氧化应激在溃疡性结肠炎中的作用及中医药防治研究进展  

Role of Oxidative Stress in Ulcerative Colitis and Traditional Chinese Medicine Prevention and Treatment:A Review

作　　者：陈博 孙夕童 董新茜 王伟[2] 宋洪泉[2] 赵继亭 郑雅[2] 张宏昊 栾庆鑫 赵康宁 邓华亮[2] 孙轸 CHEN Bo;SUN Xitong;DONG Xinqian;WANG Wei;SONG Hongquan;ZHAO Jiting;ZHENG Ya;ZHANG Honghao;LUAN Qingxin;ZHAO Kangning;DENG Hualiang;SUN Zhen(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学,济南250014 [2]山东中医药大学附属医院,济南250014

出　　处：《中国实验方剂学杂志》2023年第16期264-273,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金青年科学基金项目(81904128);山东省中医药科技项目(M-2022148)。

摘　　要：溃疡性结肠炎(UC)是一种临床常见的消化系统疾病,致病机制尚不明确,病情复杂多变,迁延难愈,治疗周期漫长,且无特效药。目前,UC的治疗多采用皮质类固醇、氨基水杨酸及生物制剂等西医手段,短时间起效快,疗效确切。但随着用药时间的延长,部分患者会出现耐药性和加剧病情发展,导致结肠癌的发生。有研究发现,氧化应激是UC重要的致病因素之一,影响着UC的发生、发展。氧化应激是机体内氧化产物与抗氧化系统不平衡的一种应激状态,丙二醛(MDA)、活性氧(ROS)、一氧化氮(NO)等氧化产物的过表达或者超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽(GSH)抗氧化酶的不足都会导致氧化应激的发生。值得注意的是,中医药作为我国独有的医学特色,运用中医药治疗UC疾病已经取得显著的成效。研究表明,中医药一方面通过抑制代谢产物的堆积,有效抑制UC发生,另一方面,通过提高抗氧化系统,达到拮抗UC发展的治疗效果。因此,以中医药调节氧化平衡状态作为诊疗思路,可能是未来治疗UC疾病的新手段、新方向。基于上述研究,该文总结了氧化应激关键致病蛋白与UC发生、发展的作用机制,归纳了中药有效成分、单味中药、中药复方、针灸调控氧化应激上下游靶点蛋白,减轻肠黏膜病理损害,降低结肠损伤指数,以及丰富肠道菌群,增加结肠长度,改善UC临床症状,以期为扩大中医药治疗UC疾病的应用范围,提供可靠的科学理论依据。Ulcerative colitis(UC) is a commonly seen digestive system disease with unclear pathogenesis.The condition is complex and variable,often chronic,and has a long treatment period with no specific cure.Currently,the treatment of UC often involves the use of corticosteroids,aminosalicylates,and biologics in western medicine,which provide fast-acting and definite efficacy in the short term.However,with prolonged medication,some patients may develop drug resistance and worsening of the disease,leading to the occurrence of colon cancer.Research has found that oxidative stress is one of the important pathogenic factors in UC and influences its onset and development.Oxidative stress is a state of imbalance between oxidative products and the antioxidant system in the body,characterized by overexpression of oxidative products such as malondialdehyde(MDA),reactive oxygen species(ROS),nitric oxide(NO),or deficiency of antioxidant enzymes such as superoxide dismutase(SOD),catalase(CAT),and glutathione(GSH).It is worth noting that traditional Chinese medicine(TCM),as a unique characteristic medicine of China,has achieved significant efficacy in the treatment of UC.Studies have shown that TCM effectively inhibits the occurrence of UC by suppressing the accumulation of metabolites and antagonizes the development of UC by enhancing the antioxidant system.Therefore,using TCM to regulate the oxidative balance as a diagnostic and therapeutic approach may be a new method and direction for the treatment of UC in the future.Based on the above research,this article summarized the mechanisms of key pathogenic proteins in oxidative stress and the occurrence and development of UC,and compiled the effective ingredients of Chinese medicine,single drugs,prescriptions,and acupuncture and moxibustion in regulating upstream and downstream target proteins of oxidative stress.These interventions can reduce pathological damage to the intestinal mucosa,lower the colon injury index,enrich the intestinal microbiota,increase colon length,and improve cli

关 键 词：溃疡性结肠炎 氧化应激 丙二醛 超氧化物歧化酶 谷胱甘肽 核因子E2相关因子2(Nrf2) 核转录因子-κB(NF-κB) 

分 类 号：R2-0[医药卫生—中医学] R22R285.5R2-031R259R574.62