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1.河南中医药大学,郑州 450000
2.河南中医药大学 第一附属医院,郑州 450000
3.河南省肿瘤医院,郑州 450000
4.河南中医药大学 第三附属医院,郑州 450000
Received:09 October 2022,
Published Online:26 December 2022,
Published:05 February 2024
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李闪闪,魏丹丹,裴俊文等.中药调控食管癌相关信号通路研究进展[J].中国实验方剂学杂志,2024,30(03):226-238.
LI Shanshan,WEI Dandan,PEI Junwen,et al.Chinese Medicine Regulates Signaling Pathways Related to Esophageal Cancer: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(03):226-238.
李闪闪,魏丹丹,裴俊文等.中药调控食管癌相关信号通路研究进展[J].中国实验方剂学杂志,2024,30(03):226-238. DOI: 10.13422/j.cnki.syfjx.20230427.
LI Shanshan,WEI Dandan,PEI Junwen,et al.Chinese Medicine Regulates Signaling Pathways Related to Esophageal Cancer: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(03):226-238. DOI: 10.13422/j.cnki.syfjx.20230427.
食管癌是常见的消化道恶性肿瘤。目前,食管癌的发病机制尚未完全阐明。虽然手术、放疗、化疗、靶向治疗及免疫治疗等在食管癌的治疗中取得较好的临床疗效,仍存在并发症多、不良反应大等问题。中药作为中医药的重要组成部分,近年来众多基础实验及临床研究证实了其治疗食管癌具有较好的效果。同时,中药多成分、多靶点的特点及食管癌发病机制尚未完全明确的现状,决定了中药防治食管癌存在相关作用机制不明等问题,需要从现代医学着手,从分子生物学、网络药理学等层面揭示中药防治疾病的作用机制。中医学认为食管癌的发生多归结于肝气郁结、痰瘀气滞、津亏热结、正气衰败、癌毒胶结等。查阅文献发现,中药复方主要为补益剂如六君子汤、润燥剂如启膈散及清热剂如复方苦参注射液等;中药单体以攻毒杀虫类、清热类、活血化瘀药及理气药等为主;与中医学所认为的食管癌发生的病因病机相挈合。研究发现,中药还可以通过调控磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)、神经源性位点缺口同源蛋白(Notch)、分泌型糖蛋白/
β
-链蛋白(Wnt/
β
-catenin)、丝裂原活化蛋白激酶(MAPK)、核转录因子-
κ
B(NF-
κ
B)、酪氨酸激酶2/转录激活因子3(JAK2/STAT3)等相关信号通路发挥促进细胞凋亡,促进细胞自噬,阻滞细胞周期,逆转细胞耐药等作用治疗食管癌,但缺乏系统认识。该文通过系统总结中药调控食管癌的相关信号通路,利于明确中药治疗在食管癌分子机制发生发展及侵袭转移等过程中的相关作用机制,以期为食管癌的治疗提供新靶点,新视角,新思路,促进中医药现代化发展。
Esophageal cancer is a common malignant tumor of the digestive tract. At present, the pathogenesis of esophageal cancer has not been fully clarified. Although surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy have achieved good clinical results in the treatment of esophageal cancer, there are still many complications and severe adverse reactions. As an important part of traditional Chinese medicine (TCM), in recent years, many basic experiments and clinical studies have proved that Chinese medicine has a good effect in treating esophageal cancer. At the same time, the multi-component and multi-target characteristics of Chinese medicine and unclear pathogenesis of esophageal cancer determine that there are some problems such as unclear mechanisms of Chinese medicine in preventing and treating esophageal cancer. It is necessary to start with modern medicine and reveal the mechanism of Chinese medicine in preventing and treating diseases from the aspects of molecular biology and network pharmacology. It is believed in TCM that the occurrence of esophageal cancer is mostly attributed to stagnation of liver Qi, phlegm stasis and Qi stagnation, fluid consumption and heat accumulation, the decline of healthy Qi, and the cementation of cancer toxicity. According to the literature review, Chinese medicinal compounds mainly include tonic formulae (such as Liu Junzitang), drying and moistening formulas (such as Qigesan), and heat-clearing formulas (such as Fufang Kushen injection). Chinese medicinal monomers mainly include drugs potent in attacking poison and killing insects, clearing heat, activating blood and resolving stasis, and regulating Qi, which is consistent with the etiology and pathogenesis of esophageal cancer in TCM. It is also found that Chinese medicine can promote cell apoptosis and autophagy, block cell cycle, and reverse cell resistance by regulating phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), neurogenic locus notch homolog protein (Notch), Wnt/
β
-catenin, mitogen-activated protein kinase (MAPK), nuclear factor-
κ
B (NF-
κ
B), Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3), and other related signaling pathways, but there is no systematic summary. This study systematically summarized the relevant signaling pathways of Chinese medicine in regulating esophageal cancer, which is helpful to clarify the relevant mechanisms of Chinese medicine in the process of esophageal cancer occurrence, development, invasion, and metastasis, so as to provide new targets and new perspectives for the treatment of esophageal cancer and promote the modernization of TCM.
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