中药调节内质网应激治疗高同型半胱氨酸血症相关动脉粥样硬化的研究进展  

Research progress of traditional Chinese medicine in regulating endoplasmic reticulum stress for atherosclerosis associated with hyperhomocysteinemia

作　　者：岳美妍 施雯婷 赵外荣[1] 张静[1] 胡燕燕 唐靖一[1,2] 周忠焱[1] YUE Meiyan;SHI Wenting;ZHAO Wairong;ZHANG Jing;HU Yanyan;TANG Jingyi;ZHOU Zhongyan(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Industrial Development Centre,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属龙华医院心病研究室,上海200032 [2]上海中医药大学产业发展中心,上海201203

出　　处：《上海中医药大学学报》2025年第2期92-100,共9页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市白玉兰人才浦江计划(23PJD094);上海市卫健委国医大师严世芸学术经验传承创新提质升级项目(2023)。

摘　　要：心血管疾病严重危害人类健康,动脉粥样硬化(AS)是众多心血管疾病的基本病理特征。同型半胱氨酸(Hcy)是心血管疾病的独立危险因素之一,Hcy通过破坏血管内皮细胞内稳态,损伤血管舒缩功能,促进血管炎症反应,引起持续性内质网应激(ERS),加速AS进展。基于中国知网、PubMed、Web of Science数据库,检索总结了中药防治高Hcy血症(HHcy)相关心血管疾病的文章,从调节ERS切入,系统归纳了中药单体成分/复方制剂调节ERS改善HHcy引起的血管功能障碍和抗AS的研究进展。最终发现HHcy导致持续的ERS反应,损伤血管舒缩功能、破坏血管内皮细胞稳态,是其加剧AS进展的主要原因。中药活性成分如川芎嗪、牛磺酸、小檗碱等,以及中药复方豁痰解毒通络方、冠心康、六味地黄软胶囊、片仔癀等,可通过调节ERS的不同环节,在HHcy引起血管损伤的不同阶段发挥保护作用。中医药凭借多成分、多靶点的特点,在干预HHcy引起的血管功能障碍和抗AS方面具有独特优势。Cardiovascular diseases seriously threaten human health,and atherosclerosis(AS)is the basic pathological feature of many cardiovascular diseases.Homocysteine(Hcy)is one of independent risk factors for cardiovascular diseases,and Hcy disrupts intracellular homeostasis of vascular endothelial cells,impairs vasodilatory function,promotes vascular inflammatory response,causes persistent endoplasmic reticulum stress(ERS),and accelerates the progression of dynamic AS.In this paper,we searched articles associated with traditional Chinese medicines(TCM)preventing and controlling hyperhomocysteinemia(HHcy)-related cardiovascular diseases from China National Knowledge Infrastructure(CNKI),PubMed,and Web of Science,and systematically summarized the research progress of TCM formulas and their ingredients ameliorate HHcy-induced vascular dysfunction and anti-AS by regulating ERS.We found that HHcy leads to a sustained ERS response that impairs vasodilatory function and disrupts intracellular homeostasis in vascular endothelial cell,which is the main reason why it exacerbates AS progression.A variety of ingredients from TCM,such as tetramethylpyrazine,taurine and berberine,etc.,as well as the TCM formulas,for example Huotan Jiedu Tongluo formula,Guanxinkang,Liuwei Di Huang soft capsule,and Pientzehuang,etc.,play protective roles in different stages of HHcy-induced vascular injury by regulating different aspects of ERS.By virtue of its multi-component and multi-target characteristics,TCM has unique advantages in intervening HHcy-induced vascular dysfunction and anti-AS.

关 键 词：内质网应激 高同型半胱氨酸血症 血管功能障碍 动脉粥样硬化 中医药 

分 类 号：R259[医药卫生—中西医结合]