摘要
甲状腺相关性眼病(TAO)是以眼周及眶周组织的浸润性病变为特征的自身免疫性疾病。目前关于TAO的发病机制尚未完全阐明,现代医学常采用糖皮质激素、免疫抑制剂等治疗方法,虽有一定疗效,但存在不良反应大、耐药率高等问题。中医药发展历史悠久,在防治TAO方面发挥着重要作用。目前,关于中医药治疗TAO的研究较多,但缺乏系统总结。基于此,该文通过系统总结中医药治疗TAO的相关文献发现,在基础研究方面,中药有效成分治疗TAO的研究较多,主要包括生物碱类、萜类、醌类、黄酮类、皂苷类等,涉及的作用机制为减少细胞自噬,阻滞细胞周期,抑制眼眶氧化应激、炎症反应等,并可能通过调控过氧化物酶体增殖物激活受体γ(PPARγ)、腺苷酸活化蛋白激酶(AMPK)、β-连环蛋白(β-catenin)、核转录因子-κB(NF-κB)、Kelch样环氧氯丙烷相关蛋白1(Keap1)/核因子E_(2)相关因子2(Nrf2)/抗氧化反应元件(ARE)等信号通路发挥作用。中药复方则主要集中于平目汤系列方与平突散系列方,作用机制与抑制免疫炎症反应,减少眼眶脂肪细胞积聚等相关。在临床研究方面,历代医家多采用化痰散瘀、疏肝健脾、益气养阴类等中药治疗,并具有较好的临床疗效。同时,目前TAO的中医外治法主要为针刺、刺络放血、推拿、中药雾化等。此外,该文还发现中药内服与外治法结合可以进一步提高患者的临床疗效。总之,该文通过检索文献,系统梳理、归纳总结了中医药治疗TAO的研究现状,以期为中医药防治TAO提供新视角、新思路。
Thyroid-associated ophthalmopathy(TAO)is an autoimmune disorder characterized by infiltrative lesions in the periocular and orbital tissues.Currently,the pathogenesis of TAO has not been fully elucidated.Modern medicine often employs treatments such as glucocorticoids and immunosuppressants,which,although effective to some extent,are associated with significant adverse effects and high rates of drug resistance.Traditional Chinese medicine(TCM),with its long history of development,plays an important role in the prevention and treatment of TAO.Although numerous studies have investigated the use of TCM in the treatment of TAO,systematic summaries remain limited.Based on a systematic review of relevant literature,this paper finds that,in basic research,many studies have focused on the active components of Chinese herbal medicines for the treatment of TAO,mainly including alkaloids,terpenes,quinones,flavonoids,and saponins.Their mechanisms of action involve reducing autophagy,inducing cell cycle arrest,inhibiting orbital oxidative stress and inflammatory responses,and possibly regulating signaling pathways such as peroxisome proliferator-activated receptorγ(PPARy),adenosine monophosphate-activated protein kinase(AMPK),β-catenin,nuclear factor-kB(NF-κB),and Kelch-like ECH-associated protein 1(Keapl)/nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element(ARE).Chinese herbal formulae are mainly derived from the Pingmu decoction and Pingtu Powder series,with mechanisms related to inhibiting immune-inflammatory responses and reducing the accumulation of orbital adipocytes.In clinical research,TCM practitioners throughout history have primarily used treatments aimed at resolving phlegm and dispersing blood stasis,soothing the liver and strengthening the spleen,and tonifying Qi and Yin,all of which have shown favorable clinical efficacy.At the same time,external TCM therapies for TAO mainly include acupuncture,bloodletting,massage,and herbal atomization.Furthermore,it has been found that combining internal herbal medication with external therapies can further enhance clinical outcomes in patients.In summary,through literature retrieval and systematic review,this paper comprehensively analyzes and summarizes the current status of TCM research on TAO,aiming to provide new perspectives and ideas for the prevention and treatment of TAO with TCM.
作者
李闪闪
魏丹丹
符宇
王萍
屈之榆
王菲
燕树勋
LI Shanshan;WEI Dandan;FU Yu;WANG Ping;QU Zhiyu;WANG Fei;YAN Shuxun(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450000,China;Obesity and Metabolic Disease Institute,Henan University of Chinese Medicine,Zhengzhou 450000,China)
出处
《中国实验方剂学杂志》
北大核心
2025年第23期248-258,共11页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(U1204824)
河南省中医药科学研究专项(20-21ZY1016)
河南省中医药传承与创新人才工程(仲景工程)中医药拔尖人才项目(CZ0237-02)。
关键词
中医药
甲状腺相关眼病
临床应用
作用机制
traditional Chinese medicine
thyroid-associated ophthalmopathy
clinical application
mechanism of action
