四神丸治疗溃疡性结肠炎的临床运用及免疫药理学研究进展  

Clinical Application and Research Progress in Immunopharmacology of Sishen Pill(四神丸)in Treatment of Ulcerative Colitis

作　　者：周文 张哲言 黄莉 万琪 赵海梅[3] 刘端勇[4] 李燕珍 ZHOU Wen;ZHANG Zheyan;HUANG Li;WAN Qi;ZHAO Haimei;LIU Duanyong;LI Yanzhen(Department of Postgraduate,Jiangxi University of Chinese Medicine,Nanchang 330004,Jiangxi,China;Scientific Research Division of Nanchang Medical College,Nanchang 330004,Jiangxi,China;School of Traditional Chinese Medicine,Jiangxi University of Chinese Medicine,Nanchang 330004,Jiangxi,China;Formula-Pattern Research Center of Jiangxi University of Chinese Medicine,Nanchang 330004,Jiangxi,China;School of Clinical Medicine,Nanchang Medical College,Nanchang 330004,Jiangxi,China)

机构地区：[1]江西中医药大学研究生院,江西南昌330004 [2]南昌医学院科研处,江西南昌330004 [3]江西中医药大学中医学院,江西南昌330004 [4]江西中医药大学方证研究中心,江西南昌330004 [5]南昌医学院临床医学院,江西南昌330004

出　　处：《中华中医药学刊》2023年第6期128-132,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82060838,82060799);江西省教育厅科技计划项目(GJJ218903,GJJ218916);江西省卫生健康委员会科技计划项目(SKJP_220211032);江西中医药大学中西医结合一级学科(江西双一流学科)项目(2022)。

摘　　要：溃疡性结肠炎(ulcerative colitis,UC)是一种病因复杂且复发率高的慢性非特异性炎症性肠病。《2017年溃疡性结肠炎中西医结合诊疗共识意见》中将出自《证治准绳》的四神丸作为治疗脾肾阳虚型UC的基础中药方剂。以四神丸为主方加减化裁、联合其他中药复方、联合西药以及其他中医特色疗法治疗慢性复发性UC具有疗效确切、不良反应小、复发率低、多靶点及多通路调控等优势。调节免疫是四神丸治疗UC的主要作用机制,主要表现在对记忆性T细胞(Memory T cell,TM)、辅助型T细胞1(T helper 1 cell,Th1)/辅助型T细胞2(T helper 2 cell,Th2)、调节性T细胞(Treg)、辅助性T细胞17(T helper cell 17,Th17)、滤泡辅助性T细胞(follicular B helper T cells,Tfh)/滤泡调节性T细胞(follicu⁃lar regulatory T cells,Tfr)、树突状细胞、B淋巴细胞和肠道菌群等以及多条信号通路调控作用,显示出四神丸良好的免疫药理作用。因此,就近年来四神丸治疗UC的临床运用及免疫药理学研究展开综述,以期为中医药治疗UC提供更多思路和途径。Ulcerative colitis(UC)is a chronic nonspecific inflammatory bowel disease with complex etiology and high recur⁃rence rate.In 2017 Consensus on Diagnosis and Treatment of UC with Integrated Traditional Chinese and Western Medicine,Sish⁃en Pill(四神丸),from Standards of Diagnosis and Treatment,is included as the basic prescription for Yang deficiency of spleen and kidney type of UC.As the main prescription of treating chronic recurrent UC,Sishen Pill combined with other Chinese medi⁃cine compound administration,western medicine and other characteristic therapy of traditional Chinese medicine have the advanta⁃ges of definite curative effect,minimal toxic and side effects,low recurrence rate,multi-target and multi-channel regulation.Immune regulation is the main mechanism of Sishen Pill in the treatment of UC,which is mainly manifested in the effects on mem⁃ory T cells(TM),helper 1 cells(Th1)/helper 2 cells(Th2),regulatory T cells(Treg),helper cell 17(Th17),follicular B helper T cells(Tfh)/follicular regulatory T cells(Tfr),dendritic cells,B lymphocytes and intestinal flora as well as the regulation of mul⁃tiple signal pathways,showing a good immunopharmacological effect of Sishen Pill.Therefore,the clinical application and immu⁃nopharmacological research of Sishen Pill in the treatment of UC in recent years were reviewed to provide more development po⁃tential for the treatment of UC with traditional Chinese medicine.

关 键 词：四神丸 溃疡性结肠炎 临床应用 调节免疫 综述 

分 类 号：R259.746.2[医药卫生—中西医结合]