中医药调控巨噬细胞改善急性肺损伤  

TCM for Regulating Macrophages to Improve Acute Lung Injury

作　　者：颜叶叶 刘锐[2] YAN Yeye;LIU Rui(Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530000;Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530000)

机构地区：[1]广西中医药大学,广西南宁530200 [2]广西中医药大学附属瑞康医院,广西南宁530011

出　　处：《河南中医》2024年第6期942-947,共6页Henan Traditional Chinese Medicine

基　　金：广西壮族自治区自然科学基金项目(2020GXNSFAA297158)。

摘　　要：中医药可通过调控肺泡巨噬细胞的吞噬、极化等,提高肺部代谢水平及免疫功能,加速体内毒素排出,减轻肺组织炎性损伤,缓解急性肺损伤(acute lung injury,ALI)的症状。中医药治疗ALI的单味药多以大黄、黄芩、白头翁、青蒿、白芍、甘草等为主,其中药活性成分主要有大黄素、黄芩苷、白头翁皂苷B4、双氢青蒿素、白芍苷、甘草酸等。中药复方常以清金化痰汤、黄连解毒汤、大承气汤、芪冬活血饮等加减为主。目前,研究存在的问题是,中医药治疗ALI的机制尚不明确,缺乏大样本量及循证研究,研究与临床应用结合不够充分,缺乏系统全面的总结;中药的配伍、使用剂量等依赖医生的个人经验总结,难以精准用药。今后,需基于网络药理学、细胞学、病理学及免疫学等,进一步加强中医药治疗ALI的机制研究及以调控巨噬细胞改善AIL为中心的大样本随机对照研究,寻找高效、安全治疗ALI及预防其并发症的中医药治疗方法。TCM can regulate the phagocytosis and polarization of alveolar macrophages to improve the metabolic level and immune function of the lungs,accelerate the excretion of toxins in the body,reduce inflammatory damage to lung tissue,and alleviate the symptoms of acute lung injury(ALI).The single herbs used in TCM for the treatment of ALI mainly include Dahuang(Radix et Rhizoma Rhei),Huangqin(Radix Scutellariae),Baitouweng(Radix Pulsatillae),Qinghao(Herba Artemisiae Annuae),Baishao(Radix Paeoniae Alba),Gancao(Radix Glycyrrhizae),etc.The main active components of these medicinal include emodin,baicalin,wormwood glycoside B4,dihydroartemisinin,paeoniflorin,and glycyrrhizic acid,etc.Chinese medicinal compounds mainly include Lung-Clearing and Phlegm-Resolving Decoction,Coptis Toxin-Resolving Decoction,Major Purgative Decoction,Astragalus and Ophiopogon Blood-Activating Decoction,etc.for modification.Currently,the problem with research on TCM treatment for ALI is that the mechanisms are not yet clear,there is a lack of large sample size and evidence-based studies,the research is not fully integrated with clinical application,and there is a lack of a systematic and comprehensive summary.The combination of Chinese medicinal,dosage,etc.depend on the personal experience of doctors,making it difficult to administer medication accurately.In the future,it is necessary to further strengthen the mechanism research of TCM treatment for ALI based on network pharmacology,cell biology,pathology,and immunology,and conduct large-sample randomized controlled trials centered on regulating macrophages to improve AIL,in order to find effective and safe TCM treatment methods for ALI and prevent its complications.

关 键 词：急性肺损伤 巨噬细胞 中药活性成分 中药复方 大黄素 黄芩苷 白头翁皂苷B4 双氢青蒿素 白芍苷 甘草酸 

分 类 号：R256.1[医药卫生—中医内科学]