青蒿琥酯联合用药及作用机制研究进展  

Artesunate Combined with Other Medications and Action Mechanism: A Review

作　　者：张雨婷 MUHAMMAD Shahbaz 张蕊 王变利[2] 张会敏[2] ZHANG Yuting;MUHAMMAD Shahbaz;ZHANG Rui;WANG Bianli;ZHANG Huimin(School of Pharmacy,Shandong University of Traditional Chinese Medicine(TCM),Jinan 250355,China;State Administration of TCM High-Level Key Discipline of TCM Analysis,Shandong Academy of Chinese Medicine,Jinan 250014,China;Qilu Hospital Affiliated to Shandong University,Jinan 250012,China;School of Basic Medical Science,Shandong University,Jinan 250100,China;Dongying Tongan Thoracic Surgery Hospital,Dongying 257300,China)

机构地区：[1]山东中医药大学药学院,济南250355 [2]山东省中医药研究院,国家中医药管理局,济南250014 [3]山东大学附属齐鲁医院,济南250012 [4]山东大学基础医学院,济南250100 [5]山东省东营同安胸外科医院,东营257300

出　　处：《中国实验方剂学杂志》2024年第3期290-298,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82004037);济南市引进创新团队项目(202228029);山东省中医药科技项目(M-2022173);山东省医药卫生发展计划项目(202213050443)。

摘　　要：青蒿素是一种从菊科蒿属植物黄花蒿(Artemisia annua)中分离出来的倍半萜类天然产物,青蒿琥酯(artesunate)是其衍生物之一,具有经济、速效、低毒、不易产生耐受等特点。目前临床主要用于脑型疟疾及各种重症疟疾的抢救,对疟原虫红内期有强大且快速杀灭的作用,能够迅速控制临床发作及症状。除此之外,青蒿琥酯还具有抗肿瘤、抗病毒、抗肝纤维化、抗炎、抗菌、保护肝细胞、免疫调节等药理作用,抑制细胞增殖、诱导细胞凋亡及下调血症水平。以青蒿素类化合物为基础的联合疗法(ACTs)是多国治疗疟疾的一线方法,主要包括蒿甲醚-本芴醇、青蒿琥酯-阿莫地喹和青蒿甲醚-苯甲酰胺等。近年来国内外学者对青蒿琥酯进行了研究,发现相对于单一疗法而言,青蒿琥酯联合疗法在增强药理作用、缩短用药时长和减少不良反应等方面更具有优越性。该文通过Web of Science核心合集(Web of Science Core Collection)系统检索并通过CiteSpace(6.2.1)软件对其进行整合,综述了近5年来青蒿琥酯联合其他药物在抗疟、抗肿瘤、抗菌和抗病毒等方面的作用机制并对其进行阐述,旨在为进一步合理开发利用青蒿琥酯及新药研发提供一定的理论依据。A sesquiterpene natural substance called artemisinin was discovered in Artemisia annua.One of its derivatives,artesunate(ART),has the properties of economy,immediate effect,low toxicity,and good tolerance.Since it has a quick and powerful killing effect on plasmodium in the erythrocyte phase and can quickly handle clinical seizure and symptoms,it is currently mostly utilized to treat cerebral malaria and other severe instances of malaria. In addition, it has antitumor, antivirus, anti-hepatic fibrosis, anti-inflammatory,antibacterial, hepatocyte protection, immunological modulation, and other pharmacological properties and caninhibit cell proliferation, induce cell apoptosis, and reduce the incidence of sepsis. In many countries,artemisinin-based combination therapies( ACTs), such as artemether-benflumetol, artesunate-amodiaquine, andartemether-lumefantrine, are the first-line treatments for malaria. Recent research on artesunate by Chinese andinternational scholars has revealed that compared with monotherapy, artesunate combination therapy offers morebenefits in terms of improving pharmacological effects, shortening the duration of medicine, and minimizingadverse effects. Through systematic retrieval of Web of Science Core Collection and integration throughCiteSpace( 6.2.1) software, this article reviewed the mechanism of artesunate combined with other medicationswith regard to antimalarial, antitumor, antibacterial, and antiviral features in the previous five years, so as toprovide some theoretical basis for rational development and utilization of ART and new drug research anddevelopment.

关 键 词：青蒿琥酯 联合疗法 作用机制 抗疟 抗肿瘤 

分 类 号：R2-0[医药卫生—中医学] R33[文化科学—情报学] G353.11R254.5R531.3