中药多糖改善心肌缺血再灌注损伤的作用机制  

Mechanism of Chinese Medicine Polysaccharide in Improving Myocardial Ischemia-reperfusion Injury

作　　者：武思晴 苗明三[1,2] 苗晋鑫 WU Siqing;MIAO Mingsan;MIAO Jinxin(Henan University of Chinese Medicine,Zhengzhou 450046,China;Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-yao,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学,郑州450046 [2]豫药全产业链研发河南省协同创新中心,郑州450046

出　　处：《中国实验方剂学杂志》2025年第9期277-288,共12页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省重大专项(221100310400);河南省国际合作重点项目(231111521200);国家中医药管理局联合开放课题(GZYKJS-2022-040-1);中国博士后面上项目(2023M741087);河南省科协青年人才托举工程(2024HYTP050);河南省高校科技人才创新项目(23HASTIT045)。

摘　　要：心肌缺血再灌注损伤(MIRI)是近年来心血管疾病的主要并发症之一,严重威胁患者的生命与健康。近年来,对于MIRI的现代医学研究取得了较大进展,但由于存在发病机制复杂、药物不良反应、术后风险较大等问题,MIRI亟需更为安全有效的治疗药物。MIRI的病理作用涉及炎症反应、氧化应激、细胞凋亡等作用机制,而中药多糖类化合物具有抗炎、抗氧化、抗凋亡等药理作用,对于改善MIRI具有重大意义。且大量研究发现,中药多糖类化合物主要通过神经调节因子-1/表皮生长因子受体(NRG-1/ErbB)、磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/Akt)、核因子E_(2)相关因子2/血红素加氧酶-1(Nrf2/HO-1)、腺苷酸激活蛋白激酶/沉默调节蛋白1/过氧化物酶体增殖活化受体γ辅助活化因子1α(AMPK/SIRT1/PGC1α)、Ras同源基因/Rho激酶(Rho/ROCK)、糖原合成酶激酶-3(GSK-3)、p38丝裂原活化蛋白激酶(p38 MAPK)等信号通路,发挥改善MIRI的作用。该文在广泛梳理国内外相关文献的基础上,系统总结了中药多糖类化合物在MIRI治疗中的最新研究成果,对中药多糖类化合物改善MIRI的作用机制进行了总结分析,在对信号通路与代谢组学联合探究的基础上研究MIRI新的治疗方向,强调了跨学科合作在推动新药研发中的重要性,旨在为中药多糖类化合物的基础研究及临床应用提供有价值的参考,最终造福广大心血管疾病患者。Myocardial ischemia-reperfusion injury(MIRI)is one of the major complications of cardiovascular diseases in recent years,seriously threatening the life and health of patients.In recent years,although significant progress has been made in modern medical research on MIRI,due to its complex pathogenesis,adverse drug reactions,and high postoperative risks,there is an urgent need for safer and more effective therapeutic drugs.The pathological effects of MIRI involve inflammatory responses,oxidative stress,apoptosis,and other mechanisms,while Chinese medicine polysaccharide compounds exhibit pharmacological effects such as anti-inflammation,antioxidation,and anti-apoptosis,which are of great significance for improving MIRI.Numerous studies have found that Chinese medicine polysaccharide compounds mainly exert their effects by activating signal pathways such as nerve regenerative factor-1/epidermal growth factor receptor(NRG-1/ErbB),phosphatidylinositol-3-kinase/protein kinase B(PI3K/Akt),nuclear factor E_(2)-related factor 2/heme oxygenase-1(Nrf2/HO-1),adenosine 5ʹ-monophosphateactivated protein kinase/silent information regulator 1/peroxisome proliferators-activated receptorγcoactivator lα(AMPK/SIRT1/PGC1α),Ras homologous gene/Rho kinase(Rho/ROCK),glycogen synthase kinase 3(GSK-3),and P38 mitogen-activated protein kinase(p38-MAPK),thereby playing a role in improving MIRI.This paper,based on an extensive review of relevant literature in China and abroad,systematically summarizes the latest research findings on the use of Chinese medicine polysaccharide compounds in the treatment of MIRI,analyzes the mechanisms by which these compounds improve MIRI,and explores new therapeutic directions based on the joint investigation of signaling pathways and metabolomics.The paper emphasizes the importance of interdisciplinary cooperation in promoting the development of new drugs,aiming to provide valuable references for the basic research and clinical application of Chinese medicine polysaccharide compounds,ultimately benefitin

关 键 词：中药多糖类 心肌缺血再灌注损伤 抗炎 抗细胞凋亡 抗氧化 

分 类 号：R256[医药卫生—中医内科学] R714.252[医药卫生—中医学] R287