Research progress on experimental mechanism of traditional Chinese medicine treatment of chronic atrophic gastritis
-
摘要: 慢性萎缩性胃炎(CAG)是消化系统疾病中的常见病,具有病程长、频反复、难治愈、易癌变的特点。目前其发病机制尚不明确,西医认为与幽门螺杆菌(Hp)感染、免疫、胆汁及十二指肠液反流、遗传等因素相关,治疗上主要以杀灭Hp、促进胃肠动力、抑制胃酸为主,对于改善症状有一定疗效,但难以逆转病理,阻止炎-癌转化。中医治疗以辨证论治为基础,通过中药、针灸等治疗方式,在治疗CAG的过程中显示出了极大的优势。本文通过对中医治疗CAG的相关实验研究文献整理发现,中医在减轻CAG炎症反应、修复受损胃黏膜、阻断胃黏膜炎-癌转化等方面疗效极佳,这主要与中药、针灸等有效改善炎症微环境、调节程序性死亡、抗氧化应激、修复胃黏膜损伤、改善胃黏膜代谢及调控胃肠激素释放等6个方面相关,本文现从以上方面进行归纳总结,以期为中医治疗CAG相关机制进展的研究提供参考。Abstract: Chronic atrophic gastritis(CAG) is a common disease of digestive system, which has the characteristics of long course, frequent recurrence, difficult to cure and easy to become cancerous. At present, its pathogenesis is not clear, Western medicine believes that it is related to Helicobacter pylori(Hp) infection, immunity, bile and duodenal reflux, genetics and other factors. The treatment is mainly to kill Hp, promote gastrointestinal motility, and inhibit gastric acid, which has a certain effect on improving symptoms, but it is difficult to reverse pathology and prevent the transformation of inflammation to cancer. TCM treatment is based on syndrome differentiation and has shown great advantages in the treatment of CAG through TCM, acupuncture and other treatment methods. Through the review of relevant experimental research literature on the treatment of CAG by traditional Chinese medicine, it is found that traditional Chinese medicine has excellent efficacy in alleviating CAG inflammation, repairing damaged gastric mucosa, and blocking the transformation of gastric mucositis to cancer. This is mainly related to the effective improvement of inflammatory microenvironment, regulation of programmed death, anti-oxidative stress, repair of gastric mucosal damage, improvement of gastric mucosal metabolism and regulation of gastrointestinal hormone release by traditional Chinese medicine, acupuncture and moxibustion, etc. This paper summarizes from the above six aspects, in order to provide reference for the research on the progress of relevant mechanisms of TCM treatment of CAG.
-
-
[1] 安振涛, 奚肇宏, 严展鹏, 等. 慢性萎缩性胃炎中医证候规范化与客观化研究进展[J]. 中国中西医结合消化杂志, 2020, 28(3): 234-237. https://zxyxh.whuhzzs.com/article/doi/10.3969/j.issn.1671-038X.2020.03.18
[2] 许召君, 张成武, 马晓明. 全身免疫炎症指数在实体癌中的应用研究进展[J]. 新医学, 2023, 54(2): 110-114. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXX202302005.htm
[3] 黎秀娟, 黎丽群, 马超北, 等. 基于"脾-线粒体相关"探讨NLRP3炎症小体与慢性萎缩性胃炎的关系[J]. 中国实验方剂学杂志, 2023, 29(17): 267-273. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX202317028.htm
[4] 李慧臻, 王天麟, 马佳乐, 等. 半夏泻心汤对Hp阳性慢性萎缩性胃炎小鼠趋化因子CXCL9、CXCL10及炎性因子的影响[J]. 时珍国医国药, 2021, 32(10): 2316-2320. https://www.cnki.com.cn/Article/CJFDTOTAL-SZGY202110003.htm
[5] 钟欢, 黎铭玉, 舒文娜, 等. 针刺与艾灸对慢性萎缩性胃炎大鼠环氧化酶-2和炎症相关因子的影响差异研究[J]. 中华中医药杂志, 2022, 37(4): 2246-2250. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202204130.htm
[6] 李园, 丁霞, 许爱丽, 等. 基于生物网络模块探讨慢痞消治疗慢性萎缩性胃炎的作用机制[J]. 北京中医药大学学报, 2019, 42(8): 673-679. https://www.cnki.com.cn/Article/CJFDTOTAL-JZYB201908012.htm
[7] 游绍伟, 易旭, 赵琦, 等. 基于NF-κB信号通路探讨萎胃通调汤对大鼠慢性萎缩性胃炎的作用机制[J]. 中国实验方剂学杂志, 2023, 29(2): 88-97. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX202302012.htm
[8] 魏冬梅, 张斌, 王邦才, 等. 基于TLR4炎症通路探讨养胃和络饮对慢性萎缩性胃炎大鼠的作用机制[J]. 中国药学杂志, 2023, 58(12): 1102-1109. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYX202312006.htm
[9] 董天雄, 余壮明. 黄芪多糖对慢性萎缩性胃炎大鼠蛋白酪氨酸激酶1/信号转导子与激活子3信号传导通路的影响[J]. 中国临床药理学杂志, 2020, 36(22): 3764-3768. https://www.cnki.com.cn/Article/CJFDTOTAL-GLYZ202022045.htm
[10] Liu S, Shu L, Yang J, et al. Rhein Exhibits Anti-Inflammatory Effects in Chronic Atrophic Gastritis via Nrf2 and MAPK Signaling[J]. Turk J Gastroenterol, 2023, 34(5): 525-532.
[11] Griffioen AW, Nowak-Sliwinska P. Programmed cell death lives[J]. Apoptosis, 2022, 27(9-10): 619-621. doi: 10.1007/s10495-022-01758-5
[12] Bedoui S, Herold MJ, Strasser A. Emerging connectivity of programmed cell death pathways and its physiological implications[J]. Nat Rev Mol Cell Biol, 2020, 21(11): 678-695. doi: 10.1038/s41580-020-0270-8
[13] D'Arcy MS. Cell death: a review of the major forms of apoptosis, necrosis and autophagy[J]. Cell Biol Int, 2019, 43(6): 582-592. doi: 10.1002/cbin.11137
[14] 臧嘉益, 崔明, 景蓉蓉. 程序性细胞死亡方式在胃癌发生机制及诊疗中的研究进展[J]. 南京医科大学学报(自然科学版), 2022, 42(10): 1476-1481. https://www.cnki.com.cn/Article/CJFDTOTAL-NJYK202210017.htm
[15] 游绍伟, 易旭, 赵琦, 等. 萎胃通调汤对大鼠慢性萎缩性胃炎癌前病变及IKKβ, Bcl-2表达的影响[J]. 中国实验方剂学杂志, 2021, 27(6): 55-61. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX202106008.htm
[16] 王坤, 马林, 汪花, 等. 穴位埋线对慢性萎缩性胃炎大鼠JAK 2-STAT 3信号转导通路相关因子表达的影响[J]. 针刺研究, 2018, 43(11): 682-686. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYJ201811002.htm
[17] 段永强, 巩子汉, 王丽园, 等. 香砂六君子汤对慢性萎缩性胃炎大鼠胃组织PI3K信号通路相关因子表达的影响[J]. 中国中医药信息杂志, 2020, 27(3): 33-38. https://www.cnki.com.cn/Article/CJFDTOTAL-XXYY202003008.htm
[18] Klionsky DJ, Petroni G, Amaravadi RK, et al. Autophagy in major human diseases[J]. EMBO J, 2021, 40(19): e108863. doi: 10.15252/embj.2021108863
[19] 宋媛媛, 杨龙, 刘越洋, 等. 萎平舒胶囊对慢性萎缩性胃炎模型大鼠胃黏膜细胞自噬水平的影响[J]. 陕西中医药大学学报, 2020, 43(6): 53-58. https://www.cnki.com.cn/Article/CJFDTOTAL-SXXY202006013.htm
[20] 周瑞东, 徐杉, 龚纯, 等. 安胃汤对慢性萎缩性胃炎大鼠ULK1相关自噬蛋白表达的影响[J]. 中华中医药学刊, 2022, 40(7): 74-78. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS202207019.htm
[21] Ketelut-Carneiro N, Fitzgerald KA. Apoptosis, Pyroptosis, and Necroptosis-Oh My! The Many Ways a Cell Can Die[J]. J Mol Biol, 2022, 434(4): 167378. doi: 10.1016/j.jmb.2021.167378
[22] 周志鹏, 韦维, 陈丽, 等. 安胃汤对CAG大鼠NLRP3/Caspase-1/IL-1β信号轴细胞焦亡调控研究[J]. 时珍国医国药, 2022, 33(12): 2885-2888. https://www.cnki.com.cn/Article/CJFDTOTAL-SZGY202212018.htm
[23] Kajarabille N, Latunde-Dada GO. Programmed Cell-Death by Ferroptosis: Antioxidants as Mitigators[J]. Int J Mol Sci, 2019, 20(19): 4968. doi: 10.3390/ijms20194968
[24] Fu D, Wang C, Yu L, et al. Induction of ferroptosis by ATF3 elevation alleviates cisplatin resistance in gastric cancer by restraining Nrf2/Keap1/xCT signaling[J]. Cell Mol Biol Lett, 2021, 26(1): 26. doi: 10.1186/s11658-021-00271-y
[25] Chu YM, Wang TX, Jia XF, et al. Fuzheng Nizeng Decoction regulated ferroptosis and endoplasmic reticulum stress in the treatment of gastric precancerous lesions: A mechanistic study based on metabolomics coupled with transcriptomics[J]. Front Pharmacol, 2022, 13: 1066244. doi: 10.3389/fphar.2022.1066244
[26] Jomova K, Raptova R, Alomar SY, et al. Reactive oxygen species, toxicity, oxidative stress, and antioxidants: chronic diseases and aging[J]. Arch Toxicol, 2023, 97(10): 2499-2574. doi: 10.1007/s00204-023-03562-9
[27] Cheung EC, Vousden KH. The role of ROS in tumour development and progression[J]. Nat Rev Cancer, 2022, 22(5): 280-297. doi: 10.1038/s41568-021-00435-0
[28] 刘怀智, 周海娟, 陈刚, 等. 基于NOX/ROS信号通路探讨益气化瘀解毒方治疗慢性萎缩性胃炎的机制[J]. 中华中医药杂志, 2021, 36(5): 2936-2940. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202105122.htm
[29] 白敏, 成映霞, 段永强, 等. 香砂六君子汤对慢性萎缩性胃炎大鼠胃黏膜相关因子水平的影响[J]. 中国中医药信息杂志, 2020, 27(11): 52-57. https://www.cnki.com.cn/Article/CJFDTOTAL-XXYY202011011.htm
[30] 严安. 基于Keap1/Nrf2/ARE轴探讨灭幽汤对HP相关性胃炎脾胃湿热证小鼠氧化应激的影响[D]. 长沙: 湖南中医药大学, 2023.
[31] 石铖, 王茜, 刘宇, 等. 基于Keap1/Nrf2/ARE信号通路探讨半夏泻心汤对慢性萎缩性胃炎大鼠的影响及作用机制[J]. 中国实验方剂学杂志, 2021, 27(20): 31-37. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX202120007.htm
[32] 罗伟, 刘春雷, 王军英, 等. 针刺与智能通络治疗仪联合应用对慢性萎缩性胃炎大鼠胃电节律及胃黏膜组织前列腺素E2、前列腺素F2α的影响[J]. 针刺研究, 2014, 39(6): 482-486. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYJ201406013.htm
[33] 陈璐, 汶明琦, 王捷虹, 等. 调胃饮对慢性萎缩性胃炎大鼠血清胃泌素和前列腺素E2的调控作用[J]. 西部中医药, 2019, 32(7): 24-28. https://www.cnki.com.cn/Article/CJFDTOTAL-GSZY201907007.htm
[34] 王坤, 马林, 汪花, 等. 基于缺氧诱导因子-1α和血管内皮生长因子探讨穴位埋线改善慢性萎缩性胃炎胃黏膜淤血的机制[J]. 针刺研究, 2020, 45(5): 384-388. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYJ202005009.htm
[35] 王浩, 方芳, 王杰鹏, 等. 芍药八味汤对慢性萎缩性胃炎大鼠胃黏膜保护作用的机制研究[J]. 中国中医基础医学杂志, 2021, 27(4): 570-572. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202104013.htm
[36] 白雪峰, 谭娟, 高枫. 理中汤对慢性萎缩性胃炎模型大鼠胃黏膜保护作用及对ADAM17、EGFR蛋白的影响[J]. 中医药导报, 2021, 27(10): 32-36. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB202110007.htm
[37] 薛倩倩, 秦雪梅, 刘月涛. 基于尿液动态轨迹分析的慢性萎缩性胃炎生物标志物的筛选[J]. 中国药学杂志, 2019, 54(14): 1148-1153. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYX201914006.htm
[38] 朱景茹, 洪银洁, 黄婉仪, 等. 柴芍六君汤对慢性萎缩性胃炎肝郁脾虚证模型大鼠胃黏膜组织代谢物表达的影响[J]. 世界科学技术-中医药现代化, 2021, 23(8): 2672-2680. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX202108020.htm
[39] 尹鸿智, 钟欢, 刘倩, 等. 基于代谢组学技术探讨针刺对CAG大鼠足三里局部穴区组织代谢的影响[J]. 时珍国医国药, 2021, 32(4): 1001-1004. https://www.cnki.com.cn/Article/CJFDTOTAL-SZGY202104068.htm
[40] 刘霞, 佘畅, 钟欢, 等. 基于代谢组学技术研究艾灸"足三里"对慢性萎缩性胃炎大鼠胃组织代谢物的影响[J]. 针刺研究, 2019, 44(2): 113-119. https://www.cnki.com.cn/Article/CJFDTOTAL-XCYJ201902007.htm
[41] 徐珊, 王常松, 周嘉鹤, 等. 慢性萎缩性胃炎不同证型与胃肠激素关系的实验研究[J]. 中华中医药杂志, 2007, 22(7): 448-450. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY200707009.htm
[42] 刘远婷, 李慧, 丁甜甜, 等. 加味沙参麦冬汤调节EGFR/MAPK信号通路对慢性萎缩性胃炎大鼠的保护作用研究[J]. 吉林中医药, 2022, 42(7): 812-816. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJL202207018.htm
[43] 李琳慧, 付勇, 洪恩四, 等. 热敏灸对慢性萎缩性胃炎模型大鼠胃肠激素的影响[J]. 江西中医药大学学报, 2019, 31(6): 79-83. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXB201906026.htm
-
计量
- 文章访问数: 1115
- PDF下载数: 1331
- 施引文献: 0