

浏览全部资源
扫码关注微信
1.安徽中医药大学 研究生院,合肥 230038
2.安徽医科大学 第一附属医院,合肥 230022
Received:01 May 2020,
Published Online:03 September 2020,
Published:05 January 2021
移动端阅览
夏霖,苏丽,张梅.乌梅丸治疗晚期胆道恶性肿瘤的可行性分析[J].中国实验方剂学杂志,2021,27(01):229-234.
XIA Lin,SU Li,ZHANG Mei.Feasibility Analysis of Wumeiwan in Treatment of Advanced Biliary Tract Cancers[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(01):229-234.
夏霖,苏丽,张梅.乌梅丸治疗晚期胆道恶性肿瘤的可行性分析[J].中国实验方剂学杂志,2021,27(01):229-234. DOI: 10.13422/j.cnki.syfjx.20202224.
XIA Lin,SU Li,ZHANG Mei.Feasibility Analysis of Wumeiwan in Treatment of Advanced Biliary Tract Cancers[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(01):229-234. DOI: 10.13422/j.cnki.syfjx.20202224.
胆道恶性肿瘤是来源于胆囊及胆管上皮的一组高度异质性的恶性肿瘤,包括胆囊癌及胆管癌,恶性程度高,确诊时往往病程已至中晚期,预后差。中晚期胆道恶性肿瘤治疗难度大,缺乏统一的化疗标准及具有针对性的靶向药物,临床综合治疗一直处于瓶颈状态。中药复方具有多靶点、多环节、多途径特点,可以发挥稳定肿瘤,缓解临床症状,减轻放化疗毒副作用,提高生存质量等优势,尤其在晚期肿瘤患者对症治疗中有着不可替代的作用,因而受到诸多科研工作者关注。中医认为晚期胆道恶性肿瘤病机多属正虚邪盛、阴阳乖戾、寒热错杂,病位涉及肝胆脾胃肾,其在病位、病程及病证上与厥阴病表现相似,故临床应用乌梅丸治疗常获佳效。乌梅丸从中医“理、法、方、药”角度分析,具有寒热并调,清上温下,温肝扶阳,攻补兼施等功效,兼顾肝、脾、肾,符合晚期胆道恶性肿瘤的中医证候学特点;从现代中药药理学角度分析,乌梅丸中多种有效成分具有诱导肿瘤细胞凋亡、抑制肿瘤细胞增殖、减轻机体炎症反应、抑制血管生成、逆转肿瘤细胞多药耐药性以及调节机体免疫力等作用。该文通过从中西医角度分析乌梅丸治疗晚期胆道恶性肿瘤的可行性,为晚期胆道恶性肿瘤的临床综合治疗及中药复方的实验研究提供参考。
Biliary tract cancers are group of highly heterogeneous malignant tumors derived from gallbladder and bile duct epithelium, including gallbladder cancer and cholangiocarcinoma, with a high degree of malignancy. When diagnosed, the course of disease often develops to the middle and late stage, with a poor prognosis. It is difficult to treat the advanced biliary tract cancers, with a lack of unified chemotherapy standard and targeted drugs. Traditional Chinese medicine(TCM) compound has multi-target, multi-link and multi-path characteristics, with effects in stabilizing tumor, alleviating clinical symptoms, alleviating side effect of radiotherapy and chemotherapy, and improving the quality of life. Especially in the treatment of advanced cancer patients, it plays an irreplaceable role. Therefore, it is concerned by many researchers. According to TCM, the pathogenesis of patients with advanced biliary tract cancers are mainly due to asthenia of healthy Qi and sthenia of pathogenic factors, Yin-Yang disharmony, and simultaneous occurrence of cold and heat. The location of the disease is related to liver, gallbladder, spleen, stomach and kidney. Because the advanced biliary tract cancers are similar to Jueyin syndrome in disease location, course and disease, Wumeiwan is often used in clinical treatment. Based on "theory, method, prescription and medicine" of TCM, Wumeiwan has the effect in regulating cold and heat, clearing the upper and lower temperature, warming the liver and supporting Yang, attacking and supplementing simultaneously, balancing the liver, spleen and kidney, which conforms to the TCM syndrome characteristics of advanced biliary tract cancers, according to modern Chinese medicine pharmacology, many effective ingredients in Wumeiwan have the effects in inducing tumor cell apoptosis, inhibiting tumor cell proliferation and reducing tumor cell proliferation, reducing inflammatory response in the body, inhibiting angiogenesis, reversing multidrug resistance of tumor cells and regulating immunity. This paper analyzes the feasibility of treatment of advanced biliary tract cancers with Wumeiwan from the perspective of traditional Chinese and Western medicine, so as to provide reference for clinical comprehensive treatment of advanced biliary tract cancers and the experimental study of TCM.
李茂岚 , 刘颖斌 . 胆道恶性肿瘤临床研究进展与展望 [J]. 中国实用外科杂志 , 2020 , 40 ( 2 ): 167 - 170 .
RANI K , JENNA-LYNN S , SHAHID A , et al . Gallbladder cancer in the 21 st century [J]. J Clin Oncol , 2015 , 2015 : 1 - 26 .
ATHAUDA A , FONG C , LAU D K , et al . Broadening the therapeutic horizon of advanced biliary tract cancer through molecular characterisation [J]. Cancer Treat Rev , 2020 , 86 : 101998 .
李茂岚 , 赵铭宁 , 刘颖斌 . 胆囊癌外科治疗理念变迁 [J]. 上海医药 , 2018 , 39 ( 19 ): 9 - 11 .
USON J P , BOGENBERGER J , BORAD M J . Advances in the treatment of biliary tract cancers [J]. Curr Opin Gastroenterol , 2020 , 36 ( 2 ): 85 - 89 .
KISH M , CHAN K , PERRY K , et al . A systematic review and network Meta-analysis of adjuvant therapy for curatively resected biliary tract cancers [J]. Curr Oncol , 2020 , 27 ( 1 ): e20 - e26 .
PALMIERI L J , LAVOLÉ J , DERMINE S , et al . The choice for the optimal therapy in advanced biliary tract cancers: chemotherapy, targeted therapies or immunotherapy [J]. Pharmacol Ther , 2020 , 210 : 107517 .
ZHANG L , DOU X W , ZHANG C , et al . A review of current methods for analysis of mycotoxins in herbal medicines [J]. Toxins (Basel) , 2018 , 10 ( 2 ): 65 .
周慧灵 , 郑佳彬 , 马雪娇 , 等 . 林洪生固本清源理论指导下的恶性肿瘤“五治”治疗经验 [J]. 中华中医药杂志 , 2020 , 35 ( 1 ): 195 - 198 .
王庆国 . 伤寒论讲义 [M]. 北京 : 高等教育出版社 , 2012 : 233 .
唐冠豪 . 加味乌梅丸方联合阿法替尼参与下40例晚期胆道癌真实诊疗分析 [D]. 合肥 : 安徽中医药大学 , 2019 .
唐冠豪 , 苏丽 , 李平 . 基于“稳化生、扶正气、清瘤毒、调病络”理念治疗晚期恶性肿瘤探讨 [J]. 安徽中医药大学学报 , 2019 , 38 ( 5 ): 45 - 47 .
王雪 , 李慧杰 , 曲倩倩 , 等 . 李秀荣治疗胆囊癌的经验 [J]. 江苏中医药 , 2014 , 46 ( 7 ): 20 - 21 .
林天碧 , 王永奇 , 朱培庭 . 朱培庭治疗胆囊癌经验 [J]. 中国中医药信息杂志 , 2012 , 19 ( 5 ): 91 - 92 .
清·吴谦 , 整理 . 名医方论 [M]. 北京 : 中国医药科技出版社 , 2012 .
马清林 , 臧凯宏 , 杜丽东 , 等 . 乌梅丸治疗溃疡性结肠炎的网络药理学研究 [J]. 中药药理与临床 , 2019 , 35 ( 2 ): 11 - 16 .
WAN Y , XU L , LIU Z , et al . Utilising network pharmacology to explore the underlying mechanism of Wumei Pill in treating pancreatic neoplasms [J]. BMC Complement Altern Med , 2019 , 19 ( 1 ): 158 .
栗宏红 . 关于bcl-2、c-myc及survivin基因突变与胆囊癌关系的研究 [D]. 太原 : 山西医科大学 , 2018 .
YANG D , ZHAN M , CHEN T , et al . miR-125b-5p enhances chemotherapy sensitivity to cisplatin by down-regulating Bcl2 in gallbladder cancer [J]. Sci Rep , 2017 , 7 ( 1 ): 967472 - 971148 .
HESARI A , GHASEMI F , CICERO A F G , et al . Berberine: a potential adjunct for the treatment of gastrointestinal cancers? [J]. J Cell Biochem , 2018 , 119 ( 12 ): 9655 - 9663 .
ZHANG F , LI M , WU X , et al . 20( S )-ginsenoside Rg 3 promotes senescence and apoptosis in gallbladder cancer cells via the p53 pathway [J]. Drug Des Devel Ther , 2015 , 9 : 3969 - 3987 .
WU K , LI N , SUN H , et al . Endoplasmic reticulum stress activation mediates Ginseng Rg 3 -induced anti-gallbladder cancer cell activity [J]. Biochem Biophys Res Commun , 2015 , 466 ( 3 ): 369 - 375 .
AL-ISHAQ R K , OVERY A J , BUSSELBERG D . Phytochemicals and gastrointestinal cancer: cellular mechanisms and effects to change cancer progression [J]. Biomolecules , 2020 , 10 ( 1 ): 105 .
PANDEY P , BAJPAI P , SIDDIQUI M H , et al . Elucidation of the chemopreventive role of stigmasterol against Jab1 in Gall bladder carcinoma [J]. Endocr Metab Immune Disord Drug Targets , 2019 , 19 ( 6 ): 826 - 837 .
唐思敏 , 邓雪婷 , 李全朋 , 等 . 槲皮素对胆管癌的抑制作用及其机制研究 [J]. 中华转移性肿瘤杂志 , 2019 , 2 ( 3 ): 25 - 26,30 .
侯敬申 , 梁颖涛 , 王伟雄 , 等 . 山柰酚抑制人胆囊癌细胞增殖及其对mTORC1通路的影响 [J]. 暨南大学学报:自然科学与医学版 , 2019 , 40 ( 5 ): 419 - 425 .
TAKADA Y , KOBAYASHI Y , AGGARWAL B B . Evodiamine abolishes constitutive and inducible NF-kappaB activation by inhibiting IkappaBalpha kinase activation, thereby suppressing NF-kappaB-regulated antiapoptotic and metastatic gene expression, up-regulating apoptosis, and inhibiting invasion [J]. J Biol Chem , 2005 , 280 ( 17 ): 17203 - 17212 .
DENG X T , TANG S M , WU P Y , et al . SP/NK‐1R promotes gallbladder cancer cell proliferation and migration [J]. J Cell Mol Med , 2019 , 23 ( 12 ): 7961 - 7973 .
杨晓宇 , 苏秀兰 . 炎症与肿瘤微环境在肿瘤发生中的作用 [J]. 医学研究杂志 , 2018 , 47 ( 6 ): 6 - 10 .
金虹 , 李竞 , 高凌 . 肿瘤坏死因子受体相关因子的研究进展 [J]. 中国医药导报 , 2017 , 14 ( 11 ): 39 - 42 .
WANG Y , LIU Y F , DU X Y , et al . The anti-cancer mechanisms of berberine: a review [J]. Cancer Manag Res , 2020 , 12 : 695 - 702 .
ZHOU Y N , GUO X Q , CHEN W M , et al . Angelica polysaccharide mitigates lipopolysaccharide-evoked inflammatory injury by regulating microRNA-10a in neuronal cell line HT22 [J]. Artif Cells Nanomed Biotechnol , 2019 , 47 ( 1 ): 3194 - 3201 .
李鹏涛 , 肖智 . 癌性疼痛相关离子通道的研究进展 [J]. 医学研究生学报 , 2018 , 31 ( 7 ): 756 - 761 .
XU D Q , LI J W , JIANG F F , et al . The effect and mechanism of vascular endothelial growth factor (VEGF) on tumor angiogenesis in gallbladder carcinoma .[J]. Iran J Public Health , 2019 , 48 ( 4 ): 713 - 721 .
ZHAI B , ZHANG N , HAN X , et al . Molecular targets of beta-elemene, a herbal extract used in traditional Chinese medicine, and its potential role in cancer therapy: a review [J]. Biomed Pharmacother , 2019 , 114 : 108812 .
赵素斌 , 李守霞 , 赵国栋 , 等 . 原发性胆囊癌组织中COX-2的表达及其相关性研究 [J]. 广西医科大学学报 , 2006 , 23 ( 2 ): 258 - 259 .
LIANG Q , YANG J , HE J , et al . Stigmasterol alleviates cerebral ischemia/reperfusion injury by attenuating inflammation and improving antioxidant defenses in rats [J]. Biosci Rep , 2020 , doi: 10.1042/BSR20192133 http://dx.doi.org/10.1042/BSR20192133 .
KANGSAMAKSIN T , CHAITHONGYOT S , WOOTTHICHAIRANGSAN C , et al . Lupeol and stigmasterol suppress tumor angiogenesis and inhibit cholangiocarcinoma growth in mice via downregulation of tumor necrosis factor- α [J]. PLoS One , 2017 , 12 ( 12 ): e0189628 .
乔岐禄 , 温泉 , 赵建勋 , 等 . β -catenin与cyclinD1在胆道肿瘤中的表达及临床意义(英文) [J]. 中国现代医学杂志 , 2007 , 17 ( 2 ): 134 - 137 .
时乐 . β -catenin介导的血管生成在吴茱萸碱抗肝癌中的作用及机制研究 [D]. 南京 : 南京医科大学 , 2016 .
刘厚宝 , 金赟杰 , 沈振斌 , 等 . 胆囊、胆管癌组织中多药耐药基因产物的表达及其意义 [J]. 中华实验外科杂志 , 2008 , 25 ( 3 ): 322 - 324,410 .
SHEN D Y , ZHANG W , ZENG X , et al . Inhibition of Wnt/beta-catenin signaling downregulates P-glycoprotein and reverses multi-drug resistance of cholangiocarcinoma [J]. Cancer Sci , 2013 , 104 ( 10 ): 1303 - 1308 .
王力 , 董怀平 , 高恒强 , 等 . 槲皮素逆转人胆囊癌细胞耐药性的作用机制探讨 [J]. 山东医药 , 2007 , 47 ( 29 ): 21 - 23 .
孙梦瑶 , 王丹丹 , 吴秋雪 , 等 . 吴茱萸碱、小檗碱对SGC-7901/DDP耐药性及耐药相关蛋白的影响 [J]. 世界科学技术—中医药现代化 , 2019 , 21 ( 2 ): 197 - 203 .
SUN M , YE Y , IAO L , et al . Anticancer effects of ginsenoside Rg 3 (review) [J]. Int J Mol Med , 2017 , 39 ( 3 ): 507 - 518 .
王曼 , 黄念 , 凌昌全 . 人参皂苷Rg 3 对肿瘤的免疫调节作用及其纳米给药体系研究进展 [J]. 中草药 , 2019 , 50 ( 15 ): 3729 - 3734 .
黄容容 , 钱颖 , 向明 . 人参皂苷Rh 2 免疫调节作用研究进展 [J]. 中国免疫学杂志 , 2019 , 35 ( 23 ): 2936 - 2941 .
于雪妮 , 冯小刚 , 张建民 , 等 . 人参化学成分与药理作用研究新进展 [J]. 人参研究 , 2019 , 31 ( 1 ): 47 - 51 .
0
Views
23
下载量
1
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621