摘要
纤维化可发生于多种器官,是多种慢性疾病的最终结局。由于炎症导致器官实质细胞发生坏死,器官组织内成纤维细胞过度增殖,细胞外基质(ECM)过度沉积,持续进展可致器官结构破坏和功能丧失。中医药治疗纤维化具有较好疗效,临床常用益气活血类方药。补阳还五汤是益气活血的代表方剂,临床和实验研究表明补阳还五汤能够延缓肺、心、肝、肾等多器官纤维化的发展进程,作用机制包括改善脏器功能、减少ECM沉积、抗氧化应激、抗炎症反应、调节基质金属蛋白酶(MMPs)/基质金属酶组织抑制因子(TIMPs)失衡、调控转化生长因子-β(TGF-β)/Smad通路等。中医学认为,正气亏虚是纤维化发生的内在原因,瘀血是纤维化形成的重要病理因素,虚和瘀贯穿纤维化始终,纤维化器官组织微环境的改变符合气虚血瘀的病理表现,故益气活血法是治疗纤维化的基本法则。该文通过综述补阳还五汤治疗多器官纤维化的作用机制,为阐明其治疗多器官纤维化的科学内涵提供文献支持,也为进一步的临床研究奠定基础。
Fibrosis can occur in nearly all organs of the body and is an outcome of many chronic diseases.As inflammation leads to necrosis of parenchymal cells,excessive proliferation of fibroblasts and overproduction of extracellular matrix(ECM)occur in tissues and organs,which may cause structural damage and loss of function of organs in the case of continuous progression.Chinese medicine has definite effect on fibrosis and prescriptions with effects of replenishing Qi and activating blood,such as Buyang Huanwutang,are frequently used in clinical settings.Clinical research and experiments show that Buyang Huanwutang can delay the progression of fibrosis in multiple organs such as lung,heart,liver,and kidney by improving organ function,reducing ECM deposition,anti-oxidative stress,anti-inflammatory response,regulating the imbalance of matrix metalloproteinases(MMPs)/tissue inhibitors of metalloproteinases(TIMPs),and modulating transforming growth factor-β(TGF-β)/Smad pathway.According to traditional Chinese medicine,healthy Qi deficiency is the internal cause of fibrosis,and blood stasis is an important pathological factor in the formation of fibrosis.Moreover,deficiency and stasis exist in the whole process of fibrosis and the changes of microenvironment of fibrotic organs and tissues accord with the pathological manifestations of Qi deficiency and blood stasis.This article reviews the anti-fibrosis mechanism of Buyang Huanwutang in multiple organs,which provides a science-based explanation for the treatment of fibrosis by Buyang Huanwutang and lays a foundation for further clinical research.
作者
郝彦伟
岳胜男
李佳欣
杜全宇
王飞
HAO Yan-wei;YUE Sheng-nan;LI Jia-xin;DU Quan-yu;WANG Fei(Hospital of Chengdu University of Traditional Chinese Medicine(TCM),Chengdu 610075,China;Chengdu University of TCM,Chengdu 610072,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第11期268-274,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(82174347)
中国博士后科学基金项目(2020M683644XB)。
关键词
补阳还五汤
器官纤维化
作用机制
研究进展
炎症
Buyang Huanwutang
organ fibrosis
mechanism of action
research progress
inflammation
