中药调控便秘相关信号通路的研究进展  

Regulation of Constipation-related Signaling Pathways by Traditional Chinese Medicine:A Review

作　　者：梁勇 葛斌 石宇 张洋[2] 张虹玺[2] LIANG Yong;GE Bin;SHI Yu;ZHANG Yang;ZHANG Hongxi(Liaoning University of Traditional Chinese Medicine(TCM),Shenyang 110847,China;The Third Hospital of Liaoning University of TCM,Shenyang110003,China)

机构地区：[1]辽宁中医药大学,沈阳110847 [2]辽宁中医药大学附属第三医院,沈阳110003

出　　处：《中国实验方剂学杂志》2024年第20期230-240,共11页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(82174371);辽宁省科学技术计划项目(2022JH2/101300060)。

摘　　要：慢性便秘(CC)是临床上常见且发作频繁的功能性胃肠疾病之一,目前国内外对其总体治疗效果仍不满意,严重影响患者生活质量。便秘的病理生理学机制尚未完全阐明,研究主要集中于肠神经系统(ENS)功能紊乱、Cajal间质细胞(ICCs)异常、黏膜免疫功能改变(低度肠道炎症、肠道屏障损伤、免疫活化)、胃肠激素异常、肠道菌群失调、肠道动力障碍等。中药是我国特有的珍贵资源,具有良好的疗效和安全性,中药及活性成分可有效治疗便秘,其作用机制有待进一步研究。信号通路参与便秘的发生发展,是便秘病理机制研究和治疗药物药理研究的主要靶点之一。故笔者以“便秘”“信号通路”“中药”等为主要关键词,检索PubMed、中国基础知识设施工程(CNKI)等多种文献数据库,对中药调控便秘相关信号通路进行系统总结。综合分析后表明,中药主要通过调控干细胞因子/酪氨酸激酶受体(SCF/c-Kit)、磷脂酰肌醇3激酶/蛋白激酶B(PI3K/Akt)、5-羟色胺(5-HT)、丝裂原活化蛋白激酶(MAPK)、Toll样受体(TLRs)等信号通路,发挥调节ICCs自噬、凋亡、增殖,抗氧化应激、抗炎,保护肠道屏障,调节神经递质分泌及肠道水代谢等作用来改善便秘。体现了中药多水平、多靶点、多层面的作用优势,深入研究可为探索便秘发病机制和开发新药物提供新思路。Chronic constipation(CC)is one of the common and frequent functional gastrointestinal diseases in clinic.At present,the overall therapeutic effect of CC is still not satisfactory in China and abroad,which seriously affects the quality of life of patients.The pathophysiological mechanism of constipation has not been fully elucidated,and studies have mainly focused on the dysfunction of the enteric nervous system(ENS),abnormalities of Cajal interstitial cells(ICCs),alterations in mucosal immune function(low-grade intestinal inflammation,intestinal barrier damage,and immune activation),abnormalities of gastrointestinal hormones,dysregulation of intestinal flora,and dysfunctions of intestinal dynamics.Traditional Chinese medicine(TCM)is a unique and precious resource in China with good efficacy and safety.TCM and its active ingredients can effectively treat constipation,and its mechanism of action needs to be further investigated.Signaling pathways are involved in the development of constipation,which is one of the main targets in the study of pathological mechanisms of constipation and the pharmacological study of therapeutic drugs.Therefore,the authors searched PubMed,China National Knowledge Infrastructure(CNKI),and other literature databases with the keywords of"constipation","signaling pathway",and"traditional Chinese medicine"to systematically summarize the signaling pathways related to constipation regulated by TCM.The comprehensive analysis shows that TCM mainly plays a role in regulating autophagy,apoptosis,and proliferation and ensuring anti-oxidative stress,anti-inflammation,and protection of intestinal barrier of ICCs by modulating signaling pathways such as stem cell factor/tyrosine kinase receptor(SCF/c-kit),phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt),5-hydroxytryptophan(5-HT),mitogen-activated protein kinases(MAPK),and Toll-like receptors(TLRs).TCM regulates neurotransmitter secretion and intestinal water metabolism to improve constipation.This demonstrates the advantages of multi-level,mu

关 键 词：中药 便秘 信号通路 机制 研究进展 

分 类 号：R2-0[医药卫生—中医学] R22R242R285.5R442.2R256.35