元汤 组、卡托普利组、保元汤+ CCT020312[蛋白激酶R样内质网激酶（PERK）激活剂]组，每组15只。除空白组，其他各组大鼠采 用阿霉素诱导构建慢性心力衰竭模型。给予相应的药物干预后，检测各组大鼠心功能指标[左室舒张末期内径（LVEDD）、左 室射血分数（LVEF）、左室短轴缩短率（LVFS）及脑钠肽（BNP）、心肌肌钙蛋白 I（cTnI）]，炎症相关因子[肿瘤坏死因子 α （TNF-α）、白细胞介素1β（IL-1β）]，氧化应激因子[丙二醛（MDA）、超氧化物歧化酶（SOD）]，细胞凋亡相关指标[B细胞淋巴 瘤2（Bcl-2）、B细胞淋巴瘤2相关X蛋白（Bax）、半胱天冬酶3（Caspase-3）]及PERK/转录激活因子4（ATF4）信号通路相关蛋白葡 萄糖调节蛋白78（GRP78）、PERK、ATF4、C/EBP 同源蛋白（CHOP）水平变化。【结果】 与空白组比较，模型组大鼠 LVEDD， BNP、cTnI，TNF-α、IL-1β，MDA 水平，Bax、Caspase-3，GRP78、PERK、ATF4、CHOP蛋白表达水平显著升高，LVEF、 LVFS，SOD及Bcl-2蛋白表达水平显著降低（均P＜0.05）。与模型组和保元汤+CCT020312组比较，保元汤组、卡托普利组大 鼠LVEDD，BNP、cTnI，TNF-α、IL-1β，MDA水平，Bax、Caspase-3，GRP78、PERK、ATF4、CHOP蛋白表达水平显著降 低，LVEF、LVFS，SOD及Bcl-2蛋白表达水平显著升高（均P＜0.05）。与卡托普利组比较，保元汤组大鼠上述指标（除CHOP 蛋白表达水平外）均无显著变化（P＞0.05）。【结论】 保元汤可以延缓慢性心力衰竭大鼠进展，其机制可能与抑制 PERK/ATF4 信号传导通路缓解心肌细胞凋亡，进而减轻炎症反应和氧化应激程度，从而促进心功能及心肌损伤的修复有关。

Objective To observe the therapeutic effect and mechanism of Baoyuan Decoction for chronic heart failure model rat. Methods SD rats were randomly divided into blank group，model group，Baoyuan Decoction group， Captopril group， Baoyuan Decoction+CCT020312 [protein kinase R-like endoplasmic reticulum kinase （PERK）activator] group，15 rats in each group. Except for the blank group，the rats in the other groups were induced by Adriamycin to construct a chronic heart failure model. After corresponding drug intervention，cardiac function indexes [left ventricular end-diastolic diameter（LVEDD）， left ventricular ejection fraction（LVEF）， left ventricular fractional shortening（LVFS）， brain natriuretic peptide（BNP）， cardiac troponin I（cTnI）]， inflammation-related factors [tumor necrosis factor α（TNF-α），interleukin 1β（IL-1β）]，oxidative stress factors [malondialdehyde（MDA）， superoxide dismutase（SOD）] were detected in each group. Changes in apoptosisrelated indicators [B-cell lymphoma 2（Bcl-2），B-cell lymphoma 2-associated X protein（Bax），Caspase-3] and PERK/transcription activator 4（ATF4）signaling pathway-related proteins glucose-regulated protein 78（GRP78）PERK，ATF4，C/EBP homologous protein（CHOP）levels. Results Compared with the blank group，LVEDD， BNP，cTnI，TNF- α，IL-1β，MDA levels，protein expression levels of Bax，Caspase-3，GRP78，PERK， ATF4，CHOP in the model group were significantly increased，LVEF，LVFS，SOD levels and Bcl-2 protein expression level were significantly decreased （all P＜0.05）. Compared with the model group and Baoyuan Decoction+CCT020312 group，LVEDD，BNP，cTnI，TNF-α，IL-1β，MDA levels，protein expression levels of Bax， Caspase-3， GRP78， PERK， ATF4， CHOP in Baoyuan Decoction group and Captopril group were significantly decreased， LVEF， LVFS， SOD levels and Bcl-2 protein expression level were significantly increased（all P＜0.05）. Compared with the Captopril group，there was no significant change in the above indexes （except CHOP protein expression level） in the Baoyuan Decoction group（P＞0.05）. Conclusion Baoyuan Decoction can delay the progression of chronic heart failure rats，and its mechanism may be related to inhibiting the PERK/ATF4 signaling pathway to alleviate cardiomyocyte apoptosis， further reducing the degree of inflammatory response and oxidative stress，thereby promoting the repair of cardiac function and myocardial injury.

R285.5

陕西省教育厅重点科学研究计划项目（重点实验室）（编号：23JS012）；陕西省自然科学基金资助项目（编号：2021JM-481）