中药多糖类成分促进慢性难愈创面修复机制的研究进展  

Mechanism of Promoting Chronic Refractory Wound Repair by Polysaccharides in Traditional Chinese Medicine:A Review

作　　者：许东敏 杜娟娇[2] 杨莹 郭夏晴 XU Dongmin;DU Juanjiao;YANG Ying;GUO Xiaqin(Guangxi University of Chinese Medicine,Nanning 530000,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530000,China;Shenzhen Hospital,Beijing University of Chinese Medicine,Shenzhen 518000,China)

机构地区：[1]广西中医药大学,南宁530000 [2]广西中医药大学第一附属医院,南宁530000 [3]北京中医药大学深圳医院,广东深圳518000

出　　处：《中国实验方剂学杂志》2024年第8期245-252,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81360572)。

摘　　要：慢性难愈创面是皮肤连续性遭破坏,兼之可能由于反复感染、血管功能不全、糖尿病、肿瘤或慢性骨髓炎等因素影响造成创面愈合中断和康复延迟而形成慢性难治伤口,严重影响患者的生活质量及耗费大量医疗资源。中药多糖类成分是多数中药的有效成分,在现代药理学研究中发现中药所含多糖成分具有抗炎、抗氧化、抗辐射、降血糖、抗病毒、抗肿瘤、降血脂、免疫调节等作用。通过对文献的归纳、分析、总结,发现中药多糖成分促进慢性难愈创面的修复的机制主要从以下几个方面实现:其一,通过调节白细胞介素-4(IL-4)、白细胞介素-10(IL-10)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)等炎症因子或与巨噬细胞相关的炎症蛋白、趋化蛋白如巨噬细胞炎症蛋白-2(MIP-2)、单核细胞趋化蛋白-1(MCP-1)缩短炎症期;其二,激活血小板源性生长因子(PDGF)、碱性成纤维细胞生长因子(bFGF)、TGF-α、血管内皮生长因子(VEGF)等生长因子以募集内皮细胞和成纤维细胞进入组织增殖期;其三,激活VEGF及其下游受体血管内皮生长因子受体(VEGFR)-1和VEGFR-2介导蛋白激酶C/细胞外调节蛋白激酶(PKC/ERK)信号通路,或通过血管紧张素(ANG)途径,促进血管新生,改善创面血流;其四,通过增强成纤维细胞(FB)分泌羟辅氨酸和透明质酸(HA)促进合成胶原蛋白的能力、以及调节相关基质金属酶及其酶抑制剂调整细胞外基质;其五,清除自由基减少氧化应激给组织带来的损伤;其六,加强机体巨噬细胞吞噬能力、自然杀伤细胞(NK细胞)的活性及T细胞的增殖,提高组织的防御能力。中药多糖对创面修复可同时从多方面进行,多靶点、多通路,这是其优势潜力所在,期待后续基础研究在增进慢性难愈创面治疗手段时更加注重对于中药多糖类成分对创面修复的机制研究。A chronic refractory wound is caused by continuous skin damage.At the same time,it may be formed due to repeated infection,vascular insufficiency,diabetes,tumors,chronic osteomyelitis,and other reasons,resulting in wound repair interruption and recovery delay.Chronic refractory wound seriously affects the quality of life of patients and consumes a lot of medical resources.Polysaccharides in traditional Chinese medicine(TCM)are the effective components of most TCM.Modern pharmacological studies have found that polysaccharides contained in TCM have anti-inflammatory,antioxidant,anti-radiation,hypoglycemic,antiviral,anti-tumor,hypolipidemic,and immunomodulatory effects.Through the summary and analysis of the literature,it was found that the mechanism of polysaccharides in TCM to promote chonic refractory wound repair was mainly realized from the following aspects:firstly,regulating inflammatory cytokines like interleukin-4(IL-4),interleukin-10(IL-10),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)or regulating macrophage-related inflammatory proteins and chemotactic proteins like MIP-2,MCP-1,to shorten the inflammatory period.Secondly,activating growth factors like platelet-derived growth fator(PDGF),basic fibroblast growth factor(bFGF),TGF-α,and vascular endothelial growth factor(VEGF)to recruit endothelial cells and fibroblasts into tissue proliferation.Thirdly,activationg VEGF and its downstream receptor vascular endothelial growth factor receptor-1(VEGFR-1)and vascular endothelial growth factor receptor-2(VEGFR-2)-mediatated protein kinase C/extracellular regulated kinases(PKC/ERK)signaling pathway or promoting angiogenesie and improving wound blood flow through angiotensin(ANG).Fourthly,promoting the ablility of collagen synthesis by enhancing the secretion of hydroxyproline and hyaluronic acid(HA)from fibroblasts(FB)and regulating relevant matrix metalloenzymes and their enzyme inhibitor to regulate the extracellular matrix.Fifthly,eliminating free radiccals to reduce the damage caused by oxidative s

关 键 词：中药多糖 慢性难愈创面 修复 机制 

分 类 号：R2-0[医药卫生—中医学] R33[文化科学—情报学] G353.11R751