中药对幽门螺杆菌抑制的作用机制研究

Study on Mechanism of Chinese Medicine on Inhibition of Helicobacter pylori

幽门螺杆菌(Helicobacter pylori, Hp)感染与胃癌等胃肠道疾病的发生发展密切相关,目前因抗生素广泛使用,Hp耐药严重,在治疗方面遇到巨大的挑战。中药治疗Hp相对于化学药物具有根除率高、不良反应率和复发率低、不容易耐药等优势,但由于中药成分的复杂性,患者接受度有限,探索中药作用机制是打破局限性的关键。根据Hp的致病过程涉及的黏附、侵入、扩散、释放毒性物质、生物膜形成等致病因素及免疫炎症反应,从中药能降低Hp黏附力和运动能力、能抑制脲酶活性、能抑制CagA和VacA毒力因子的表达与释放、能抑制Hp相关炎症因子的释放和调节相关免疫反应、能抑制Hp生物膜的形成、能抑制ROS的生成等6个方面分门别类地分析了不同中药的作用机制,并按照抗Hp机制归纳列举了对应的中药,明确了牛蒡子等部分中药及中药成分的作用机制,列举了中药因成分复杂、靶点多从而不容易产生耐药的优势等,提出根据Hp致病机制研发中药,阻断Hp的致病,充分发挥不同中药的抗菌作用,为缓解耐药、提高Hp根除率提供新思路和新方法。

Helicobacter pylori(Hp)infection is closely related to the occurrence and development of gastrointestinal diseases such as gastric cancer.The serious resistance to Hp is due to the widespread use of antibiotics,and we encounter great challenges in the treatment.Compared with chemical drugs,the treatment of traditional Chinese medicine in Hp has the advantages of high eradication rate,low adverse reaction rate and recurrence rate,and is not easy to resist drugs,but due to the complexity of Chinese medicine components,patient acceptance is limited,and exploring the mechanism of action of Chinese medicine is the key to breaking the limitation.According to the pathogenic factors and immuno-inflammatory responses involved in the pathogenic process of Hp,such as adhesion,invasion,diffusion,release of toxic substances,biofilm formation and so on,the mechanisms of action of different Chinese medicines are analyzed in six aspects,such as reducing Hp adhesion and motility,inhibiting urease activity,inhibiting the expression and release of CagA and VacA virulence factors,inhibiting the release of Hp-related inflammatory factors,regulating related immune responses,inhibiting the formation of Hp biofilm and inhibiting the generation of ROS.According to the anti-Hp mechanisms,the corresponding Chinese medicines are listed,the mechanism of action of some Chinese medicines and Chinese medicine ingredients such as burdock is clarified,the advantages of Chinese medicines are not easy to produce drug resistance due to complex components and many targets,and it is proposed to develop Chinese medicines according to the pathogenic mechanism of Hp,block the pathogenesis of Hp,give full play to the antibacterial effect of different traditional Chinese medicines,and provide new ideas and methods for alleviating the drug resistance and improving the eradication rate of Hp.