枳实薤白桂枝汤现代药理作用研究进展  

Modern Pharmacological Effect of Zhishi Xiebai Guizhitang:A Review

作　　者：何湛湛 杨桢[2] 亓玉婕 陈香云 耿颖 刘珍洪[2] 陶旭光[1] 余婧[1] 张凯元 褚策 袁雨露 汪文来[1] 赵红霞[1] HE Zhanzhan;YANG Zhen;QI Yujie;CHEN Xiangyun;GENG Ying;LIU Zhenhong;TAO Xuguang;YU Jing;ZHANG Kaiyuan;CHU Ce;YUAN Yulu;WANG Wenlai;ZHAO Hongxia(Institute of Basic Theory of Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Beijing University of Chinese Medicine,Beijing 100029,China;Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China)

机构地区：[1]中国中医科学院中医基础理论研究所,北京100700 [2]北京中医药大学,北京100029 [3]首都医科大学附属北京同仁医院,北京100176

出　　处：《中国实验方剂学杂志》2023年第6期254-259,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中国中医科学院自主选题项目(YZ202042);中国中医科学院自主选题项目(YZ202019);中国中医科学院科技创新工程黑地黄丸重大攻关项目(CI2021A00606);北京市中医药科技发展基金项目(JJ2018-99)。

摘　　要：枳实薤白桂枝汤是体现温阳法治疗胸痹的经典方剂,收录于国家中医药管理局颁布的古代经典名方目录(第一批),具有通阳散结,行气化痰的功效,主治症状包括胸满而痛,甚或胸痛彻背,喘息咳唾,短气,气从胁下冲逆等。现代中医临床将其用于心血管系统、消化系统和呼吸系统等多种疾病的治疗,其中对冠心病、不稳定性心绞痛、心肌梗死、窦性心动过缓等心血管疾病的疗效尤为显著。笔者主要对近10年来关于枳实薤白桂枝汤的药理学研究进行梳理和评述,结果显示,该方各单味药与整方均对上述心血管疾病有一定改善作用,药理作用涉及改善血管内环境、改善心肌缺血、改善心肌缺血再灌注损伤、改善心肌缺氧、抗炎、稳定斑块等方面;其作用机制涉及调节体内相关活性物质、调节相关信号通路与离子通道等,具体主要包括血清血栓烷素B2(TXB2)、血清前列环素I2(PGI2)、磷脂酰肌醇3-激酶/蛋白激酶B/内皮型一氧化氮合酶(PI3K/Akt/eNOS)信号途径、三磷酸腺苷(ATP)敏感性钾通道等。此外,部分单味药的药理作用与瞬时受体电位通道锚蛋白1(TRPA1)的关系已有报道,其中TRPA1是认识该方作用机制与治疗心血管疾病的关键之一,值得深入。Zhishi Xiebai Guizhitang is a classical prescription for the treatment of chest impediment with the method of warming Yang.It is included in the Catalogue of Ancient Classical Prescriptions issued by the National Administration of Traditional Chinese Medicine(First Batch),with the effect of activating Yang,dissipating mass,moving Qi and resolving phlegm.Its main symptoms include chest fullness and pain,or even chest pain radiating to the back,wheezing,coughing,shortness of breath,and Qi reversal from the hypochondrium.In modern traditional Chinese medicine,Zhishi Xiebai Guizhitang is clinically used in the treatment of cardiovascular system,digestive system,respiratory system and other diseases,among which coronary heart disease,unstable angina pectoris,myocardial infarction,sinus bradycardia and other cardiovascular diseases have particularly significant effects.This paper reviewed the pharmacological studies of Zhishi Xiebai Guizhitang in the past 10 years.The results showed that each single medicine and the whole prescription alleviated the above cardiovascular diseases to a certain extent,with the pharmacological effects of improving intravascular environment,myocardial ischemia,myocardial ischemia-reperfusion injury,and myocardial hypoxia,anti-inflammation,plaque stabilisation,etc.,and the pharmacological mechanism involved the regulation of relevant active substances in vivo as well as related signaling pathways and ion channels,mainly including thromboxane B2(TXB2),prostacyclin I2(PGI2)and phosphatidylinositol 3-kinases/protein kinase B/endothelial nitric oxide synthase(PI3K/Akt/eNOS)signaling pathways,and ATP-sensitive potassium channels.In addition,the relationship between the pharmacological effects of some single medicines and transient receptor potential ankyrin 1(TRPA1)has been reported that TRPA1 is a key to understanding the mechanism of Zhishi Xiebai Guizhitang in treating cardiovascular diseases,which is worth of further study.

关 键 词：枳实薤白桂枝汤 药物化学 药理作用 研究进展 综述 

分 类 号：R2-0[医药卫生—中医学] R22R285.5R284R33