中药单体防治放射性肠损伤的作用及机制研究进展

Research progress in prevention and treatment of radiation-induced intestinal injury by traditional Chinese medicine active components

放射性肠损伤(radiation-induced intestinal injury,RIII)是腹盆腔恶性肿瘤患者放疗而引起的一种肠道不良事件,其不仅影响患者生活质量,而且还限制了放疗剂量及临床效果。目前,临床上防治RIII的主要手段有药物治疗、高压氧治疗、手术治疗等,其中中药因含有结构多样化的活性单体成分在RIII防治方面具有副作用小、疗效好的特点。研究发现,黄酮类、萜类、苯丙素类、生物碱类等中药单体具有减轻肠道放射性损伤的功效,主要通过抑制氧化应激、调节炎症因子的表达、调节线粒体凋亡途径、调节肠道菌群和抑制细胞凋亡发挥作用。该文检索了近10年国内外有关中药单体防治RIII方面的研究文献,以期为防治放射性肠损伤新药物的研发提供理论参考。

Radiation-induced intestinal injury(RIII),a common complication of radiotherapy for pelvic malignancies,affects the quality of life and the radiotherapy efficacy for cancer.Currently,the main clinical approaches for the prevention and treatment of RIII include drug therapy,hyperbaric oxygen therapy,and surgical treatment.Among these methods,drug therapy is cost-effective.Traditional Chinese medicine(TCM)containing a variety of active components demonstrates mild side effects and good efficacy in preventing and treating RIII.Studies have proven that TCM active components,such as flavonoids,terpenoids,phenylpropanoids,and alkaloids,can protect the intestine against RIII by inhibiting oxidative stress,regulating the expression of inflammatory cytokines,modulating the mitochondrial apoptosis pathway,adjusting intestinal flora,and suppressing cell apoptosis.These mechanisms can help alleviate the symptoms of RIII.The paper aims to provide a theoretical reference for the discovery of new drugs for the prevention and treatment of RIII by reviewing the literature on TCM active components in the last 10 years.