慢性阻塞性肺疾病发病机制及中药调节作用研究进展  

Pathogenesis of Chronic Obstructive Pulmonary Disease and Modulating Effect of TraditionalChinese Medicine:AReview

作　　者：邹吉宇 王天娇 臧凝子[1,2] 刘勇明[2] 庞立健[2] 王琳琳[2] 吕晓东[1] ZOU Jiyu;WANG Tianjiao;ZANG Ningzi;LIU Yongming;PANG Lijian;WANG Linlin;LYU Xiaodong(Liaoning University of Traditional Chinese Medicine(TCM),Shenyang 110847,China;The Affiliated Hospital of Liaoning University of TCM,Shenyang 110032,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医院,沈阳110032

出　　处：《中国实验方剂学杂志》2025年第1期287-298,共12页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(82274440);国家自然科学基金青年科学基金项目(82004294,82104804,82204993);中央引导地方科技发展基金项目(2023JH6/100100025);国家中医药管理局高水平中医药重点学科建设项目(国中医药人教函[2023]85号);辽宁省中医药创新团队项目。

摘　　要：慢性阻塞性肺疾病(COPD)作为一种可以预防和干预但却无法彻底根治的慢性呼吸系统疾病,其发病率和死亡率逐年增加,或合并一种或多种并发症,但目前却尚无特异性治疗方法。因此,COPD的医疗保健问题紧迫突出,而中医药通过多机制、多通路、多靶点延缓COPD疾病进展,故探索COPD发病机制、寻找中医治疗途径与有效方药是临床亟待解决的关键问题。中医学将COPD归属到“咳嗽”“喘证”“肺胀”等范畴,认为本虚贯穿疾病始终,触犯外邪、气机逆乱、痰瘀酝生则显标实。现代医学对COPD发病机制的研究主要包括炎症反应、氧化应激、自噬失调和衰老等方面,并且研究发现中药单体、单味药及复方可通过抑制炎症、降低氧化损伤、纠正自噬及延缓衰老等途径改善COPD,但目前尚未有研究直观梳理COPD各发病机制及其相互作用关系。同时,中药治疗COPD相关作用研究主要集中在单纯探索单一机制、单一通路,并未多机制、多通路、多靶点联合,并且将COPD各发病机制与中药调控作用和信号通路对应整理总结的研究也少之又少。该研究首次结合国内外最新文献以图、文、表相结合的形式阐述COPD各发病机制及其相互联系并梳理中药单体、单味药及复方调节COPD的信号通路、作用靶点及作用机制,以期为COPD的深入研究及中医药系统治疗COPD提供新的思路与方案。Chronic obstructive pulmonary disease(COPD),as a chronic respiratory disease that can be prevented and intervened but cannot be completely cured,has increasing incidence and mortality rates year by year,often complicated by one or more comorbidities.However,there is currently no specific treatment available.Therefore,the healthcare issues related to COPD are urgent and prominent.Traditional Chinese medicine(TCM)delays the progression of COPD through multiple mechanisms,pathways,and targets.As a result,exploring the pathogenesis of COPD and identifying TCM treatment approaches and effective prescriptions are key issues that urgently need to be addressed in clinical practice.In TCM,COPD is categorized into syndromes such as"cough","asthma",and"lung distension".It is believed that the deficiency in the origin runs through the entire disease.When external pathogens invade,Qi becomes disordered,and phlegm and blood stasis begin to accumulate,leading to an excess condition in the manifestation.Modern medicine research on the pathogenesis of COPD mainly involves aspects such as inflammatory response,oxidative stress,autophagy imbalance,and aging.Studies have found that Chinese medicine monomers,single herbs,and compound prescriptions can improve COPD by inhibiting inflammation,reducing oxidative damage,correcting autophagy,and delaying aging.However,there is no study that intuitively organizes the various pathogenesis mechanisms of COPD and their interrelationships.At the same time,research on the therapeutic effects of TCM on COPD primarily focuses on exploring a single mechanism or pathway,without integrating multiple mechanisms,pathways,and targets.Additionally,there are very few studies that summarize the corresponding relationships between the various pathogenesis mechanisms of COPD and the regulatory effects and signaling pathways of Chinese medicine.This study,for the first time,combines the latest literature in China and abroad to explain the various pathogenesis mechanisms of COPD and their interrelationships u

关 键 词：慢性阻塞性肺疾病(COPD) 发病机制 中药 信号通路 炎症反应 氧化应激 自噬失调 衰老 

分 类 号：R256[医药卫生—中医内科学] R287[医药卫生—中医学] R563