丹参及其制剂治疗冠心病的药理及机制研究新进展  

New Progress on Pharmacological Research and Mechanism of Danshen(Salviae Miltiorrhizae Radix et Rhizoma)and Its Preparations in Treatment of Coronary Heart Disease

作　　者：杨荣来[1,2] 王凤荣 YANG Ronglail;WANG Fengrong(The First Clinical College of Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)

机构地区：[1]辽宁中医药大学第一临床学院,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中华中医药学刊》2024年第11期164-169,共6页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81874415);国家中医药管理局重大疑难疾病中西医临床协作项目(国中医药办医政发〔2018〕3号);辽宁省中医药临床重点学(专)科服务能力建设项目(LNZYXZK201908)。

摘　　要：传统中药丹参及其制剂在临床应用范围广泛,对于冠心病(coronary heart disease,CHD)有良好疗效,其脂溶性成分丹参酮ⅡA具有抗动脉粥样硬化、抗心肌缺血、抗心肌纤维化和抑制心肌肥厚等作用,通过作用于Toll样受体/核转录因子-κB(toll like receptor 4/nuclear transcription factor-κB,TLR/NF-κB)、丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)/NF-κB、磷脂酰肌醇3-激酶/蛋白激酶B(phosphoinositide 3-kinase/protein kinase B,PI3 K/AKT)、雷帕霉素靶蛋白/内皮型一氧化氮合酶(mammalian target of rapamycin/endothelial nitric oxide synthase,mTOR/eNOS)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)/Smad2/3、应激激活蛋白激酶(stressac-tivated pro-tein kinase,SAPK)/MAPK、胞外信号调节蛋白激酶(extracellular regulated protein kinases,ERK)/核转录因子红细胞系2相关因子2(nuclear factor erythroid-2-related factor 2,Nrf2)、胱抑素C/Wnt(cystatin C/Wnt,Cys-C/Wnt)等信号转导通路发挥效应;隐丹参酮通过抑制炎性介质预防早期冠脉粥样硬化。水溶性成分丹酚酸A通过调节PI3 K/Akt、丝氨酸/苏氨酸激酶(serine/threonine kinase,GSK-3β)、c-Jun氨基末端激酶(c-Jun N-terminal kinase,JNK)和ERK1/2等通路抑制心肌细胞凋亡,降低炎症水平,改善心肌梗死;丹酚酸B通过抑制TLR4和核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)炎性体表达减轻心肌损伤;丹参素通过抑制Janus酪氨酸蛋白激酶(janus tyrosine protein kinase,JAK)/信号转导及转录激活因子(signal transduction and transcriptional activator,STAT)信号通路改善微循环、抗炎抗氧化、抗内皮损伤和抗血小板聚集。丹参水溶性成分制剂的主要靶点有前列腺素-内过氧化物合酶(prostaglandin-endoperoxidase synthase 2,PTGS2)、半胱氨酸天冬氨酸蛋白酶(Caspase-3)、表皮生长因子受体(epidermal growth factor receptor,EGFR)、基Danshen(Salviae Miltiorrhizae Radix et Rhizoma)and its preparations have been widely used in clinical practice,which have good curative effect on coronary heart disease(CHD).The fat-soluble component tanshinone IIA in Danshen(Salvi-ae Miltiorrhizae Radix et Rhizoma)can play the roles of anti-atherosclerosis,anti-myocardial ischemia,anti-myocardial fibrosis and myocardial hypertrophy inhibition,and it exerts effects through different signal transduction pathways[Toll-like receptor 4/nuclear transcription factor-κB(TLR/NF-κB),mitogen-activated protein kinase(MAPK)/NF-κB,phosphoinositide 3 kinase/protein kinase B(PI3 K/AKT),mammalian target of rapamycin/endothelial nitric oxide synthase(mTOR/eNOS),transforming growth factor-β1(TGF-β1)/Smad2/3,stressac-tivated protein kinase(SAPK)/MAPK,extracellular regulated protein kinases(ERK)/nuclear factor erythroid-2-related factor 2(Nrf2),cystatin C(CYSC)/Wnt].Cryptotanshinone can prevent early coronary atherosclerosis by inhibiting inflammatory mediators.Salvianolic acid A,a water-soluble component,can inhibit myocardial cells apoptosis,reduce inflammation and improve myocardial infarction by regulating PI3 K/Akt,serine/threonine kinase(GSK-3β),c-Jun N-terminal kinase(JNK)and ERK1/2 pathways.Salvianolic acid B can alleviate myocardial injury by inhibiting the expressions of TLR4 and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome.Tanshinol can improve microcirculation,anti-inflammation,anti-oxidation,anti-endothelial injury and anti-platelet aggregation by inhibiting Janus tyrosine protein kinase(JAK)/signal transduction and transcriptional activator(STAT)signaling pathways.The main targets of Danshen(Salviae Miltiorrhizae Radix et Rhizoma)water-soluble preparations include prostaglandin-endoperoxidase synthase 2(PTGS2),cysteine proteinase-3(Caspase-3),epidermal growth factor receptor(EGFR),matrix metalloproteinase-9(MMP9),MAPKs,TLR4,JUN,STAT3,TLR/NF-κB,PI3 K/Akt,JAK2/STAT3 and Nrf2/heme oxygenase-1(HO-1),etc.,which can play the rol

关 键 词：丹参 丹参制剂 冠心病 药理研究 作用机制 研究进展 

分 类 号：R259.414[医药卫生—中西医结合]