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1.山东第一医科大学 附属省立医院,济南 250021
2.山东中医药大学 第二临床医学院,济南 250002
3.山东第一医科大学(山东省医学科学院)临床医学院,济南 250117
Received:14 January 2022,
Published Online:22 June 2022,
Published:20 October 2022
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赖靖江,禚孝丽,蒋凤仙等.参苓白术散在多种疾病模型中的潜在作用机制[J].中国实验方剂学杂志,2022,28(20):267-273.
LAI Jingjiang,ZHUO Xiaoli,JIANG Fengxian,et al.Potential Mechanism of Shenling Baizhusan in Disease Treatment: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(20):267-273.
赖靖江,禚孝丽,蒋凤仙等.参苓白术散在多种疾病模型中的潜在作用机制[J].中国实验方剂学杂志,2022,28(20):267-273. DOI: 10.13422/j.cnki.syfjx.20221530.
LAI Jingjiang,ZHUO Xiaoli,JIANG Fengxian,et al.Potential Mechanism of Shenling Baizhusan in Disease Treatment: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(20):267-273. DOI: 10.13422/j.cnki.syfjx.20221530.
参苓白术散是中国传统中药复方,其方在四君子汤(人参、白术、茯苓、甘草)基础上加味而成,具有益气健脾、渗湿止泻等功效,是“培土生金”代表方剂之一。在临床中,该复方主要用于治疗小儿营养不良、慢性腹泻、胃肠功能紊乱等多种疾病,且在肿瘤放化疗相关胃肠道不良反应中具有良好的疗效。随着现代分子生物学的进展,学者们对参苓白术散在不同疾病治疗中发挥作用的认识不断深入,特别是参苓白术散可影响不同的细胞信号转导通路从而治疗不同的疾病。通过检索中国知网、万方数据、重庆维普、美国生物技术信息中心下属的医学图书检索系统(PubMed)、考克兰图书馆(Cochrance Library)、荷兰医学文摘数据库(Embase)6个数据库近5年国内外相关文献26篇(英文文献4篇,中文文献22篇),总结发现参苓白术散在炎症性肠病动物模型中通过调节核转录因子-
κ
B(NF
-κ
B)细胞信号通路、丝裂原活化蛋白激酶(MAPK)细胞信号通路、Janus激酶/信号传导及转录激活蛋白(JAK/STAT)细胞信号通路及肌球蛋白轻链激酶-肌球蛋白轻链(MLCK-MLC)细胞信号通路的激活,减缓炎症反应,从而发挥保护胃肠黏膜的作用;在非酒精性脂肪性肝病动物模型中参苓白术散可调节胞内磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白(PI3K/Akt/mTOR)细胞信号通路和Kelch样ECH关联蛋白1/核转录因子E
2
相关因子2/糖基化终产物(Keap1/Nrf2/ARE)细胞信号通路的激活,从而能够改善高脂饮食诱导的脂肪代谢紊乱、减轻肝脏脂质蓄积以及炎症反应;在肺癌骨转移动物模型中参苓白术散调节PI3K/Akt/mTOR信号通路的激活,从而发挥镇痛作用。因此,该文拟从细胞信号转导通路层面对参苓白术散在不同疾病模型中发挥作用的机制展开综述,以期为参苓白术散复方的后续深入研究提供思路线索。
Shenling Baizhusan is a traditional Chinese medicine compound prescription formulated on the basis of Si Junzitang (Ginseng Radix et Rhizoma, Atractylodis Macrocephalae Rhizoma, Poria, Glycyrrhizae Radix et Rhizoma). It has excellent functions of replenishing Qi, invigorating spleen, draining dampness, and checking diarrhea, and is one of the classical prescriptions of ''reinforcing earth to generate metal''. This prescription is primarily used in clinical practice to treat malnutrition in children, chronic diarrhea, gastrointestinal dysfunction, and other disorders. In addition, it has a good effect on gastrointestinal adverse reactions associated with radiotherapy and chemotherapy. With the booming of molecular biology, researchers have revealed the role of Shenling Baizhusan in the treatment of diseases, especially the mechanism of regulating different signaling pathways. We retrieved 26 relevant papers (4 written in English and 22 in Chinese) published in recent 5 years from 6 databases including China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP, PubMed, Cochrance Library, and Excerpta Medica Database (Embase). On the basis of these papers, we summarized the mechanisms of Shenling Baizhusan in disease treatment. In the animal model of inflammatory bowel disease, Shenling Baizhusan can protect gastrointestinal mucosa by regulating the activation of nuclear factor kappa-B (NF-
κ
B), mitogen-activated protein kinase (MAPK), Janus kinase/signal transducer and activator of transcription (JAK/STAT), and myosin light chain kinase-myosin light chain (MLCK-MLC) signaling pathways. In the animal model of non-alcoholic fatty liver disease, Shenling Baizhusan regulates the activation of phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) signaling pathway and Kelch-like ECH-associating protein 1/NF-E
2
-related factor 2/advanced glycation end-products (KEAP1/NRF2/AREs) signaling pathway, thus alleviating the lipid metabolism disorder induced by high-fat diet and reducing liver lipid accumulation and inflammatory response. In the animal model of lung cancer with bone metastasis, Shenling Baizhusan regulates the activation of PI3K/Akt/mTOR signaling pathway, thus playing an analgesic role. By summarizing the mechanisms of Shenling Baizhusan in treatment of different disease models from signaling pathways, we aim to provide clues for the in-depth study of this prescription.
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