中药复方对骨性关节炎干预机制的研究进展
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摘要
目的:对近年来中药复方治疗骨性关节炎干预机制的文献进行归纳分析。方法:通过对中国知网、维普、万方和国外的Pub Med数据库进行检索,对近年来有关中药复方对骨性关节炎干预机制的文献进行查阅。结果:发现中药复方主要从细胞因子水平、信号通路水平、基因表达水平等方面对骨性关节炎起到调控作用。结论:西医对骨性关节炎的基础实验研究和药理研究,不断证实了复杂的细胞因子-信号通路-基因表达轴的存在,长期西药维持治疗骨性关节炎逐渐暴露出明显毒副作用,患者难以耐受,然而中药复方在中医基础理论指导下,通过整体观念和辨证论治的思路进行多组分、多靶点、多环节、多途径的个体化治疗与细胞因子-信号通路-基因表达轴的复杂性不谋而合,表现出中药复方通过增效和减毒的辨证配伍在治疗骨性关节炎有着不可比拟的优势。
Obectives Literature about the intervention of Chinese herbal compound in the treatment of osteoarthritis in recent years has been summarized and analyzed in this paper. Methods By searching the three major domestic database: CNKI,CQVIF,Wanfang and foreign Pubmed database,the literature on the intervention mechanism of Chinese herbal compound in osteoarthritis in recent years has been reviewed. The results show that the intervention mechanism of Chinese herbal compound in osteoarthritis mainly refers to its regulation of cytokine level,signal pathway level and gene expression level. Conclusion Basic experimental research and pharmacological study of osteoarthritis in western medicine has also continuously confirmed the presence of complex cytokines-signaling pathway-gene expression axis. Long-term treatment of osteoarthritis by western medicine has gradually exposed its obvious toxic side effects which patients have difficulties in tolerating. However,guided by the basic theories of traditional Chinese medicine,Chinese herbal compound provides multicomponet,multiple targets,multiple links and multiple ways of individualized treatment through the concept of holism and the thinking of syndrome differentiation,which coincides with the complexity of cytokines-signaling pathway-gene expression axis on this point. The dialectical compatibility of Chinese herbal compound through synergistic effect and attenuation is an incomparable advantage in the treatment of osteoarthritis.
Obectives Literature about the intervention of Chinese herbal compound in the treatment of osteoarthritis in recent years has been summarized and analyzed in this paper. Methods By searching the three major domestic database: CNKI,CQVIF,Wanfang and foreign Pubmed database,the literature on the intervention mechanism of Chinese herbal compound in osteoarthritis in recent years has been reviewed. The results show that the intervention mechanism of Chinese herbal compound in osteoarthritis mainly refers to its regulation of cytokine level,signal pathway level and gene expression level. Conclusion Basic experimental research and pharmacological study of osteoarthritis in western medicine has also continuously confirmed the presence of complex cytokines-signaling pathway-gene expression axis. Long-term treatment of osteoarthritis by western medicine has gradually exposed its obvious toxic side effects which patients have difficulties in tolerating. However,guided by the basic theories of traditional Chinese medicine,Chinese herbal compound provides multicomponet,multiple targets,multiple links and multiple ways of individualized treatment through the concept of holism and the thinking of syndrome differentiation,which coincides with the complexity of cytokines-signaling pathway-gene expression axis on this point. The dialectical compatibility of Chinese herbal compound through synergistic effect and attenuation is an incomparable advantage in the treatment of osteoarthritis.
引文
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[2] Tang X,Wang S,Zhan S,et al. The Prevalence of Symp-tomatic Knee Osteoarthritis in China:Results From theChina Health and Retirement Longitudinal Study[J]. Ar-thritis Rheumatol,2016,68(3):648-653.
[3] Loeser R F. Osteoarthritis year in review 2013:biology[J].Osteoarthritis Cartilage,2013,21(10):1436-1422.
[4] Glyn-Jones S,Palmer A J R,Agricola R,et al. Osteoar-thritis[J]. Lancet,2015,386(9991):376-387.
[5] Mapp P I,Sagar D R,Ashraf S,et al. Differences instructural and pain phenotypes in the sodium monoiodoace-tate and meniscal transection models of osteoarthritis[J].Osteoarthritis Cartilage,2012,21(9):1336-1345.
[6] Li H,Li L,Min J,et al. Levels of metalloproteinase(MMP-3,MMP-9),NF-kappa B ligand(RANKL),and nitric oxide(NO)in peripheral blood of osteoarthritis(OA)patients[J]. Clinical Laboratory,2012,58(7-8):755-762.
[7] Hunter D J. Pharmacologic therapy for osteoarthritis--the era of disease modification[J]. Nature ReviewsRheumatology,2011,7(1):13-16.
[8]袁琴,阚卫兵,宋朋飞,等.中医药治疗骨关节炎基础研究进展[J].辽宁中医药大学学报,2012,14(1):101-104.
[9]王爱国,吕佳康,谷福顺,等.中医中药治疗膝骨关节炎的新药研究及评价[J].中国临床药理学杂志,2017,33(16):1610-1612.
[10]白雯,吕素飞,陶庆文,等.中医药对实验动物骨关节炎组织形态学影响的研究进展[J].世界中西医结合杂志,2015,10(10):1469-1472.
[11] Mobasheri A,Rayman M P,Gualillo O,et al. The role ofmetabolism in the pathogenesis of osteoarthritis[J]. Na-ture Reviews Rheumatology,2017,13(5):302-311.
[12] Osta B,Roux J P,Lavocat F,et al. Differential Effectsof IL-17A and TNF-alpha on Osteoblastic Differentia-tion of Isolated Synoviocytes and on Bone Explants fromArthritis Patients[J]. Front Immunol,2015,6(8):151-158.
[13] Iezumi Y,Yamada A,Minami E,et al. IL-1beta sup-presses nephronectin expression in osteoblasts via ERK1/2 and JNK[J]. Biochem Biophys Res Commun,2017,493(1):773-775.
[14]潘贤峰,杨鑫斌,段培青,等.补肾活血方对家兔骨关节炎滑液中IL-6和MMP-13表达的影响[J].中国医科大学学报,2015,44(10):909-912.
[15]王桂芳,石宇,张金超.蚁龙通痹汤改善兔膝骨关节炎软骨组织骨生物力学的炎症机制[J].中国实验方剂学杂志,2012,18(15):218-222.
[16]郑业虎.独活寄生丸联合塞来昔布对老年膝骨关节炎患者炎性因子、内皮功能及膝关节功能的影响[J].中国老年学杂志,2017,37(10):2513-2515.
[17]刘继平,程玥,周园里,等.蠲痹胶囊醇提工艺对大鼠骨性关节炎模型的影响[J].中成药,2016,38(8):1661-1668.
[18]丁晓明,孙勤国,姚雪婷,等.四妙散对寒湿痹阻证型膝关节骨性关节炎患者IL-7表达的影响[J].辽宁中医杂志,2017,44(4):794-797.
[19]赵乐,李艳彦,王永辉,等.黄芪桂枝五物汤对阳虚寒凝型骨关节炎大鼠免疫相关细胞因子的影响[J].中国实验方剂学杂志,2017,23(7):160-166.
[20]张静,杨晓利,张竞,等.腰痛宁胶囊对腰椎骨性关节炎患者血清IL-1β、TGF-β1的影响[J].中成药,2015,37(4):916-918.
[21]潘建科,罗斌,郭达,等.龙鳖胶囊对膝骨关节炎大鼠IL-1β、IL-6、IL-10水平的影响[J].中华中医药杂志,2015,30(5):1675-1679.
[22] Bowles R D,Mata B A,Bell R D,et al. In vivo lumi-nescence imaging of NF-kappa B activity and serum cyto-kine levels predict pain sensitivities in a rodent model ofosteoarthritis[J]. Arthritis Rheumatol,2014,66(3):637-646.
[23] Liu M,Fan F,Shi P,et al. Lactoferrin promotes MC3T3-E1 osteoblast cells proliferation via MAPK signalingpathways[J]. Int J Biol Macromol,2017,107(PtA):137-143.
[24] Takamatsu A,Ohkawara B,Ito M,et al. Verapamil pro-tects against cartilage degradation in osteoarthritis by in-hibiting Wnt/beta-catenin signaling[J]. PLo S One,2014,9(3):e92699.
[25]宋朋飞,阚卫兵,赵婧,等.补肾活血方对人滑膜细胞Wnt/β-catenin信号通路的调控作用[J].中华中医药杂志,2014,29(9):2806-2809.
[26]詹宏钢,林剑.独活寄生汤对膝骨关节炎患者Wnt/β-catenin-BMP信号通路调控作用的临床研究[J].中国中医药科技,2013,20(5):451-452,439.
[27]潘彩彬,王武炼,吴广文,等.独活寄生汤含药血清对大鼠退变软骨细胞Bcl-2、Bax表达的影响[J].风湿病与关节炎,2014,3(12):30-33.
[28]王武炼,林煜,张怡元,等.独活寄生汤含药血清对退变软骨细胞细胞色素C及pro-Caspase-9、3的影响[J].中国组织工程研究,2015,19(33):5269-5273.
[29]谈冰,刘健,章平衡,等.基于NF-κB信号通路的变化探讨新风胶囊改善骨关节炎患者高凝状态的机制[J].中国免疫学杂志,2016,32(6):842-848.
[30]袁普卫,李小群,康武林,等.蠲痹胶囊对膝骨关节炎豚鼠关节软骨组织形态及滑膜中Toll样受体4、NF-κB p65及肿瘤坏死因子-α表达的影响[J].中医正骨,2016,28(9):5-12.
[31]林飞太,林煜,张怡元,等.独活寄生汤含药血清对兔退变软骨细胞“caveolin-p38MAPK”信号通路调控作用的影响[J].风湿病与关节炎,2015,4(4):5-9.
[32]高润成,王志文,袁强,等.麝香乌龙丸对兔膝骨关节炎软骨组织形态及p38MAPK,Caspase-3表达的影响[J].中国实验方剂学杂志,2013,19(11):228-231.
[33] Beyer C,Zampetaki A,Lin N Y,et al. Signature of cir-culating microRNAs in osteoarthritis[J]. Ann RheumDis,2015,74(3):e18.
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