中医药介导相关信号通路治疗肝衰竭的研究进展  

Treatment of Liver Failure by Chinese Medicine Mediating Related Signaling Pathways:A Review

作　　者：赖嘉文 徐丽静 姚元谦 叶志豪 刘文钒 吕建林[2] LAI Jiawen;XU Lijing;YAO Yuanqian;YE Zhihao;LIU Wenfan;LYU Jianlin(Graduate School of Guangxi University of Chinese Medicine,Nanning 530299,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530022,China)

机构地区：[1]广西中医药大学研究生院,南宁530299 [2]广西中医药大学第一附属医院,南宁530022

出　　处：《中国实验方剂学杂志》2024年第7期272-280,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81860839);广西自然科学基金项目(2020GXNSFAA238020,2022GXNSFAA035446);广西研究生教育创新计划资助项目(JGY2021110);广西高校中青年教师(科研)基础能力提升项目(2021KY0300)。

摘　　要：肝衰竭(LF)因其起病凶险、并发症多、难以治疗、预后欠佳等特点,对广大患者产生极大的困扰。该病是由感染、肝损伤物质、自身免疫、循环障碍等多种因素导致的肝脏损伤,是以凝血障碍、黄疸、肝性脑病、腹水等为主要表现的一组常见临床证候群,其中医范畴为“鼓胀”“黄疸”等病证。目前西医治疗LF的研究进展较缓慢,且其临床应用效果仍不理想。与之相比,中医治疗该病具有悠久的历史,已经过数千年的临床实践及验证,具有疗效确切,不良反应较小的特点。LF的病理机制极为复杂,涉及的信号通路繁多,主要与炎症反应、氧化应激、肝纤维化、细胞凋亡等过程有关。近年来多项研究表明,中医药可通过介导体内相关信号通路干预LF的发生发展。但目前仍缺乏相应的总结性记载,故本综述通过查阅整理国内外相关文献,归纳总结出多条与中医药干预LF相关的信号通路:核转录因子-κB(NF-κB)、丝裂原活化蛋白激酶(MAPK)、磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)、转化生长因子-β/果蝇抗生物皮肤生长因子蛋白(TGF-β/Smads)、核因子E_(2)相关因子2/血红素加氧酶-1(Nrf2/HO-1)等,并阐述其干预LF的具体机制。该文旨在提供切实有效的中医药治疗LF相关通路及对应机制,为临床治疗LF及进一步的科学研究提供新的思路和理论依据。Liver failure(LF) is a great trouble to the majority of patients due to its severe onset,many complications,difficult treatment,poor prognosis and other characteristics.This disease is liver injury caused by infection,hepatotoxic substances,autoimmunity,circulation disorders and other factors.It is a group of common clinical symptoms mainly manifested by coagulation disorders,jaundice,hepatic encephalopathy,ascites,and so on.In traditional Chinese medicine,it falls under the categories of "tympanites","jaundice" and other diseases.At present,the research progress of Western medicine in the treatment of LF is slow,and its clinical application effect is still not ideal.In contrast,traditional Chinese medicine has a long history in the treatment of this disease,with over thousands of years of clinical practice and verification.It is characterized by exact efficacy and fewer side effects.The pathological mechanism of LF is extremely complex,involves a variety of signaling pathways,and is mainly related to inflammation,oxidative stress,liver fibrosis,cell apoptosis and other processes.In recent years,many studies have shown that traditional Chinese medicine can intervene in the occurrence and development of LF by mediating relevant signaling pathways in vivo,but there is still a lack of relevant summary.Therefore,this review summarized several signaling pathways related to the intervention of traditional Chinese medicine in LF by referring to and sorting out relevant literature worldwide,including nuclear factor kappa B(NF-κB),mitogen-activated protein kinase(MAPK),phosphatidylin-ositol-3-kinase/protein kinase B(PI3K/Akt),transforming growth factor-β/drosophila mothers against decapentaplegic proteins(TGF-β/Smads),and nuclear factor erythroid 2-related factor 2/heme oxygenase-1(Nrf2/HO-1),and elaborated the specific mechanism of their intervention in LF.This paper aims to provide practical and effective pathways and corresponding mechanisms for the treatment of LF by traditional Chinese medicine,and to provide new

关 键 词：肝衰竭 中医药 信号通路 病理机制 炎症反应 氧化应激 综述 

分 类 号：R2-0[医药卫生—中医学] R22R242R2-031R285.5