摘要
糖尿病性溃疡(diabetic ulcer, DU)是一种常发生在足部或下肢的慢性难愈型溃疡,是一种致残率及病死率均较高的糖尿病并发症。DU发病机制复杂,其治疗过程(如清创、皮瓣移植、应用抗生素)也同样复杂且周期漫长。DU患者在忍受病痛折磨的同时还负担着巨大经济和心理压力。因此,帮助DU创面快速愈合、降低致残率及病死率、保护肢体功能、提高生命质量尤为重要。该文通过查阅国内外大量相关文献发现,自噬能够清除DU创面病原体,减轻创面炎症,加速溃疡伤口愈合及组织修复。同时,自噬主要相关因子微管结合轻链蛋白3(LC3)、自噬特异性基因(Beclin-1)和泛素结合蛋白(p62)介导自噬的始终。中医药治疗DU,不仅注重解决临床症状,加速溃疡创面愈合、减少溃疡的复发、延缓DU进一步恶化,且更加注重辨证论治与整体观念等中医理论指导下,调和阴阳,改善中医证候,治疗基础疾病,从根源治愈DU。因此,兹就自噬及主要相关因子LC3、Beclin-1和p62在DU创面愈合中的作用及中药干预进行综述,旨在为临床治疗DU创面及后续相关深入研究提供参考和思路。
Diabetic ulcer(DU)is a chronic and refractory ulcer which often occurs in the foot or lower limbs.It is a diabetic complication with high morbidity and mortality.The pathogenesis of DU is complex,and the therapies(such as debridement,flap transplantation,and application of antibiotics)are also complex and have long cycles.DU patients suffer from great economic and psychological pressure while enduring pain.Therefore,it is part icularly important to promote rapid wound healing,reduce disability and mortality,protect limb function,and improve the quality of life of DU patients.By reviewing the relevant literature,we have found that autophagy can remove DU wound pathogens,reduce wound inflammation,and accelerate ulcer wound healing and tissue repair.The main autophagy-related factors microtubule-binding light chain protein 3(LC-3),autophagy-specific gene Beclin-1,and ubiquitin-binding protein p62 mediate autophagy.The traditional Chinese medicine(TCM)treatment of DU mitigates clinical symptoms,accelerates ulcer wound healing,reduces ulcer recurrence,and delays further deterioration of DU.Furthermore,under the guidance of syndrome differentiation and treatment and the overall concept,TCM treatment harmonizes Yin and Yang,ameliorates TCM syndrome,and treats underlying diseases, thereby curing DU from the root. Therefore, this article reviews the role of autophagy and major relatedfactors LC-3, Beclin-1, and p62 in the healing of diabetic ulcer wounds and the intervention of TCM, aiming to providereference for the clinical treatment of diabetic ulcer wounds and subsequent in-depth studies.
作者
魏晓涛
刘涛
何志军
李金鹏
宋渊
陈杰
王海刚
何元旭
王威威
谢婧
WEI Xiao-tao;LIU Tao;HE Zhi-jun;LI Jin-peng;SONG Yuan;CHEN Jie;WANG Hai-gang;HE Yuan-xu;WANG Wei-wei;XIE Jing(Gansu University of Chinese Medicine,Lanzhou 730000,China;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730000,China;Second Provincial People’s Hospital of Gansu,Lanzhou 730000,China;The Fourth Affiliated Hospital of Gansu University of Chinese Medicine,Lanzhou 730000,China)
出处
《中国中药杂志》
CAS
CSCD
北大核心
2023年第7期1724-1730,共7页
China Journal of Chinese Materia Medica
基金
国家自然科学基金项目(81660802,81860863)
甘肃省自然科学基金项目(22JR5RA620)
甘肃省中医药管理局重点课题(GZKZ-2020-2)
甘肃省中医药管理局普通课题(GZKG-2021-51)
甘肃省重点研发计划项目(21YF5FA021)
甘肃省青年科技基金计划项目(21JR11RA211)
兰州市人才创新创业专项(2019-RC-63)。
