摘要
急性胰腺炎(AP)是临床常见的急腹症,具有起病急、发展快、病情重、并发症多、致死率高等特点。早期阶段如果治疗不及时可向重症急性胰腺炎(SAP)发展。AP发病机制繁杂,涉及多个细胞分子层面。目前已经明确氧化应激和活性氧(ROS)的生成参与了AP的生理病理过程,这与胰腺细胞内的抗氧化酶数量少及活性低有关。核转录因子E2相关因子2(Nrf2)是维持组织细胞内氧化还原平衡的“金钥匙”,通过与下游血红素加氧酶-1(HO-1)等抗氧化酶协作,构成了体内对抗氧化反应和炎症的重要信号通路。中药因其多成分、多靶点、多给药方式、多方剂等特点在治疗疾病方面有着独特疗效。基于中西医协同理念,目前中药在治疗AP方面也逐渐成为新热潮。AP胰腺组织中氧化应激水平与Nrf2/HO-1信号通路处于一个动态变化的过程,通过中医药干预可以有效清除ROS,影响炎症途径,减少氧化应激损伤,从而起到保护胰腺的作用,提示该通路在AP中有着重要作用。该文就近年来关于中医药调控Nrf2/HO-1信号通路治疗AP的相关文献进行梳理阐述,总结出以该通路为靶点的中药单体主要以清热解毒类、活血化瘀类、益气温中类为主,中药复方包括茵陈蒿汤、清胰Ⅱ号等,以期为AP疾病的防治及进一步的药物开发提供新方向。
Acute pancreatitis(AP)is a common clinical acute abdominal disease,which is characterized by acute onset,rapid development,severe disease,many complications,and high mortality rate.It can progress to severe AP(SAP)if not treated promptly in the early stage.The pathogenesis of AP is complex and involves multiple cellular and molecular levels.It is now clear that oxidative stress and reactive oxygen species(ROS)production are involved in the physiopathological process of AP,which is associated with a low quantity and activity of antioxidant enzymes in pancreatic cells.Nuclear factor E2-related factor 2(Nrf2)serves as the''golden key''to maintain redox homeostasis in tissue cells and constitutes an important signaling pathway for antioxidant response and inflammation in vivo by collaborating with downstream antioxidant enzymes such as heme oxygenase-1(HO-1).Traditional Chinese medicine has unique efficacy in treating diseases due to its multicomponent,multi-target,multi-drug delivery,and multi-formulation characteristics.Based on the concept of synergy between traditional Chinese and Western medicine,traditional Chinese medicine is becoming a new craze in the treatment of AP.The level of oxidative stress and Nrf2/HO-1 signaling pathway in AP pancreatic tissue are in a dynamic change process,and the intervention of traditional Chinese medicine can clean ROS production,affect the inflammatory pathway,and reduce oxidative stress damage,so as to protect against pancreatic injury.This suggests that this pathway plays an important role in AP.This article reviews the recent literature on the regulation of the Nrf2/HO-1 signaling pathway by traditional Chinese medicine for AP and summarizes that the monomers of traditional Chinese medicine targeting this pathway are mainly heat-clearing and detoxifying,blood-activating and blood-stasis-removing,and Qi benefiting and middle warming,and the compounds of traditional Chinese medicine include Yinchenhao Decoction and QingYiⅡ,so as to provide a new direction for the prevention and treatment of AP and further drug development.
作者
辛宛铃
王宁
梁岑怡
祖悦
李偲嘉
冯敏超
陈国忠
XIN Wanling;WANG Ning;LIANG Cenyi;ZU Yue;LI Sijia;FENG Minchao;CHEN Guozhong(Guangxi University of Chinese Medicine,Nanning 530001,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2024年第5期265-271,共7页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金项目(82160890)。
