中药有效成分对血脂异常作用机制的研究进展

Advances in Mechanism of Traditional Chinese Medicines and Its Active Ingredients Treating Dyslipidemia

血脂异常是脂质代谢性疾病。目前,我国成人血脂异常发病率高达40.40%,美国成人单项低密度脂蛋白胆固醇(LDL-C)异常者超1亿,发病率逐年上升且呈低龄化趋势。血脂异常与脂肪肝、动脉粥样硬化、高血压、冠心病、糖尿病和脑卒中等多种疾病密切相关,现已发展为全球性公共卫生问题,严重威胁人类生命健康。现代医学认为其发病机制复杂,与糖脂代谢异常、胰岛素抵抗(IR)等多种因素有关。祖国医学将其归于本虚标实之证,与肝、脾、肾关系密切,认为膏脂过多可酿生痰浊而致诸多疾病。针对其治疗而言,西医主要使用他汀类化学合成制剂,治疗效果较稳定,但肌痛、肌炎、横纹肌溶解和急性肾损伤等诸多不良反应是制约其临床应用的主要因素。祖国医学源远流长,中药具有多途径、多靶点、多层次调节血脂异常,且不良反应少、药物依赖性低的优点。当前中药防治血脂异常的相关研究越来越多,但主要集中在疗效观察和处方总结等方面,对中药作用机制的深入探讨和归纳总结相对较少。通过检索和整理国内外近5年的相关文献,从有效成分、治疗途径和作用靶点等方面进行综述,全面介绍了中药在调节血脂异常机制方面的最新研究进展,并对未来可能的研究方向提出了一些建议,以期为中药在临床上更好地防治该病提供新思路和理论依据。

Dyslipidemia is a disease of lipid metabolism. At present,the prevalence of dyslipidemia in adults in China is as high as 40.40%. In the United States,there are more than 100 million individuals with abnormal low-density lipoprotein cholesterol(LDL-C),and the incidence rate is increasing year by year and showing a trend of becoming younger. Dyslipidemia is closely related to a variety of diseases such as fatty liver,atherosclerosis,hypertension,coronary heart disease,diabetes,and stroke. It has now developed into a global public health problem that seriously threatens human life and health. Modern medicine believes that its pathogenesis is complicated and is related to abnormal glucose and lipid metabolism,insulin resistance(IR)and other factors. Chinese medicine ascribes it to primary asthenia-secondary sthenia syndrome,which is closely related to the liver,spleen,and kidney. It is believed that excessive fat and grease can cause phlegm and cause many diseases. In terms of its treatment,western medicine mainly uses statin chemical synthesis preparations,with stable therapeutic effect,but many adverse reactions such as myalgia,myositis,rhabdomyolysis and acute renal injury are the main factors restricting its clinical application. Traditional Chinese medicine(TCM)has a long history,and multi-pathway,multi-target,multi-level regulation of dyslipidemia,few adverse reactions and low drug dependence are the principal advantages of TCM in treating dyslipidemia. At present,there are more and more researches on the prevention and treatment of dyslipidemia by TCM,but they are mainly focused on the observation of curative effect and the summary of prescription, and there are relatively few in-depth discussion and summary of the mechanism of TCM. Through comprehensively retrieving and collating the relevant domestic and foreign literatures in the past five years,we reviews from the perspective of effective ingredients,therapeutic pathways,and targets of action,and comprehensively introduces the latest research progress of TCM on the mechanism of regulating dyslipidemia,and put forward some suggestions for the possible research direction in the future,in order to provide new ideas and theoretical basis for TCM in clinical prevention and treatment of this disease.