特发性肺纤维化的发病机制及中药调节作用研究进展  

Pathogenesis of Idiopathic Pulmonary Fibrosis and Modulating Effect of Chinese Medicine:A Review

作　　者：邹恩国 黄天宇 王木兰[1] 查晨亮 龚琴 朱卫丰[1] 冯育林[1,2] 刘良徛[3] 李俊[1,2] ZOU Enguo;HUANG Tianyu;WANG Mulan;ZHA Chenliang;GONG Qin;ZHU Weifeng;FENG Yulin;LIU Liangji;LI Jun(Jiangxi University of Chinese Medicine,Nanchang 330006,China;National Pharmaceutical Engineering Center for Solid Preparation in Chinese Herbal Medicine,Jiangxi University of Chinese Medicine,Nanchang 330006,China;The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China)

机构地区：[1]江西中医药大学,南昌330006 [2]江西中医药大学中药固体制剂制造技术国家工程研究中心,南昌330006 [3]江西中医药大学附属医院,南昌330006

出　　处：《中国实验方剂学杂志》2024年第10期280-289,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中央引导地方科技发展资金项目(20222ZDH01096);江西省大学生创新创业训练项目(s202310412053)。

摘　　要：特发性肺纤维化(IPF)作为一种肺部进行性疾病,预后不佳,目前尚无可靠手段进行根治。当下治疗IPF以器官移植和给予化学药为主,但效果欠佳且不良反应颇多,无法满足目前的临床需求。因此,开发更安全、有效的药物已成为亟需解决的问题,而研究IPF的发病机制将有助于新药的开发。现阶段关于IPF发病机制的研究主要集中在巨噬细胞极化、上皮-间质转化(EMT)、氧化应激和自噬作用等方面,但对于系统说明各发病机制原理及揭示各机制存在的联系尚未有研究报道。中医理论认为“气虚血瘀”“气阳虚弱”是IPF的关键病机,故临床常采用益气活血、温阳补气和祛瘀化痰类等中药或复方治疗IPF。现代药理学研究表明,此类中药在抑制巨噬细胞极化、改善氧化还原平衡、抑制EMT和调节细胞自噬等方面可发挥积极作用,但针对中药如何调节相关通路而治疗IPF,目前尚无系统的报道。该文通过总结国内外最新文献,将逐一并系统的阐述IPF的发病机制,同时更全面的概述中药中有效成分或复方调节IPF的作用机制。针对IPF的发病机制,结合中药的调节作用,着重挖掘系统治疗IPF的方案,以期为IPF的深入研究及相关药物研发提供新的思路。Idiopathic pulmonary fibrosis(IPF),as a progressive lung disease,has a poor prognosis and no reliable and effective therapies.IPF is mainly treated by organ transplantation and administration of chemical drugs,which are ineffective and induce side effects,failing to meet the clinical needs.Therefore,developing safer and more effective drugs has become an urgent task,which necessitates clear understanding of the pathogenesis of IPF.The available studies about the pathogenesis of IPF mainly focus on macrophage polarization,epithelial-mesenchymal transition(EMT),oxidative stress,and autophagy,while few studies systematically explain the principles and links of the pathogeneses.According to the traditional Chinese medicine theory,Qi deficiency and blood stasis and Qi-Yang deficiency are the key pathogeneses of IPF.Therefore,the Chinese medicines or compound prescriptions with the effects of replenishing Qi and activating blood,warming Yang and tonifying Qi,and eliminating stasis and resolving phlegm are often used to treat IPF.Modern pharmacological studies have shown that such medicines play a positive role in inhibiting macrophage polarization,restoring redox balance,inhibiting EMT,and regulating cell autophagy.However,few studies report how Chinese medicines regulate the pathways in the treatment of IPF.By reviewing the latest articles in this field,we elaborate on the pathogenesis of IPF and provide a comprehensive overview of the mechanism of the active ingredients or compound prescriptions of Chinese medicines in regulating IPF.Combining the pathogenesis of IPF with the modulating effects of Chinese medicines,we focus on exploring systemic treatment options for IPF,with a view to providing new ideas for the in-depth study of IPF and the research and development of related drugs.

关 键 词：特发性肺纤维化(IPF) 发病机制 中药 作用机制 巨噬细胞极化 上皮-间质转化(EMT) 氧化应激 自噬 

分 类 号：R2-0[医药卫生—中医学] R242R2-031R259R563R256.1