摘要
矽肺临床治疗始终面临重大挑战。随着中药研究的深入发展,中药在矽肺防治领域展现出独特的整体调节优势,作用机制包括抑制炎症反应、抑制上皮-间质转化、调节巨噬细胞极化、抑制细胞凋亡、抑制氧化应激反应、调节免疫反应、改善肺部微生态、调控铁死亡和干扰尿液代谢通路等,其涉及转化生长因子-β1/母亲DPP同源物信号通路、磷脂酰肌醇3-激酶/蛋白激酶B/核因子-κB信号通路、Janus蛋白酪氨酸激酶/信号传导与转录激活因子信号通路等多种信号通路。复方中药具有系统调控性,单体成分则靶点明确,二者结合有助于中医药现代化。然而,目前中药治疗矽肺研究仍存在若干局限性,包括:基础研究缺乏统一剂量与毒理学数据,作用机制尚不明确;临床证据不足,转化难度大;临床试验样本量小、随访短、疗效评价体系不完善。未来需加强中药治疗矽肺机制研究,推进高质量临床试验,建立中西医结合疗效标准,促进基础研究成果向临床转化。
The clinical treatment of silicosis remains a major challenge.With the rapid advancement of research in traditional Chinese medicine,increasing evidence suggests that traditional Chinese medicine exerts a unique holistic regulatory effect in the prevention and treatment of silicosis.The mechanisms of treatment effects involve inhibition of inflammatory responses,suppression of epithelial-mesenchymal transition,regulation of macrophage polarization,inhibition of apoptosis and oxidative stress,modulation of immune responses,improvement of pulmonary microecology,regulation of ferroptosis,and interference with urinary metabolic pathways.These effects are mediated through multiple signaling pathways,including the transforming growth factor-β1/mothers against decapentaplegic homolog pathway,phosphatidylinositol 3-kinase/protein kinase B/nuclear factor-κB pathway,and Janus kinase/signal transducer and activator of transcription pathway.Compound traditional Chinese medicine formulations provide systemic regulatory effects,whereas monomeric components exhibit precise target specificity.Their combination may facilitate the modernization of traditional Chinese medicine.However,current studies on traditional Chinese medicine therapy for silicosis face several limitations,including the lack of standardized dosages and toxicological data in basic research,unclear mechanisms of action,insufficient clinical evidence and difficult to advance into clinical development,limited clinical sample sizes,short follow-up durations,and incomplete efficacy evaluation systems.Future research should focus on elucidating the mechanisms of action of traditional Chinese medicine in silicosis,conducting highquality clinical trials,establishing integrative efficacy evaluation criteria for traditional Chinese medicine and Western medicine,and promoting the translational application of basic research findings to clinical practice.
作者
盘叶花
吕纪华
PAN Yehua;LÜ Jihua(Guangxi Institute of Chinese Medicine&Pharmaceutical Science,Guangxi Key Laboratory of Traditional Chinese Medicine Quality Standards,Nanning,Guangxi 530022,China)
出处
《中国职业医学》
2025年第4期465-471,476,共8页
China Occupational Medicine
基金
广西科技重大专项(桂科AA23023035-2)
广西中医药适宜技术开发与推广项目(GZSY23-10)
防城港市科学研究与技术开发计划项目(防科AB21014044)。
关键词
矽肺
中药
治疗
作用机制
研究进展
Silicosis
Traditional Chinese medicine
Treatment
Mechanism
Research progress
