中药启膈散防治食管癌机制研究概述  

Overview of the mechanism of Qigesan in the prevention and treatment of esophageal cancer

作　　者：张明蕊 范焕芳 陈佳琪 许绍青 金明哲 杨柳 ZHANG Mingrui;FAN Huanfang;CHEN Jiaqi;XU Shaoqing;JIN Mingzhe;YANG Liu(Graduate School of Hebei University of Chinese Medicine,Shijiazhuang 050091,China)

机构地区：[1]河北中医药大学研究生学院,石家庄050091 [2]河北中医药大学第一附属医院肿瘤二科 [3]河北省浊毒证重点实验室

出　　处：《环球中医药》2024年第6期1205-1211,共7页Global Traditional Chinese Medicine

基　　金：河北省自然科学基金(H2021423030)。

摘　　要：启膈散为专治噎膈的经验效方,具有理气开郁、化痰润燥等功效,于临床辨证加减治疗或辅助治疗食管癌颇有疗效。文章检索近年来启膈散防治食管癌的基础研究文献,从抑制细胞增殖、诱导细胞凋亡、抑制细胞迁移侵袭、提升机体免疫功能和增强化疗敏感性等方面对启膈散拮抗食管癌的作用机制进行整理和总结,发现启膈散可通过激活含半胱氨酸的天冬氨酸蛋白水解酶3(Caspase-3)蛋白,参与Caspases蛋白酶级联反应环节诱导食管癌细胞凋亡,并可调控miR-133a/磷脂酰肌醇3-激酶(phosphatidylinositol 3-kinase,PI3K)/蛋白激酶B(protein kinase B,AKT)通路抑制食管癌细胞增殖;通过增强细胞粘附作用、抑制细胞骨架重构和抑制血管生成干预食管癌迁移侵袭的多个环节;通过提高白介素(interleukin,IL)-10、肿瘤坏死因子(tumor necrosis factor,TNF)、单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)、IL-6、IL-12p70等细胞因子水平、影响免疫细胞活性从而提升机体免疫功能;还可增强食管癌细胞化疗敏感性,与顺铂联用可协同增效。本文对相关实验研究文献进行综述,总结了启膈散防治食管癌的作用机制和相关数据挖掘进展,旨在为启膈散的临床应用及食管癌的治疗提供思路。Qigesan is an effective prescription for the treatment of dysphagia.It has the functions of regulating qi to open depression,eliminating phlegm and moistening dryness,etc.And it is very effective in the clinical treatment of esophageal cancer.This article searched the basic research literature of Qigesan for the prevention and treatment of esophageal cancer in recent years,and sorted out and summarized the mechanism of Qigesan against esophageal cancer from the aspects of inhibiting cell proliferation,inducing cell apoptosis,inhibiting cell migration and invasion,improving body immune function and enhancing chemotherapy sensitivity.It was found that Qigesan can activate Caspase-3 protein.Participating in the cascade reaction of Caspases can induce apoptosis of esophageal cancer cells,and regulate miR-133a/PI3K/Akt pathway to inhibit the proliferation of esophageal cancer cells;By enhancing cell adhesion,inhibiting cytoskeletal remodeling and inhibiting angiogenesis,it interferes with the migration and invasion of esophageal cancer;By increasing the levels of IL-10,TNF,MCP-1,IL-6,IL-12p70 and other cytokines,affecting the activity of immune cells,thereby improving the immune function of the body;It can also enhance the sensitivity of esophageal cancer cells to chemotherapy,and the combination of cisplatin can be synergistic.In this paper,the relevant experimental research literature was reviewed,and the mechanism of action and related data mining progress of Qigesan in the prevention and treatment of esophageal cancer were summarized,aiming to provide ideas for the clinical application and treatment of esophageal cancer.

关 键 词：中医药 启膈散 噎膈 食管癌 恶性肿瘤 基础实验 机制研究 

分 类 号：R256[医药卫生—中医内科学]