参苓白术散在消化系统疾病中的应用及机制研究进展
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摘要
参苓白术散起源宋代,是体现"培土生金"治法的名方,其配伍精良、疗效确切深受历代及当代医家重视,于临床中广泛应用。该方尤其在消化系统疾病的治疗中,更显卓著疗效,故该文对近5年文献关于参苓白术散在溃疡性结肠炎、腹泻型肠易激综合征、非酒精性脂肪肝病、抗生素相关性腹泻等消化系统疾病中应用及机制的研究进展做一综述,以供学习参考。
Shenling Baizhu Decoction originates on Song Dynasty. It is a famous prescription to reflect the treatment of"strengthening earth to generate metal". The ancient and modern doctors pay attention to and widely use in clinical because the prescription is excellent compatibility and really curative effect. This decoction is more effective especially in the treatment of digestive system diseases. In order to provide the reference for the study,this paper summarizes the applications and research progresses about nearly five years of Shenling Baizhu Decoction in ulcerative colitis,diarrhea predominant irritable bowel syndrome,nonalcoholic fatty liver disease,antibiotic associated diarrhea and other digestive system diseases.
Shenling Baizhu Decoction originates on Song Dynasty. It is a famous prescription to reflect the treatment of"strengthening earth to generate metal". The ancient and modern doctors pay attention to and widely use in clinical because the prescription is excellent compatibility and really curative effect. This decoction is more effective especially in the treatment of digestive system diseases. In order to provide the reference for the study,this paper summarizes the applications and research progresses about nearly five years of Shenling Baizhu Decoction in ulcerative colitis,diarrhea predominant irritable bowel syndrome,nonalcoholic fatty liver disease,antibiotic associated diarrhea and other digestive system diseases.
引文
[1]太平惠民和剂局.太平惠民和剂局方[M].北京:人民卫生出版社,2007.
[2]吴昆.医方考[M].北京:人民卫生出版社,2007.
[3]王师英,胡鸿毅,林江.中医药治疗溃疡性结肠炎机制研究进展[J].辽宁中医杂志,2016,43(11):2452-2456.
[4]Bressler B,Marshall J K,Bernstein C N,et al.Clinical practice guidelines for the medical management of nonhospitalized ulcerative colitis:the Toronto consensus[J].Gastroenterology,2015,148(5):1035-1058.
[5]张声生,沈洪,郑凯,等.溃疡性结肠炎中医诊疗专家共识意见(2017)[J].中华中医药杂志,2017,32(8):3585-3589.
[6]穆丽萍,肖明.参苓白术散治疗溃疡性结肠炎长期应用的疗效与安全性[J].辽宁中医杂志,2016,43(2):309-311.
[7]王雪梅.参苓白术散对溃疡性结肠炎患者血浆MMP-2、MMP-9水平的影响[J].环球中医药,2016,9(4):398-401.
[8]李晓冰,崔利宏,陈玉龙,等.参苓白术散对溃疡性结肠炎小鼠肠道调节性T细胞免疫调节作用[J].中成药,2014,36(6):1295-1297.
[9]李姿慧,王键,蔡荣林,等.参苓白术散对脾虚湿困型溃疡性结肠炎大鼠结肠组织NF-κB p65蛋白表达及相关炎性因子的影响[J].北京中医药大学学报,2015,38(5):315-317,360-361.
[10]贾育新,毕殿勇,成映霞,等.参苓白术散对脾虚湿困型溃疡性结肠炎模型大鼠血清IL-1β、Il-4及Caspase-8基因蛋白表达的影响[J].时珍国医国药,2016,27(9):2084-2086.
[11]毕殿勇,贾育新,成映霞,等.参苓白术散对脾虚湿困型溃疡性结肠炎模型大鼠IL-1β、IL-4及p38 MAPK基因蛋白表达的影响[J].中药药理与临床,2017,33(1):7-11.
[12]孙娟,王键,胡建鹏,等.参苓白术散对脾虚湿困证溃疡性结肠炎大鼠结肠菌群的影响[J].云南中医学院学报,2013,36(4):1-4.
[13]李姿慧,王键,王又闻,等.参苓白术散对脾虚湿困型溃疡性结肠炎大鼠血清EGF、SOD、MDA的影响[J].世界华人消化杂志,2012,20(5):56-59.
[14]周华,张敏,李华,等.参苓白术散治疗大鼠脾虚湿困型溃疡性结肠炎的机制[J].中国老年学杂志,2017,37(3):547-549.
[15]张声生,魏玮,杨俭勤.肠易激综合征中医诊疗专家共识意见(2017)[J].中医杂志,2017,58(18):1614-1620.
[16]杨家耀,陶冬青,曾毅,等.加味参苓白术散联合电针对35例腹泻型肠易激综合征患者临床症状及心理状态的干预作用[J].世界华人消化杂志,2017,25(12):1115-1122.
[17]谢文堂,李茂清,周三林,等.参苓白术散与艾灸对肠易激综合征患者血清脑肠肽的影响[J].中国中医药信息杂志,2015,22(3):36-38.
[18]王思玉,彭美哲,李享,等.健脾化湿法治疗腹泻型肠易激综合征的临床研究[J].北京中医药,2014,33(4):246-249.
[19]朱创键.双歧三联活菌胶囊联合参苓白术散对腹泻型IBS患者血浆SS和NPY水平影响及疗效观察[J].中国微生态学杂志,2015,27(5):552-554,557.
[20]石清兰,毛德文,官志杰,等.加味参苓白术散治疗非酒精性脂肪肝临床观察[J].辽宁中医药大学学报,2012,14(9):180-181.
[21]冯高飞,陈若.疏肝健脾方对非酒精性脂肪性肝炎患者肝纤维化指标的影响[J].辽宁中医杂志,2015,42(12):2357-2359.
[22]张玉佩,杨钦河,金玲,等.参苓白术散对NAFLD大鼠肝脏脂质代谢及SIRT1/UCP2通路的影响[J].中药新药与临床药理,2016,27(1):38-44.
[23]张玉佩,杨钦河,邓远军,等.参苓白术散对高脂饮食诱导的NAFLD大鼠肝组织超微结构及AMPKα磷酸化的影响[J].中药药理与临床,2016,32(1):6-10.
[24]金玲,杨钦河,张玉佩,等.参苓白术散对NAFLD大鼠肝组织Nrf2/ARE信号通路的影响[J].中药新药与临床药理,2016,27(3):327-332.
[25]YANG Q,XU Y,LIU Y,et al.Effects of Chaihu-Shugan-San and Shen-Ling-Bai-Zhu-San on p38 MAPK pathway in kupffer cells of nonalcoholic steatohepatitis[J].Evid Based Complement Alternat Med,2014,2014(3):671013.
[26]YANG Q,XU Y,FENG G,et al.p38 MAPK signal pathway involved in anti-inflammatory effect of Chaihu-Shugan-San and Shen-ling-bai-zhu-San on hepatocyte in non-alcoholic steatohepatitis rats[J].Afr J Tradit Complement Altern Med,2014,11(1):213-21.
[27]滕晋,王丹,向露,等.参苓白术颗粒预防老年抗生素相关性肠道菌群失调的RCT研究[J].成都中医药大学学报,2015,38(3):52-54.
[28]刘凤环,蔡厚田.中药治疗抗生素相关性脾虚型腹泻疗效观察[J].现代中西医结合杂志,2014,23(25):2822-2823,2826.
[29]董开忠,高永盛,秦宁恩加,等.参苓白术散对抗生素引起肠道菌群失调小鼠的影响[J].中国实验方剂学杂志,2015,21(1):154-157.
[30]舒青龙,徐刚,叶荷平,等.参苓白术散对体外艰难梭菌生长的影响[J].中国实验方剂学杂志,2013,19(2):258-262.
[31]舒青龙,彭淑红,封勇,等.中药复方对艰难梭菌毒素基因tcd A/tcd B体外表达的影响[J].中国微生态学杂志,2013,25(4):373-375,380.
[32]南宝,李烜.参苓白术散加减组方辅助化疗用于晚期结直肠癌的临床观察[J].中国药房,2016,27(33):4646-4648.
[33]白玉茹,代二庆,高志华,等.参苓白术散辅助治疗结直肠癌患者术后化疗的临床观察[J].中成药,2017,39(2):278-282.
[34]彭樱,奚胜艳,王彦晖,等.参苓白术散对H22肝癌移植瘤小鼠化疗后肿瘤凋亡相关因子的影响[J].中华中医药杂志,2017,32(7):2909-2913.
[35]李志鹏,徐力,薛恬,等.参苓白术散联合TS化疗方案治疗进展期胃癌50例临床观察[J].中医杂志,2016,57(16):1393-1396.
[36]王晓华,周强,刘晓梅.参苓白术散联合西药治疗胃癌的临床效果观察[J].实用癌症杂志,2014,29(11):1464-1466.
[37]周波,戴飞跃.参苓白术散对胃癌IV期患者外周血CD4+CD25+Tregs的影响[J].湖南中医药大学学报,2015,35(5):50-52.
[2]吴昆.医方考[M].北京:人民卫生出版社,2007.
[3]王师英,胡鸿毅,林江.中医药治疗溃疡性结肠炎机制研究进展[J].辽宁中医杂志,2016,43(11):2452-2456.
[4]Bressler B,Marshall J K,Bernstein C N,et al.Clinical practice guidelines for the medical management of nonhospitalized ulcerative colitis:the Toronto consensus[J].Gastroenterology,2015,148(5):1035-1058.
[5]张声生,沈洪,郑凯,等.溃疡性结肠炎中医诊疗专家共识意见(2017)[J].中华中医药杂志,2017,32(8):3585-3589.
[6]穆丽萍,肖明.参苓白术散治疗溃疡性结肠炎长期应用的疗效与安全性[J].辽宁中医杂志,2016,43(2):309-311.
[7]王雪梅.参苓白术散对溃疡性结肠炎患者血浆MMP-2、MMP-9水平的影响[J].环球中医药,2016,9(4):398-401.
[8]李晓冰,崔利宏,陈玉龙,等.参苓白术散对溃疡性结肠炎小鼠肠道调节性T细胞免疫调节作用[J].中成药,2014,36(6):1295-1297.
[9]李姿慧,王键,蔡荣林,等.参苓白术散对脾虚湿困型溃疡性结肠炎大鼠结肠组织NF-κB p65蛋白表达及相关炎性因子的影响[J].北京中医药大学学报,2015,38(5):315-317,360-361.
[10]贾育新,毕殿勇,成映霞,等.参苓白术散对脾虚湿困型溃疡性结肠炎模型大鼠血清IL-1β、Il-4及Caspase-8基因蛋白表达的影响[J].时珍国医国药,2016,27(9):2084-2086.
[11]毕殿勇,贾育新,成映霞,等.参苓白术散对脾虚湿困型溃疡性结肠炎模型大鼠IL-1β、IL-4及p38 MAPK基因蛋白表达的影响[J].中药药理与临床,2017,33(1):7-11.
[12]孙娟,王键,胡建鹏,等.参苓白术散对脾虚湿困证溃疡性结肠炎大鼠结肠菌群的影响[J].云南中医学院学报,2013,36(4):1-4.
[13]李姿慧,王键,王又闻,等.参苓白术散对脾虚湿困型溃疡性结肠炎大鼠血清EGF、SOD、MDA的影响[J].世界华人消化杂志,2012,20(5):56-59.
[14]周华,张敏,李华,等.参苓白术散治疗大鼠脾虚湿困型溃疡性结肠炎的机制[J].中国老年学杂志,2017,37(3):547-549.
[15]张声生,魏玮,杨俭勤.肠易激综合征中医诊疗专家共识意见(2017)[J].中医杂志,2017,58(18):1614-1620.
[16]杨家耀,陶冬青,曾毅,等.加味参苓白术散联合电针对35例腹泻型肠易激综合征患者临床症状及心理状态的干预作用[J].世界华人消化杂志,2017,25(12):1115-1122.
[17]谢文堂,李茂清,周三林,等.参苓白术散与艾灸对肠易激综合征患者血清脑肠肽的影响[J].中国中医药信息杂志,2015,22(3):36-38.
[18]王思玉,彭美哲,李享,等.健脾化湿法治疗腹泻型肠易激综合征的临床研究[J].北京中医药,2014,33(4):246-249.
[19]朱创键.双歧三联活菌胶囊联合参苓白术散对腹泻型IBS患者血浆SS和NPY水平影响及疗效观察[J].中国微生态学杂志,2015,27(5):552-554,557.
[20]石清兰,毛德文,官志杰,等.加味参苓白术散治疗非酒精性脂肪肝临床观察[J].辽宁中医药大学学报,2012,14(9):180-181.
[21]冯高飞,陈若.疏肝健脾方对非酒精性脂肪性肝炎患者肝纤维化指标的影响[J].辽宁中医杂志,2015,42(12):2357-2359.
[22]张玉佩,杨钦河,金玲,等.参苓白术散对NAFLD大鼠肝脏脂质代谢及SIRT1/UCP2通路的影响[J].中药新药与临床药理,2016,27(1):38-44.
[23]张玉佩,杨钦河,邓远军,等.参苓白术散对高脂饮食诱导的NAFLD大鼠肝组织超微结构及AMPKα磷酸化的影响[J].中药药理与临床,2016,32(1):6-10.
[24]金玲,杨钦河,张玉佩,等.参苓白术散对NAFLD大鼠肝组织Nrf2/ARE信号通路的影响[J].中药新药与临床药理,2016,27(3):327-332.
[25]YANG Q,XU Y,LIU Y,et al.Effects of Chaihu-Shugan-San and Shen-Ling-Bai-Zhu-San on p38 MAPK pathway in kupffer cells of nonalcoholic steatohepatitis[J].Evid Based Complement Alternat Med,2014,2014(3):671013.
[26]YANG Q,XU Y,FENG G,et al.p38 MAPK signal pathway involved in anti-inflammatory effect of Chaihu-Shugan-San and Shen-ling-bai-zhu-San on hepatocyte in non-alcoholic steatohepatitis rats[J].Afr J Tradit Complement Altern Med,2014,11(1):213-21.
[27]滕晋,王丹,向露,等.参苓白术颗粒预防老年抗生素相关性肠道菌群失调的RCT研究[J].成都中医药大学学报,2015,38(3):52-54.
[28]刘凤环,蔡厚田.中药治疗抗生素相关性脾虚型腹泻疗效观察[J].现代中西医结合杂志,2014,23(25):2822-2823,2826.
[29]董开忠,高永盛,秦宁恩加,等.参苓白术散对抗生素引起肠道菌群失调小鼠的影响[J].中国实验方剂学杂志,2015,21(1):154-157.
[30]舒青龙,徐刚,叶荷平,等.参苓白术散对体外艰难梭菌生长的影响[J].中国实验方剂学杂志,2013,19(2):258-262.
[31]舒青龙,彭淑红,封勇,等.中药复方对艰难梭菌毒素基因tcd A/tcd B体外表达的影响[J].中国微生态学杂志,2013,25(4):373-375,380.
[32]南宝,李烜.参苓白术散加减组方辅助化疗用于晚期结直肠癌的临床观察[J].中国药房,2016,27(33):4646-4648.
[33]白玉茹,代二庆,高志华,等.参苓白术散辅助治疗结直肠癌患者术后化疗的临床观察[J].中成药,2017,39(2):278-282.
[34]彭樱,奚胜艳,王彦晖,等.参苓白术散对H22肝癌移植瘤小鼠化疗后肿瘤凋亡相关因子的影响[J].中华中医药杂志,2017,32(7):2909-2913.
[35]李志鹏,徐力,薛恬,等.参苓白术散联合TS化疗方案治疗进展期胃癌50例临床观察[J].中医杂志,2016,57(16):1393-1396.
[36]王晓华,周强,刘晓梅.参苓白术散联合西药治疗胃癌的临床效果观察[J].实用癌症杂志,2014,29(11):1464-1466.
[37]周波,戴飞跃.参苓白术散对胃癌IV期患者外周血CD4+CD25+Tregs的影响[J].湖南中医药大学学报,2015,35(5):50-52.