摘要
血管新生是生理、病理状态下调节血管的关键过程,其动态平衡对维持组织稳态至关重要。生理性血管新生受低氧诱导因子–1α(Hypoxia–inducible Factor–1α,HIF–1α)/血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)通路调控,参与伤口愈合等。病理性血管新生则与糖尿病视网膜病变等疾病密切相关,表现为VEGF、炎性因子及氧化应激的异常激活。补阳还五汤作为经典益气活血方剂,具有调节血管新生的能力,在缺血性脑卒中中,其通过激活磷脂酰肌醇3激酶–蛋白激酶B通路上调VEGF表达、促进内皮细胞糖酵解,增强侧支循环并改善神经功能;在糖尿病视网膜病变中,其则通过缓解线粒体功能障碍及氧化应激下调VEGF表达,从而抑制病理性血管增生。这种“异病同治”效应体现了中医药多靶点、多信号通路的独到优势,也为血管新生相关疾病的治疗提供了多靶点干预策略。未来需深入解析其药效物质基础及分子网络调控机制。
Angiogenesis is a critical process for regulating blood vessel formation under both physiological and pathological conditions,with its dynamic equilibrium being crucial for maintaining tissue homeostasis.Physiological angiogenesis is governed by the HIF-1α/VEGF pathway,and participates in processes such as wound healing.In contrast,pathological angiogenesis is closely associated with diseases such as diabetic retinopathy,manifested as abnormal activation of VEGF,inflammatory factors,and oxidative stress.The Buyang Huanwu decoction(补阳还五汤),as a classic prescription in traditional Chinese medicine(TCM)for replenishing Qi(气)and activating blood circulation,exhibits a unique capacity to modulate angiogenesis bidirectionally.In ischemic stroke,the Buyang Huanwu decoction enhances collateral circulation and improves neurological function by upregulating VEGF expression and promoting endothelial cell glycolysis through the PI3K/Akt pathway.Conversely,in diabetic retinopathy,the prescription suppresses pathological vascular proliferation by decreasing the expression of VEGF through mitigating mitochondrial dysfunction and oxidative stress.This“treating different diseases by the same method”effect demonstrates the unique advantages of TCM in terms of multiple targets and multiple signaling pathway,and also provides a multi-target intervention strategy for the treatment of angiogenesis-related disorders.In the future,it is necessary to deeply elucidate its pharmacodynamic material basis and the regulatory mechanism of its molecular networks.
出处
《中医临床研究》
2025年第27期114-120,共7页
Clinical Journal Of Chinese Medicine
基金
辽宁省教育厅科学研究经费项目(L202060)。
关键词
补阳还五汤
糖尿病视网膜病变
缺血性脑卒中
血管新生
双向调节
The Buyang Huanwu decoction
Diabetic retinopathy
Ischemic stroke
Angiogenesis
Bidirectional regulation
