白头翁汤治疗腹泻相关疾病研究进展

Research Progress of Pulsatilla Decoction in Treating Diarrhea-Related Diseases

白头翁汤是治疗痢疾的经典方剂,近年来,多用于治疗腹泻型肠易激综合征、放射性肠炎、炎症性肠病、结直肠癌等疾病,其机制可能与调节肠道黏膜屏障功能、抑制促炎因子、促进抗炎因子的表达、减少结肠上皮细胞凋亡、抑制细胞增殖、调节肠道微环境、降低血液黏稠度、抗氧化等有关。但目前的研究尚存在以下不足:(1)临床上使用中药复方联合西医治疗,有效率较高,但医疗费用较高,复发率较高,不良反应较多,可发挥中医“未病先防”优势,早期诊治,以延缓病情发展,减轻医疗负担;(2)中药复方成分复杂,具有多靶点、协同治疗的特点,安全性及不良反应尚不明确,建议继续深入研究中药复方的有效成分、作用机制、药物禁忌等;(3)临床试验的标本量较少,缺乏随机双盲试验研究;动物实验缺少回复实验及进一步验证,建议深入进行动物实验研究,并将研究成果加快向临床转变,以及时调整治疗方案。

Pulsatilla Decoction is a classic formula for the treatment of dysentery.In recent years,it has been used to treat diarrhea-type irritable bowel syndrome,radiation enteritis,inflammatory bowel disease,colorectal cancer,etc.Its mechanism may be related to regulating intestinal mucosal barrier function,inhibiting pro-inflammatory factors,promoting the expression of anti-inflammatory factors,reducing the apoptosis of colonic epithelial cells,inhibiting cell proliferation,regulating intestinal microenvironment,reducing blood viscosity,antioxidant effect and so on.However,there are still some shortcomings in the current research.(1)Firstly,the clinical use of Chinese medicinal compound combined with Western medicine treatment has shown an improved effective rate,but the medical cost is high,and so is the recurrence rate.In addition,there are more adverse reactions.Therefore,it is recommended to carry out research on"prevention before disease."Early diagnosis and treatment may delay the progression of the disease and reduce the medical burden;(2)Secondly,the composition of Chinese medicinal compounds is complex,with the characteristics of multi-target and hypochoric treatment,and the safety and adverse reactions are not clear.Therefore,further research is recommended on the effective ingredients,mechanism of action and drug contraindications of Chinese medicinal compounds;(3)Finally,there is a lack of sufficient clinical experiments due to the small sample size and the lack of randomized double-blind experimental research,as well as the insufficient use of animal and response experiments for further verification.Therefore,it is recommended to conduct in-depth animal experiments,accelerate the research results towards clinical translation,and make timely adjustments to treatment regimens.