经典方药治疗溃疡性结肠炎的研究进展

Review of classical prescriptions in treatment of ulcerative colitis

溃疡性结肠炎(UC)是一种以腹痛、腹泻、黏液性血便等特征为主要临床表现,以结直肠黏膜层及黏膜下层损伤为主的连续性炎性肠道疾病。具有复发率高、治愈难度大、聚集性及地域性等特点。中医方药治疗UC具有疗效确切、多靶点调控、毒副作用小等优势。特别是经典方药突出体现了中医药理论的特色和优势,近年来吸引了大量科研工作者的关注。为了使相关领域研究人员能够及时而全面地了解经典方药在UC治疗领域的情况,该文从药效物质基础、质量控制、作用机制及临床应用4个方面综述了经典方药治疗UC的最新研究进展。首先评述了生物碱类、多糖类、皂苷类和黄酮类等经典方药的有效组分用于治疗UC的最新研究进展;然后总结了气相色谱、液相色谱、质谱及液相色谱-质谱联用等分析手段用于UC治疗的经典方药质量控制的最新研究成果;接着归纳了网络药理学、分子对接、整合药理学平台和动物实验等在研究方药治疗UC的作用机制领域的进展;最后归纳了清热利湿、平调寒热、疏肝理脾、健脾益气、温补脾肾等经典方药治疗UC的临床应用研究。希望该文对经典方药治疗UC研究进展的系统总结有利于促进经典方药在UC治疗领域的应用和发展。

Ulcerative colitis(UC) is a continuous inflammatory bowel disease with the main clinical manifestations of abdominal pain, diarrhea, and mucous bloody stools, mainly attacking the colorectal mucosa and submucosa. It is characterized by high recurrence rate, difficult cure, and clustering and regional occurrence. Chinese medicinal prescriptions for the treatment of UC have good therapeutic effect, multi-target regulation, slight toxicity, and no obvious side effects. In particular, the classical prescriptions highlight the characteristics and advantages of traditional Chinese medicine theory and have attracted much attention in recent years. To enable researchers to timely and comprehensively understand the classical prescriptions in the treatment of UC, we reviewed the studies about the pharmacodynamic material basis, quality control, action mechanism, and clinical application of relevant classical prescriptions. We first introduced the latest research progress in the active components such as alkaloids, polysaccharides, saponins, and flavonoids in relevant classical prescriptions. Then, we reviewed the latest research achievements on the quality control of classical prescriptions for the treatment of UC by gas chromatography, liquid chromatography, mass spectrometry, liquid chromatography-mass spectrometry and the like. Further, we summarized the research advances in the mechanisms of relevant prescriptions in the treatment of UC based on network pharmacology, molecular docking, integrated pharmacology platform, and animal experiments. Finally, we generalized the clinical application of the classical prescriptions for clearing heat and removing dampness, mildly regulating cold and heat, soothing liver and regulating spleen, strengthening spleen and invigorating Qi, and tonifying spleen and stomach. By systematic summary of the research progress in relevant classical prescriptions, we hope to promote the application and development of such prescriptions in UC treatment.