中药治疗肺纤维化的研究进展  

Research progress on traditional Chinese medicine against treating pulmonary fibrosis

作　　者：丁大力 沈学彬 姚佳慧 喻丽珍 周梦娟[1] 年四辉 DING Da-li;SHEN Xue-bin;YAO Jia-hui;YU Li-zhen;ZHOU Meng-juan;NIAN Si-hui(School of Pharmacy,Wannan Medical College,Wuhu 241002,China;Institute of Modern Chinese Medicine,Wannan Medical College,Wuhu 241002,China)

机构地区：[1]皖南医学院药学院,安徽芜湖241002 [2]皖南医学院现代中药研究所,安徽芜湖241002

出　　处：《中草药》2021年第22期7006-7024,共19页Chinese Traditional and Herbal Drugs

基　　金：安徽高校自然科学研究重点项目(KJ2017A258);安徽省科技厅重点研究与开发计划项目(201904a0702106);安徽省药学卓越人才教育培养计划项目(2019zyrc062)。

摘　　要：肺纤维化是由多种病因引起,并最终导致患者正常肺组织结构改变的一种慢性进行性肺间质疾病,预后较差。目前,治疗肺纤维化的药物主要是糖皮质激素与免疫抑制剂,但其具有较严重的不良反应。近年来,随着对肺纤维化研究的不断深入,利用中药治疗肺纤维化的探索与应用逐渐增多。中药及其有效成分能够通过转化生长因子-β1(transforming growth factor-β1,TGF-β1)/Smad、磷脂酰肌醇3-激酶(phosphatidylinositol 3-kinase,PI3K)/蛋白激酶B(protein kinase B,PKB/Akt)以及核因子E2相关因子-2(nuclear factor-erythroid 2-related factor-2,Nrf2)/谷胱甘肽(glutathione,GSH)等通路降低炎症因子表达、调节氧化还原平衡、诱导肺成纤维细胞凋亡、阻断纤维化进程,表现出了良好的抗肺纤维化作用,并能够有效改善纤维化症状并延缓病程进展。归纳并总结了近年来中药治疗肺纤维化的研究进展,以期为深入研究中药抗肺纤维化的具体机制以及发现有效中药活性成分提供参考。Pulmonary fibrosis is a chronic progressive pulmonary interstitial disease that is caused by a variety of factors and eventually leads to alterations in the normal lung tissue structure of patients.Up to now,glucocorticoids and immunosuppressants are the main drugs in treatment of pulmonary fibrosis,however,they have unavoidable side effects.In recent years,there are more and more research focusing on pulmonary fibrosis and a further understanding has been gradually delineated in these days,which inspires the exploration and application of traditional Chinese medicine as therapeutic agents in treatment of pulmonary fibrosis.Traditional Chinese medicines and their effective components could downregulate the expression of pro-inflammatory factors,regulate the redox balance,induce the apoptosis of lung fibroblasts and block the pathopoiesis of fibrosis through various signaling pathways including transforming growth factor-β1(TGF-β1)/Smad,phosphatidylinositol 3-kinase(PI3K)/protein kinase B(PKB/Akt),nuclear factor-erythroid 2-related factor-2(Nrf2)/glutathione(GSH),exhibiting therapeutic effect on pulmonary fibrosis and could effectively attenuate the symptoms and progression of fibrosis.Research progress on traditional Chinese medicine against treating pulmonary fibrosis were summarized in this paper to provide a reference for further study of the underlying mechanisms of traditional Chinese medicine against pulmonary fibrosis and discovery of effective compounds.

关 键 词：中药 肺纤维化 黄酮类 酚类 萜类 皂苷类 生物碱类 中药复方 

分 类 号：R285[医药卫生—中药学]