中药复方抗食管癌研究进展  

Chinese Herbal Prescription Against Esophageal Cancer:A Review

作　　者：白杨[1] 曹珊[1] 韩倩倩[1] 何航[1] 李炎辉 BAI Yang;CAO Shan;HAN Qianqian;HE Hang;LI Yanhui(Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学,郑州450046

出　　处：《中国实验方剂学杂志》2022年第13期277-282,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省科技发展计划项目(212102311080);河南省科技攻关项目(192102310429);河南省中医药科学研究专项(2022ZYZD20)。

摘　　要：食管癌是恶性程度高、侵袭能力强、预后较差的一类上消化道恶性肿瘤,属中医学“噎膈”范畴。中药复方在抗肿瘤方面具有显著优势。通过查阅国内外相关文献,获知构成食管癌(噎膈)的证素包括气滞、痰、气虚、血瘀、阴虚等,中医临床辨证多分为痰气交阻、气阴两虚、津亏热结、气虚痰湿、痰热互结、痰瘀互结、热毒瘀结、正虚毒蕴等,大半夏汤、启膈散、旋覆代赭汤、六君子汤、沙参麦冬汤、通幽汤等为临床常用方剂,其中启膈散、六君子汤、通幽汤等经体内外实验研究已证明可通过直接抑制肿瘤细胞增殖、或促进凋亡、影响肿瘤微环境、调节细胞能量代谢、抑制血管生成等机制发挥抗食管癌作用,且中药复方通过靶向非编码单链RNA分子(microRNA)发挥抗食管癌作用的研究越来越多,发现临床收效良好的复方大半夏汤、参赭培气汤、小陷胸汤、人参半夏汤、六神丸等尚无深入的机制研究,古籍所载的吴茱萸汤、通关散等复方却于现代少有应用。因此,该文将中医经典古籍中专药专方、现代临床常用复方及实验研究进行梳理,以期推广中药复方抗食管癌的治疗方法,发挥中西医结合治疗的协同优势。Esophageal cancer is a type of upper gastrointestinal malignant tumor with a high degree of malignancy,strong invasion ability,and poor prognosis,which belongs to the category of"dysphagia"in traditional Chinese medicine(TCM).In addition to tumor resistance,Chinese herbal prescription plays a role in sensitization.In light of information in literature,the syndrome elements of esophageal cancer include Qi stagnation,phlegm,Qi deficiency,blood stasis,and Yin deficiency.After clinical differentiation,the syndromes of esophageal cancer are divided into phlegm and Qi obstruction,Qi and Yin deficiency,fluid deficiency and heat accumulation,Qi deficiency and phlegm dampness,combined phlegm and heat,combined phlegm and stasis,combined heat toxin and stasis,healthy Qi deficiency and toxin accumulation,et al.Dabanxiatang,Qigesan,Xuanfu Daizhetang,Liujunzitang,Shashen Maidongtang,and Tongyoutang are the common clinical prescriptions,where Qigesan,Liu Junzitang,and Tongyoutang have been proved by in vitro and in vivo experiments to exert anti-esophageal cancer effect by directly inhibiting tumor cell proliferation,promoting apoptosis,affecting tumor microenvironment,regulating cell energy metabolism,and inhibiting angiogenesis.In addition,an increasing number of studies have been conducted on anti-esophageal cancer effect of Chinese herbal prescription by targeting non-coding single-stranded microRNA.The specific mechanisms of Da Banxiatang,Shenzhe Peiqitang,Xiao Xianxiongtang,Renshen Banxiatang,and Liushenwan have been scarcely reported despite good clinical efficacy.Wuzhuyu Tang and Tongguansan recorded in ancient books have been rarely applied in modern times.Therefore,the present study reviewed the special drugs and prescriptions mentioned in ancient TCM classics,the commonly used Chinese herbal prescriptions in modern clinical practice,and experimental research progress,to promote treatment methods of Chinese herbal prescriptions against esophageal cancer.

关 键 词：中药复方 食管癌 大半夏汤 六君子汤 通幽汤 小陷胸汤 参赭培气汤 增殖 凋亡 微环境 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学] R2-031R285.5