西黄丸抗肿瘤临床应用及药理作用机制研究进展

Anti-tumor Application and Pharmacological Mechanism of Xihuangwan:A Review

恶性肿瘤目前严重危害着人类健康和生命安全,也是我国居民疾病死亡的主要原因之一。现代西医药使用了手术、化疗和放疗等多种有效方法,但死亡人数依旧逐年递增。目前临床上使用的抗肿瘤化疗药大多具有不良反应,影响抗肿瘤的临床疗效及治疗后的状况,长期使用还会产生耐药性,达不到良好的抗肿瘤效果。随着中医药的大力发展,中药治疗在肿瘤治疗方面发挥了极大的作用。中医认为,“热毒”是肿瘤发生的重要致病原因之一,因此常采取清热解毒法攻克肿瘤,起到了比较好的疗效。有很多中药及中药复方都属于清热解毒剂。西黄丸作为传统中医经典的清热剂,由牛黄、麝香、乳香、没药4味中药组成。能清热解毒,消肿散结,主治热毒壅结所致痈疽疔毒、瘰疬、流注、癌肿等。现代临床主要用于肺癌、乳腺癌、胃癌、肝癌、结直肠癌等多种恶性肿瘤的治疗及辅助治疗,改善中晚期恶性肿瘤患者的临床症状,提高生活质量。西黄丸主要活性成分有五环三萜类(如乳香酸类)、挥发油类、甾体类(如猪去氧胆酸)和胆红素等,研究发现其活性成分也有抗肿瘤作用。本文作者叙述了西黄丸处方来源、药学研究及抗肿瘤的临床研究现状及药理作用机制,可进一步研究开发西黄丸抗肿瘤临床应用并为其二次开发提供参考。

Malignant tumors are currently seriously endangering human health and life,which has become one of the main causes of death in China.In modern Western medicine,they are mainly tackled by surgery,chemotherapy,and radiotherapy,but the death toll continues to rise year by year.At present,most of the anti-tumor chemotherapeutics used in clinical practice have toxic and side effects,affecting the anti-tumor efficacy and the conditions after treatment.Long-term medication will also induce drug resistance,making the good anti-tumor effect difficult to be achieved.With the vigorous development of traditional Chinese medicine(TCM),it has played a crucial role in the fight against tumors.It is believed in TCM that"heat toxin"is one of the important causes of tumors.Therefore,the methods of clearing away heat and removing toxin are often emphasized in the treatment of tumors,and the resulting outcomes are satisfactory.There are many Chinese herbs and Chinese herbal compounds classified into the heat-clearing and toxin-removing type.Xihuangwan,a classic heat-clearing prescription,is composed of Calculus Bovis,Moschus,Olibanum,and Myrrh and has the effects of clearing away heat,removing toxin,eliminating edema,and dissipating mass,which is mainly used to treat carbuncle,pustule,scrofula,multiple abscess,and cancer caused by heat-toxin obstruction.In modern clinical practice,it has been employed in patients with lung cancer,breast cancer,gastric cancer,liver cancer,colorectal cancer,and other malignant tumors,especially during the advanced stage,as a routine or adjuvant treatment for alleviating their clinical symptoms and improving their quality of life.The main active components of Xihuangwan are pentacyclic triterpenoids(such as masticinic acids),volatile oils,steroids(like porcine deoxycholic acid),and bilirubin,which have been proved effective in anti-tumor.This paper reviewed the prescription source,pharmaceutical research,clinical anti-tumor research,and pharmacological mechanisms of Xihuangwan,which has provided reference for further expanding the anti-tumor applications of Xihuangwan and enhancing its secondary development.