摘要
放化疗性口腔黏膜炎是放化疗的一种常见的不良反应,其发病机制通过五个阶段模型进行阐述,其中包括一系列生物学信号的传导,尚未完全明确。目前缺乏较为理想的药物治疗方法。中药作为多靶点治疗方法,多个临床研究已证实其治疗效果。目前对于中药治疗口腔黏膜炎的作用机制研究体现在调节炎症因子,抑制炎症反应,包括下调促炎细胞因子、调节抗炎因子的水平;抗氧化应激损伤,包括上调抗氧化剂、降低过氧化产物的水平;促进黏膜修复,促进生长因子的分泌、加速黏膜修复细胞迁移;改善口腔环境,表现为抑制口腔的酸性环境;抑制细菌生长,包括抗革兰阴性菌活性、防止微生物感染;止痛,包括减轻机械性疼痛超敏反应及自发痛等方面。但多数研究仍局限于单一的作用机制,并未从多层面、多靶点进行研究。对日本汉方药Hangeshashinto的研究从抗炎、抗菌、抗氧化、止痛、促进修复多方面进行阐述,较为充分体现了中药的多靶点作用机制。该文对中药的作用机制研究进行阐述,为进一步的研究提供参考。
Radiotherapy or chemotherapy-induced oral mucositis is a common adverse reaction to chemoradiotherapy,whose pathogenesis is clarified as a five-stage model,including a series of biological signals,however,the pathogenesis is still not yet clear.There is still lack of ideal drug treatment.Traditional Chinese medicine,as a multi-targeted drug treatment,has significant effects in some clinical studies.The mechanisms of traditional Chinese medicine include anti-inflammatory effect(down regulating proinflammatory cytokines and regulating anti-inflammatory cytokines),antioxidative effect(up-regulating oxidation inhibitors and preventing peroxidization),enhancing wound healing(up-regulating growth factor and accelerating migration of the mucosal repairing cells,improving oral acidic microenvironment),antimicrobial effect especially Gram-negative bacteria,and analgesic effect(relieving mechanical pain hypersensitivity and spontaneous pain).Many studies focused on single mechanism rather thanmultiple targets.Studies on Hangeshashinto focused on anti-inflammatory effect,antimicrobial effect,antioxidative effect,analgesic effect and enhancing wound healing,which reflect the multiple-targeted characteristics of traditional Chinese medicine.The research progress of these mechanisms has been analyzed in this article to provide reference for following studies.
作者
陈晨
于然
陈冬梅
娄彦妮
贾立群
CHEN Chen;YU Ran;CHEN Dongmei;LOU Yanni;JIA Liqun(Beijing University of Chinese Medicine,Beijing 100029,China;China-Japan Friendship Hospital,Beijing 100029,China)
出处
《辽宁中医杂志》
CAS
2021年第11期214-217,共4页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81973693)
关键词
放射性口腔黏膜炎
化疗性口腔黏膜炎
中药
作用机制
radiation oral mucositis
chemotherapy-induced oral mucositis
traditional Chinese medicine
mechanism
