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1.成都中医药大学 临床医学院,成都 610032
2.成都中医药大学 中医药创新研究院/交叉学科研究院,成都 610093
3.彭州市第三人民医院,四川 彭州 611931
4.成都中医药大学 附属医院,成都 610072
Received:18 July 2024,
Accepted:18 September 2024,
Published Online:23 September 2024,
Published:20 April 2025
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罗成,宁博,张馨月等.重症肺炎与信号通路的关系及中药调控进展[J].中国实验方剂学杂志,2025,31(08):294-302.
LUO Cheng,NING Bo,ZHANG Xinyue,et al.Relationship Between Severe Pneumonia and Signaling Pathways and Regulation by Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(08):294-302.
罗成,宁博,张馨月等.重症肺炎与信号通路的关系及中药调控进展[J].中国实验方剂学杂志,2025,31(08):294-302. DOI: 10.13422/j.cnki.syfjx.20241637.
LUO Cheng,NING Bo,ZHANG Xinyue,et al.Relationship Between Severe Pneumonia and Signaling Pathways and Regulation by Chinese Medicine: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(08):294-302. DOI: 10.13422/j.cnki.syfjx.20241637.
重症肺炎是临床常见的呼吸道危急重症之一,具有病情进展快、治疗难度大、病死率高、并发症多等特点,对患者的生命健康构成了巨大威胁。重症肺炎的发病机制十分复杂,有研究表明重症肺炎的发生、发展与多条信号通路的密切相关。目前,重症肺炎的治疗主要以抗感染、机械通气及糖皮质激素为主,往往临床效果不理想。因此寻找安全有效的替代疗法显得尤为重要。近年来,随着中医药研究的深入,中医药在治疗重症肺炎方面受到了广泛的关注。因此,该文对近年来重症肺炎与相关信号通路的关系和中医药如何调控信号通路治疗重症肺炎进行综述,发现中医药可通过调控Toll样受体4(TLR4)/髓样分化因子88(MyD88)/核转录因子-
κ
B(NF-
κ
B)、Janus激酶(JAK)/信号转导子和转录激活子(STAT)、磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)/哺乳动物雷帕霉素靶蛋白(mTOR)、NOD样受体蛋白3(NLRP3)和核因子E
2
相关因子2(Nrf2)信号通路等发挥减轻炎症反应、抑制细胞凋亡及焦亡、改善氧化应激等效应治疗重症肺炎。其中笔者发现各个信号通路均调控炎症来治疗重症肺炎,因此,减轻炎症反应是中药治疗重症肺炎最核心的作用机制。这可为重症肺炎的临床治疗提供方向,为新药研发提供一定的科学依据。
Severe pneumonia is one of the most common and critical respiratory diseases in clinical practice. It is characterized by rapid progression, difficult treatment, high mortality, and many complications, posing a significant threat to the life and health of patients. The pathogenesis of severe pneumonia is highly complex, and studies have shown that its occurrence and development are closely related to multiple signaling pathways. Curr
ently, the treatment of severe pneumonia mainly focuses on anti-infection, mechanical ventilation, and glucocorticoids, but clinical outcomes are often not ideal. Therefore, finding safe and effective alternative therapies is particularly important. In recent years, with the deepening of research into traditional Chinese medicine (TCM), it has gained widespread attention in the treatment of severe pneumonia. This paper reviewed the relationship between severe pneumonia and relevant signaling pathways in recent years and how TCM regulated these pathways in the treatment of severe pneumonia. It was found that TCM could regulate the Toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-
κ
B (NF-
κ
B), Janus kinase (JAK)/signal transducer and activator of transcription (STAT), phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR), NOD-like receptor protein 3 (NLRP3), and nuclear factor E
2
-related factor 2 (Nrf2) signaling pathways, playing a role in reducing the inflammatory response, inhibiting cell apoptosis and pyroptosis, improving oxidative stress, and other effects in the treatment of severe pneumonia. Among these pathways, it was found that all of them regulated inflammation to treat severe pneumonia. Therefore, reducing inflammation is the core mechanism by which Chinese medicine treats severe pneumonia. This review provides direction for the clinical treatment of severe pneumonia and offers a scientific basis for the research and development of new drugs.
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