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1.河北中医药大学 研究生学院,石家庄 050091
2.河北中医药大学 第一附属医院,石家庄 050017
Published:05 September 2024,
Published Online:20 June 2024,
Received:24 January 2024,
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赵薇,张亚茜,姜宇轩等.柴胡疏肝散及其加减方治疗功能性消化不良的研究进展[J].中国实验方剂学杂志,2024,30(17):248-255.
ZHAO Wei,ZHANG Yaxi,JIANG Yuxuan,et al.Chaihu Shugansan and Its Modified Formulas in Treatment of Functional Dyspepsia: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(17):248-255.
赵薇,张亚茜,姜宇轩等.柴胡疏肝散及其加减方治疗功能性消化不良的研究进展[J].中国实验方剂学杂志,2024,30(17):248-255. DOI: 10.13422/j.cnki.syfjx.20241996.
ZHAO Wei,ZHANG Yaxi,JIANG Yuxuan,et al.Chaihu Shugansan and Its Modified Formulas in Treatment of Functional Dyspepsia: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(17):248-255. DOI: 10.13422/j.cnki.syfjx.20241996.
柴胡疏肝散由柴胡、白芍、川芎、枳壳、陈皮、香附、甘草组成,具有疏肝解郁、理气止痛的功效,是后世医家所推崇治疗胃痞病的经典方剂。该文对柴胡疏肝散治疗功能性消化不良的临床应用和基础研究进展进行系统综述。现代临床应用中,柴胡疏肝散原方及其加减方均可用于治疗功能性消化不良,并可与其他方剂(四君子汤、金铃子散、枳术丸等)、西药(多潘立酮片、黛力新、布拉氏酵母菌等)、中医针刺等疗法联合应用。临床疗效结果显示柴胡疏肝散及其加减方能明显降低汉密顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、中医证候积分,改善患者胃脘胀满、心烦、善太息等症状、提高患者生活质量且复发率低。实验药理学证明柴胡疏肝散可抑制Cajal间质细胞自噬,调控内质网应激、信号通路,调节脑肠肽水平以促进胃肠动力;抑制结肠组织5-羟色胺(5-HT)表达,降低腹壁撤退反射(AWR)评分以改善内脏高敏状态;降低白细胞介素-6(IL-6)、肿瘤坏死因子-
α
(TNF-
α
)等炎症因子表达量以修复十二指肠黏膜炎症;调控肠道菌群,维持肠道内菌群稳态。其主要有效活性成分如柴胡皂苷、芍药苷、橙皮苷、柚皮苷等可起到抗炎、抗氧化、抗菌等作用。
Chaihu Shugansan composed of Bupleuri Radix, Paeoniae Radix Alba, Chuanxiong Rhizoma, Aurantii Fructus, Citri Reticulatae Pericarpium, Cyperi Rhizoma, and Glycyrrhizae Radix et Rhizoma has the effects of soothing liver, relieving depression, regulating Qi movement, and relieving pain. It is a classic formula for treating gastric distension recommended by doctors of later ages. This article systematically reviews the clinical application and basic experimental progress of Chaihu Shugansan in the treatment of functional dyspepsia. In modern clinical practice, Chaihu Shugansan and its modified formulas are used to treat functional dyspepsia, and they can be applied in combination with other formulas (Si Junzitang, Jinlingzisan, Zhizhuwan, etc.), western medicine (domperidone tablets, deanxit,
Saccharomyces boulardii
, etc.), traditional Chinese medicine (TCM) acupuncture and other therapies. The results of clinical studies have shown that Chaihu Shugansan and its modified formulas can significantly reduce the Hamilton depression scale (HAMD) score, Hamilton anxiety scale (HAMA) score, and TCM syndrome score, ameliorate the symptoms, improve the quality of life, and decrease the recurrence rate. The experimental pharmacological studies have demonstrated that Chaihu Shugansan can inhibit the autophagy of Cajal interstitial cells, regulate the endoplasmic reticulum stress signaling pathway, and modulate the brain-gut peptide level to improve the gastrointestinal motility. Chaihu Shugansan can inhibit the expression of 5-hydroxytryptamine in the colon tissue and reduce the abdominal withdrawal reflex (AWR) score to improve visceral hypersensitivity. Furthermore, Chaihu Shugansan can lower the levels of pro-inflammatory cytokines such as interleukin-6 and tumor necrosis factor-
α
to repair duodenal mucosal inflammation. In addition, it can regulate intestinal flora to maintain intestinal flora balance. The main active ingredients such as saikosap
onin, paeoniflorin, hesperidin, and naringin in Chaihu Shugansan can exert anti-inflammatory, antioxidant, and antimicrobial effects.
柴胡疏肝散功能性消化不良胃肠动力炎症因子肠道菌群
Chaihu Shugansanfunctional dyspepsiagastrointestinal motilitypro-inflammatory cytokinesintestinal flora
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