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中国医学科学院 北京协和医学院药物研究所 天然药物活性物质与功能国家重点实验室, 北京 100050
Published:20 December 2023,
Published Online:31 May 2023,
Received:15 March 2023,
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唐铭泽,申圳,高天乐等.中药天然产物在疼痛管理中应用的研究进展[J].中国实验方剂学杂志,2023,29(24):260-272.
TANG Mingze,SHEN Zhen,GAO Tianle,et al.Application of Natural Ingredients of Traditional Chinese Medicine in Pain Management: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(24):260-272.
唐铭泽,申圳,高天乐等.中药天然产物在疼痛管理中应用的研究进展[J].中国实验方剂学杂志,2023,29(24):260-272. DOI: 10.13422/j.cnki.syfjx.20231103.
TANG Mingze,SHEN Zhen,GAO Tianle,et al.Application of Natural Ingredients of Traditional Chinese Medicine in Pain Management: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(24):260-272. DOI: 10.13422/j.cnki.syfjx.20231103.
疼痛是最普遍的健康问题之一。目前用于治疗疼痛的药物主要为抗惊厥药、三环类抗抑郁药和阿片类药物。然而在应用过程中均存在治疗效果有限,有较严重不良反应问题。近年来,对于中草药中具有镇痛活性天然成分的研究愈加广泛,以生物碱类化合物、香豆素类化合物、黄酮类化合物、萜类化合物为代表的一系列天然成分均表现出了良好的镇痛活性,并且在对于其镇痛机制的进一步研究中发现大部分天然产物均具有多靶点的镇痛机制,能够从阻断离子通道,调节相关受体,抗炎,抗氧化等多方面发挥镇痛效果。除此之外,许多传统中药组方在临床应用中均显示出良好的镇痛能力,且同样通过多重复杂的镇痛机制产生作用。“药物云”(dCloud)理论能够更好地描述二者的作用机制。dCloud从2个维度展示了多靶点镇痛药的完整治疗谱,即直接抑制疼痛信号的“直接作用”,以及针对疼痛根源的“背景功效”。笔者针对截至目前在中草药中发现的具有镇痛作用的天然成分,以及临床上具有良好镇痛效果的中药组方的镇痛功效及潜在机制做出归纳总结,以期为从中医药中寻找新型镇痛药物提供新的依据。
Pain is one of the most prevalent health problems. Current medications for pain are mainly anticonvulsants, tricyclic antidepressants, and opioidergic drugs. However, their therapeutic effectiveness is limited during application, and some even have severe side effects. In recent years, research on natural ingredients from Chinese herbal medicine has been extensively conducted for their analgesic activities. A series of natural ingredients represented by alkaloids, coumarins, flavonoids, and terpenoids have shown great analgesic activity, and further studies on their analgesic mechanism have found that most natural products have multi-target analgesic mechanisms. It can exert analgesic effects by blocking ion channels, regulating related receptors, or inducing anti-inflammatory or antioxidant effects. In addition, many traditional Chinese medicine (TCM) formulas have shown great analgesic ability after clinical application and have multiple complex analgesic mechanisms. The drug cloud (dCloud) theory can better describe the mechanisms, and it can represent the complete therapeutic spectrum of multi-target analgesics from two dimensions, namely the "direct efficacy" that directly inhibits pain signals and the "background efficacy" that targets the root causes of pain. The authors summarized the research progress of natural ingredients with analgesic effects found in Chinese herbal medicine so far, as well as the analgesic efficacy and potential mechanisms of TCM formulas with great analgesic effects in clinical applications, so as to provide a new basis for searching for new analgesic drugs from TCM.
中医药疼痛镇痛中药复方天然产物
traditional Chinese medicinepainanalgesicChinese herbal compoundnatural ingredients
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