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1.长春中医药大学,长春 130117
2.长春中医药大学 附属医院,长春 130000
Received:25 December 2024,
Revised:2025-02-27,
Accepted:14 March 2025,
Online First:19 March 2025,
Published:20 March 2026
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陈思玉,曹政华,许荣等.从“痹”论治特发性肺纤维化的研究进展[J].中国实验方剂学杂志,2026,32(06):254-264.
CHEN Siyu,CAO Zhenghua,XU Rong,et al.Treatment of Idiopathic Pulmonary Fibrosis from Impediment[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(06):254-264.
陈思玉,曹政华,许荣等.从“痹”论治特发性肺纤维化的研究进展[J].中国实验方剂学杂志,2026,32(06):254-264. DOI: 10.13422/j.cnki.syfjx.20250928.
CHEN Siyu,CAO Zhenghua,XU Rong,et al.Treatment of Idiopathic Pulmonary Fibrosis from Impediment[J].Chinese Journal of Experimental Traditional Medical Formulae,2026,32(06):254-264. DOI: 10.13422/j.cnki.syfjx.20250928.
特发性肺纤维化(IPF)是一种慢性纤维化致死性间质性肺疾病,预后不佳。当下治疗IPF以器官移植和给予化学药为主,但效果欠佳且不良反应颇多,无法满足目前的临床需求。因此,亟须寻找新的更为安全、有效的治疗药物。中医药治疗IPF因其独特的优势,近年来一直广受关注,越来越多的研究表明中医药防治IPF疗效显著,具有广阔的应用前景。现代医学研究表明可从炎症(巨噬细胞极化)、氧化应激、上皮-间质转化(EMT)、自噬抑制等相关信号通路等方面讨论IPF发病机制,但对于系统说明各信号通路与中医理论存在的联系尚未有研究报道。中医理论认为“肺络痹阻”是IPF的基本病机,故以通补肺络为原则,采用扶正祛邪、益气活血、解毒通络治疗IPF,疗效确切,可有效缓解临床症状、改善肺功能和血氧分压、提高患者生活质量、减少不良反应。实验研究发现,基于通补肺络法干预IPF炎症(巨噬细胞极化)、氧化应激、EMT、自噬抑制等几大信号通路方面效果显著。该文从“痹”的角度出发,对IPF发病机制、IPF中医治法研究进展、从“单体-中药-复方”论治IPF进行综述,从而揭示从痹论治IPF的科学内涵,为丰富中医治疗IPF方法提供新的理论依据。
Idiopathic pulmonary fibrosis (IPF) is a chronic and fibrotic lethal interstitial lung disease with poor prognosis. It is mainly treated by organ transplantation and administration of chemical drugs, which have poor efficacy and induce side effects, failing to meet the clinical needs. Therefore, it is urgent to develop more safe and effective drugs to treat IPF. Traditional Chinese medicine (TCM) has garnered increasing attention in recent years in the treatment of IPF due to its unique advantages. Increasing studies have shown that TCM has remarkable therapeutic effects on IPF and thus demonstrate broad application prospects. Modern medical research shows that the pathogenesis of IPF can be discussed from inflammation (macrophage polarization), oxidative stress, epithelial-mesenchymal transition (EMT), autophagy inhibition and other related signaling pathways, while few studies systematically explain the relationship between the signaling pathways and TCM theory. According to the theory of TCM, lung collateral obstruction is the basic pathogenesis of IPF. Therefore, according to the principle of dredging and replenishing lung collaterals, IPF can be treated with the methods of reinforcing healthy qi and eliminating pathogen, replenishing qi and activating blood, and detoxifying and dredging collaterals, which demonstrate definite curative effect and can effectively relieve clinical symptoms, restore the lung function and blood oxygen partial pressure, improve the quality of life of patients, and reduce adverse reactions. Experimental studies have found that dredging and replenishing lung collaterals have significant effects on IPF inflammation (macrophage polarization), oxidative stress, EMT, autophagy inhibition and other signaling pathways. Therefore, from the perspective of impediment, this article reviews pathogenesis of IPF, the research progress in TCM treatment of IPF, and the treatment of IPF from active components, single herbs, and compound prescriptions of TCM, with the aim of revealing the scientific connotation of the treatment of IPF from impediment and providing a new theoretical basis for enriching the TCM methods of treating IPF.
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