非药物干预方式改善慢性病共病相关机制研究进展

Latest Advances in Mechanisms of Non-pharmacological Interventions to Improve Multiple Chronic Conditions

在目前药物治疗负担过于繁重的背景下,非药物干预亦能作为一种重要的辅助或主导的治疗方式参与慢性病尤其共病的管理过程,其治疗潜力如今越来越得到重视,尤其在慢性病中。非药物干预的作用益处已经被广泛认识,而对其具体的作用机制仍未建立系统的认知,因此,本文从运动、饮食及心理等层面总结了目前非药物干预方式改善慢性病的作用机制,通过调节炎症-免疫反应、应激反应、葡萄糖及脂质代谢、基因表达及肠道菌群,各个通路各自或交互作用影响疾病进程,帮助临床医生更全面的认识慢性病共存的复杂机制,而非药物干预作为该复杂网络的统一阻断方法,成为有巨大潜力的慢性病共病治疗管理手段。

As an important adjuvant therapy or primary treatment for single or multiple chronic conditions,the efficacy of non-pharmacological interventions has been widely recognized,and the potential of them has been valued increasingly,especially when pharmacological interventions constitute a considerable economic burden,but there is a lack of systematic understanding of the possible mechanism of action of non-pharmacological interventions.Considering this,we reviewed mechanisms of actions of current non-pharmacological interventions(involving exercise,diet and psychology)for chronic diseases,which affect the disease development through regulating inflammation-immune responses,and stress responses,modulating glucose and lipid metabolism,gene expression and intestinal microbiota,via each pathway individually or interactively.This review will help to enhance the understanding of the complex pathogenesis of multimorbidity,and the great potential of non-pharmacological interventions against the pathogenesis.