摘要
左归丸作为中医经典方剂之一,具有峻补真阴、填精益髓的功效,在临床上广泛应用于治疗因先天精亏而导致的疾病。该文通过系统回顾“先天不足”等相关古籍,以及左归丸治疗先天不足的现代科研文献,从左归丸的组方原则和中医理论中先天不足的概念出发,探讨了左归丸治疗先天不足的理论基础,并结合现代研究成果互参互证。古代医家早已发现父母之不足,可以导致子代形体发育异常、机体羸弱,张景岳将先天精气分为真阴、元阳,以“阴阳互济”组方左归丸,专补先天真阴。实验研究发现,左归丸能提高间隙连接蛋白43(Cx43)蛋白表达及间隙连接细胞间通讯(GJIC)功能,促进骨髓基质细胞(BMSCs)成骨分化成熟,改善先天精亏引起的骨发育异常;增强皮质颤蛋白(Reelin)表达和活性等改善脑发育异常;上调Cx43蛋白表达,干预磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)通路等改善生殖功能异常;促进T细胞发育成熟,激活胸腺内Wnt/β-链蛋白(β-catenin)信号通路等改善免疫功能异常;促进β-catenin的表达,抑制微管相关蛋白1轻链3(LC3)的表达改善皮肤功能异常。还能通过中医“精-神”之间的相关性,干预指导干细胞的分化。左归丸在部分儿科、男科、妇科疾病、老年疾病、内科疾病、骨科疾病和皮肤疾病的临床应用中均显示出显著的治疗效果。基于实验与临床应用的验证,文章进一步分析了“先天不足”的具体内涵,提出“先天不足”应细分精气阴阳,其中“先天精亏”属于真阴不足,可以导致子代的“肾精不足”,出现基于“肾藏精”的功能表达异常。药理学研究发现左归丸中菟丝子、枸杞子、牛膝含有槲皮素和山柰酚等有效成分,影响环加氧酶2(PTGS2)、白细胞介素-6(IL-6)、丝裂原活化蛋白激酶14(MAPK14)、肿瘤坏死因子(TNF)、17号染色体基因(TP53)、血管内皮生长因子A(VEGFA)、白蛋白(A
Zuoguiwan,one of the classic formulas of traditional Chinese medicine(TCM),has the effects of nourishing genuine Yin,supplementing essence,and replenishing marrow,and it is widely used in the clinical treatment of diseases caused by congenital essence deficiency.This article systematically reviewed the ancient books involving congenital deficiency and the modern research reports on the treatment of congenital deficiency with Zuoguiwan.From the formulation principle of Zuoguiwan and the TCM concept of congenital deficiency,this article discussed the theoretical basis of treating congenital deficiency with Zuoguiwan based on the modern research results.Ancient physicians have discovered that the deficiency of parents can lead to abnormal physical development and weakness of the offspring.ZHANG Jingyue divided congenital essence Qi into genuine Yin and primordial Yang and formulated Zuoguiwan based on the principle of Yin-Yang mutual assistance for supplementing congenital genuine Yin.Experimental studies have shown that Zuoguiwan can up-regulate the expression of connexin 43(Cx43)protein and improve gap junction intercellular communication(GJIC)function to promote osteogenic differentiation and maturation of bone marrow mesenchymal stem cells and ameliorate abnormal bone development caused by congenital essence deficiency.Zuoguiwan can enhance the expression and activity of Reelin to ameliorate abnormal brain development.It can upregulate the expression of Cx43 protein to intervene in the phosphatidylinositol 3 kinase/protein kinase B(PI3K/Akt)pathway,thus repairing the reproductive functions.Zuiguiwan can promote the development and maturation of T cells and activate the Wnt/β-catenin signaling pathway in the thymus to improve immune functions.In addition,it can promote the expression ofβ-catenin and inhibit the expression of microtubule-associated proteins 1 light chain 3(LC3)to attenuate skin dysfunctions.Moreover,Zuoguiwan can guide the differentiation of stem cells via the correlation between essence and vit
作者
陈好远
沈灿
张泽权
徐安莉
张智华
金晶
赵敏
CHEN Haoyuan;SHEN Can;ZHANG Zequan;XU Anli;ZHANG Zhihua;JIN Jing;ZHAO Min(School of Integrated Chinese and Western Medicine,Hubei University of Chinese Medicine,Wuhan 430065,China;School of Traditional Chinese Medicine(TCM),Hubei University of Chinese Medicine,Wuhan 430061,China;Affiliated Hospital of Hubei University of Chinese Medicine,Wuhan 430060,China;Hubei Provincial Hospital of TCM,Wuhan 430060,China;Hubei Provincial Institute of TCM,Wuhan 430060,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2024年第17期51-59,共9页
Chinese Journal of Experimental Traditional Medical Formulae
基金
湖北省教育厅科学研究计划项目(D20212001)
湖北省自然科学基金计划项目(2023AFD114)。
关键词
左归丸
先天精亏
肾藏精
研究进展
Zuoguiwan
congenital essence deficiency
kidney storing essence
research progress
