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1.成都中医药大学 附属医院,成都 610075
2.成都中医药大学,成都 611137
Received:24 April 2021,
Published Online:22 June 2021,
Published:20 August 2021
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梁静涛,霍之瀛,王敏等.大黄䗪虫丸抗多器官纤维化作用机制的研究进展[J].中国实验方剂学杂志,2021,27(16):237-244.
LIANG Jing-tao,HUO Zhi-ying,WANG Min,et al.Mechanism of Dahuang Zhechongwan Against Multiple Organ Fibrosis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(16):237-244.
梁静涛,霍之瀛,王敏等.大黄䗪虫丸抗多器官纤维化作用机制的研究进展[J].中国实验方剂学杂志,2021,27(16):237-244. DOI: 10.13422/j.cnki.syfjx.20211693.
LIANG Jing-tao,HUO Zhi-ying,WANG Min,et al.Mechanism of Dahuang Zhechongwan Against Multiple Organ Fibrosis: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(16):237-244. DOI: 10.13422/j.cnki.syfjx.20211693.
大黄䗪虫丸出自于张仲景的《金匮要略》,具有补虚缓中、生新祛瘀的功效。该方已经广泛运用于多种疾病的临床治疗,并取得了肯定的疗效。多器官纤维化的研究表明大黄䗪虫丸能够减缓心、肝、肾、肺等器官纤维化的发展进程,在临床和实验研究中均收获了良好的效果。该文通过综述大黄䗪虫丸治疗多器官纤维化的实验机制研究发现,虽然各器官纤维化发病部位不同,但其发病机制联系紧密,从中医角度来讲,这类疾病存在着共同病机,即均为“虚劳”状态,疾病日久导致病理产物“干血”的形成。从现代医学的角度来看,这类疾病均出现细胞外基质(ECM)沉积的病理改变,其发生发展都落脚在某些效应细胞[如肝星状细胞(HSC),胰腺星状细胞(PSC)等],并有着相同的细胞 [如肿瘤坏死因子-
α
(TNF-
α
),白细胞介素-6(IL-6),IL-1
β
,
α
-平滑肌肌动蛋白(
α
-SMA)等]及某些关键通路[转化生长因子-
β
1
(TGF-
β
1
)/Smad,磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt),脂多糖(LPS)旁分泌和自分泌机制等]参与其中。大黄䗪虫丸作为仲景治疗“虚劳干血”的经典方剂,治疗纤维化的作用可能是通过对上述机制的干预起到抑制ECM沉积,从而缓解疾病进程的作用。希望通过该综述为阐明大黄䗪虫丸治疗多器官纤维化的科学内涵提供文献支持,同时为进一步实验及临床研究奠定基础。
Dahuang Zhechongwan (DHZCW) is a classic prescription from the
Jingui Yaolue
(《金匮要略》) by ZHANG Zhong-jing,with the effects of tonifying deficiency, relaxing the middle, promoting regeneration, and resolving stasis. It has been widely used in the clinical treatment of various diseases with definite efficacy achieved. The research on multiple organ fibrosis has shown that DHZCW can slow down the development of organ fibrosis in the heart, liver, kidney, lung, etc., and good results in both clinical practice and experimental research have been obtained. The present study reviewed the previous investigations on the experimental mechanism of DHZCW in the treatment of multiple organ fibrosis and revealed that the pathogenesis was closely related despite different disease sites. From the perspective of traditional Chinese medicine (TCM),these diseases shared a common pathogenesis,which was manifested by deficiency. Long-term diseases led to the formation of "dried blood". From the perspective of modern medicine, the diseases all showed pathological changes in the deposition of extracellular matrix (ECM), and their occurrence and development were all based on certain effector cells [such as hepatic stellate cell (HSC) and pancreatic stellate cell (PSC)], with same cytokines [such as tumor necrosis factor-
α
(TNF-
α
),interleukin-6 (IL-6),IL-1
β
,and
α
-smooth muscle actin (
α
-SMA)] and some key pathways [transforming growth factor-
β
1
(TGF-
β
1
)/Smad, phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt), and lipopolysaccharide (LPS) paracrine and autocrine mechanisms] involved. As a classic prescription for "deficiency-induced dry blood", DHZCW was effective in treating fibrosis, which was presumedly related to the inhibition of ECM deposition by intervening in the above-mentioned mechanisms, thereby delaying the disease progression. This study is expected to provide literature support to clarify the scientific connotation of DHZCW in the treatment of multiple organ fibrosis and lay a foundation for further experimental and clinical research.
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