中医方药对腰椎间盘退行性变抑制作用的机制探讨  

Study on the Mechanism of Inhibiting Effect of Traditional Chinese MedicinePrescriptions on Lumbar Intervertebral Disc Degeneration

作　　者：李法杰 谷金玉 张悦 杨满红 万田豪 夏迪 张清 LI Fajie;GU Jinyu;ZHANG Yue;YANG Manhong;WAN Tianhao;XIA Di;ZHANG Qing(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]中国中医科学院中医临床基础医学研究所,北京100700

出　　处：《辽宁中医药大学学报》2024年第1期179-183,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：中国中医科学院“优势病种-医院制剂-新药”研发专项(ZZ15-XY-PT-12)。

摘　　要：腰椎间盘退行性变(lumbar intervertebral disc degeneration,LIVDD)是一种常见的脊柱退行性病变,其发生频率较高,对病人的生存造成了很大影响。中医方药在LIVDD的治疗中有着广泛的应用和良好的效果,近年来许多学者从多种角度运用多种途径证明中医方药治疗LIVDD的可能机制主要有:增强腰椎间盘超微结构的稳定性、对腰椎间盘细胞增殖的促进作用、对腰椎间盘细胞衰老和凋亡的抑制作用、促进腰椎间盘细胞的自我吞噬、对炎症因子释放的抑制作用、对ECM降解的抑制作用以及提高腰椎间盘营养代谢等。但是,目前还存在着研究模型无法更好地模拟人体LIVDD,研究方药多以复方为主,中药单体的作用机制研究较少等问题,中医方药在临床上的应用往往会因为证候的不同而存在方药配伍规律各异,所以可以将LIVDD的理论进一步细分为不同的辨证分型,以探究中医方药对LIVDD不同证型的不同疗效,并在此基础上进一步研究其机制,然而不同证候模型的建立也是一个很大的挑战,需要不断实践创新及应用积累,才能达到更高的科学性和可行性。Lumbar intervertebral disc degeneration(LIVDD)is a common spine degeneration,which occurs with a high frequency and has a great impact on the survival of patients.Traditional Chinese medicine(TCM)prescriptions are widely used and have good effects in the treatment of LIVDD.In recent years,many scholars have proved that the possible mechanisms of TCM prescriptions for the treatment of LIVDD are as follows:It can enhance the stability of ultrastructure of lumbar intervertebral disc,promote the proliferation of lumbar intervertebral disc cells,inhibit the aging and apoptosis of lumbar intervertebral disc cells,promote the self-phagocytosis of lumbar intervertebral disc cells,inhibit the release of inflammatory factors,inhibit the degradation of ECM,and improve the nutritional metabolism of lumbar intervertebral disc,etc.However,at present,there are still some problems that research models cannot better simulate LIVDD in human body,and the researches on prescriptions are mainly based on compound prescriptions,and there are few researches on the mechanism of action of TCM monomer.The clinical application of TCM prescriptions often has different compatibility rules due to different syndromes.Therefore,LIVDD theory can be further subdivided into different syndrome differentiation types.To explore the different effects of TCM prescriptions on different syndrome types of LIVDD,and further study its mechanism on this basis.However,the establishment of different syndrome models is also a big challenge,which requires continuous practice,innovation and application accumulation,so as to achieve higher scientific and feasibility.

关 键 词：中医方药 腰椎间盘退行性变 抑制作用 机制 

分 类 号：R274.9[医药卫生—中西医结合]