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1.江西中医药大学,南昌 330004
2.广西中医药大学 研究生学院,南宁 530000
3.江西中医药大学 附属医院,南昌 330006
Received:12 January 2022,
Published Online:25 March 2022,
Published:05 June 2022
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章晓云,曾浩,李华南等.痛风性关节炎的发病机制及中医药治疗研究进展[J].中国实验方剂学杂志,2022,28(11):256-267.
ZHANG Xiao-yun,ZENG Hao,LI Hua-nan,et al.Pathogenesis of Gouty Arthritis and Intervention with Chinese Medicines: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(11):256-267.
章晓云,曾浩,李华南等.痛风性关节炎的发病机制及中医药治疗研究进展[J].中国实验方剂学杂志,2022,28(11):256-267. DOI: 10.13422/j.cnki.syfjx.20221036.
ZHANG Xiao-yun,ZENG Hao,LI Hua-nan,et al.Pathogenesis of Gouty Arthritis and Intervention with Chinese Medicines: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(11):256-267. DOI: 10.13422/j.cnki.syfjx.20221036.
痛风性关节炎(GA)是一种以嘌呤代谢紊乱为基础的代谢性风湿病,以受累关节反复发作的红肿热痛及功能障碍为主要表现,可急性发作或慢性迁延。现代医学认为其与尿酸升高、炎症因子参与、抗氧化应激减弱、细胞凋亡、肠道菌群失调及骨代谢失衡等密切相关,但具体发病机制仍不明确。GA具有易诊难治,复发率较高的特点,严重降低患者的生活质量。目前西医治疗以服用秋水仙碱、皮质类固醇、非甾体抗炎药及选择性环氧化酶-2抑制剂等为主,短期疗效显著,然而长时间使用将带来严重的不良反应。中医药不仅安全性较高、不良反应少,而且可通过各活性成分多途径、多靶点作用于多个环节从而发挥协同治疗的功效,目前已受到广大学者的重视。基于此,该文系统查阅相关文献,从中医药调节炎性细胞因子、降低机体尿酸水平、维持肠道菌群稳定、提高抗氧化应激反应能力、调节细胞凋亡及骨代谢等方面进行详细综述,以期进一步阐明GA的发病机制,并为中医药防治GA的临床应用提供理论参考及科学依据。
Gouty arthritis (GA) is the metabolic rheumatism caused by purine metabolism disorder, which can be acute or chronic. The main manifestations of GA include recurrent redness, swelling, heat pain, and dysfunction of the affected joints. According to the theory of modern medicine, GA is closely associated with the increase in uric acid, the participation of inflammatory cytokines, the weakening of antioxidant response, apoptosis, and the imbalance of intestinal flora and bone metabolism, whereas the specific pathogenesis remains unclear. GA is characterized by easy diagnosis, difficult treatment, and high recurrence rate, which seriously affects the life quality of patients. Colchicine, corticosteroids, non-steroidal anti-inflammatory drugs, and selective cyclooxygenase-2 inhibitors are the commonly used western medicines for this disease, which demonstrate remarkable short-term therapeutic effect. However, long-term use of these medicines will bring serious adverse reactions. Chinese medicines, with high safety and causing few adverse reactions, have a variety of active components which can act on multiple pathways and targets to exert synergistic effects, thus attracting wide attention. This paper systematically reviews the literature reporting the Chinese medicines in improving antioxidant response, reducing chondrocyte apoptosis, and regulating intestinal flora and bone metabolism, aiming to further clarify the pathogenesis of GA and provide a scientific basis for the clinical application of Chinese medicines in the prevention and treatment of GA.
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