摘要
纤维化可发生于不同的组织器官,是多种慢性疾病进展的共同结局,表现为成纤维细胞过度活化和细胞外基质过度沉积。靶向经典纤维化信号转化生长因子-β(TGF-β)是目前药物治疗该类疾病的常规策略。传统中医药用于纤维化疾病的治疗已有成熟的理论作支撑。该理论强调“内邪汇聚、虚实夹杂”是纤维化疾病的共同病理基础;气滞、血瘀、痰浊乃至癥瘕积聚为其关键病理因素;“以阳制阴”为中医药治疗本类疾病的核心思想。药理学探索揭示了中医药“多层次、多靶点”治疗纤维化疾病的科学本质,即网络式调控TGF-β/果蝇蛋白同源物(Smad)、磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)、刺猬蛋白(Hedgehog)、Wnt/β-黏连蛋白(β-catenin)、炎症细胞因子等纤维化相关分子信号活性,抑制成纤维细胞功能,从而为寻找新型抗纤维化药物提供新的机遇。该文通过回顾古籍文献和现代研究报告,综述祖国医药治疗纤维化疾病的传统认识与作用机制研究进展,以期为本领域后续研究提供思路。
Fibrosis can occur in diverse tissue and organs and is the common outcome as multiple chronic diseases progress.It is characterized by over-activation of fibroblasts and excessive deposition of extracellular matrix.Targeting transforming growth factor-β(TGF-β),a classical signaling molecule in fibrosis,is currently a routine strategy for drug therapy of this disease.The use of traditional Chinese medicine(TCM)in the treatment of fibrotic diseases has been supported by mature theories.The theories emphasize that the internally-accumulated pathogens and mixed deficiency-excess underlie the shared pathology of fibrotic diseases.Qi stagnation,blood stasis,phlegm turbidity,and mass accumulation are key pathological factors."Yin suppression by Yang"is the core thought for treatment with TCM of the disease.Pharmacological investigations reveal the scientific nature of TCM in treating fibrotic diseases,namely multilevelled and multitargeted.In other words,it refers to networked regulation of signaling activities of fibrosis-related molecules such as TGF-β/Drosophila protein homolog(Smad),phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt),Hedgehog,Wnt/β-catenin,and inflammatory cytokines,so as to inhibit fibroblast function and provide a promising insight into novel anti-fibrotic drug.This paper summarized the conventional understanding of fibrotic disease treatment with TCM and its mechanism of action by reviewing ancient literature and modern research reports,which offers an idea for follow-up research in this field.
作者
杨靖
李英
曾莉
赵奉茹
YANG Jing;LI Ying;ZENG Li;ZHAO Fengru(Chengdu Fifth People's Hospital/The Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 611130,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2024年第3期270-278,共9页
Chinese Journal of Experimental Traditional Medical Formulae
基金
四川省医院协会青年药师科研专项资金项目(22007)
四川省中医药管理局项目(2020JC0012)。
关键词
中医药
纤维化
传统理论
分子机制
traditional Chinese medicine
fibrosis
conventional theory
molecular mechanism
