中药干预全膝关节置换术后深静脉血栓信号通路研究进展

Chinese Medicine Intervention on Deep Vein Thrombosis-related Signaling Pathways After Total Knee Arthroplasty: A Review

全膝关节置换术作为膝关节骨性关节炎后期常见的治疗手段,通过为患者进行换膝来改善患者的临床症状。下肢深静脉血栓作为全膝关节置换术最常见的并发症也随之出现。既往的研究表明,全膝关节置换术后深静脉血栓的形成多与机体内炎症因子的过度表达有关。核转录因子-κB、Toll样受体4、磷脂酰肌醇3-激酶/蛋白激酶B、肿瘤坏死因子、核转录因子E2相关因子2等信号通路作为与炎症相关的经典信号通路,通过调控信号通路的表达干预机体内炎症因子的形成。通过抑制炎症因子的形成,可以进一步抑制机体内血小板的活化,达到抑制血栓形成的目的。通过查阅文献发现,无论是中药单体、中药提取物及中药复方干预全膝关节置换术后的深静脉血栓,都通过上述相关信号通路的调节,直接或间接的抑制炎症因子的表达,从而干预血栓的形成。因此,中药运用于临床,不仅可以减少术后并发症及促进患者的术后康复,而且由于中药的价廉、不良反应小等优势也为患者带来了福音。该文通过中药干预全膝关节置换术后深静脉血栓相关信号通路研究现状进行总结,旨在为中药干预深静脉血栓的深入研究提供参考依据,也为中药运用于临床,减少患者术后深静脉血栓的形成提供了理论依据及广阔的治疗空间。

Total knee arthroplasty,as a common treatment option for advanced knee osteoarthritis,can alleviate the clinical symptoms of patients.Deep vein thrombosis of the lower extremity is the most common complication of total knee arthroplasty.Previous studies have shown that the occurrence of deep vein thrombosis after total knee arthroplasty is mostly related to the overexpression of inflammatory factors in vivo.Nuclear transcription factor-κB,Toll-like receptor 4,phosphatidylinositol 3-kinase/protein kinase B,tumor necrosis factor,and nuclear transcription factor E2-related factor 2 are typical signaling pathways related to inflammation.Regulating the expression of the signaling pathways can intervene the formation of inflammatory factors.Inhibiting the formation of inflammatory factors can help suppress the activation of platelets,thereby blocking thrombosis.According to previous research,Chinese medicine monomers,Chinese medicine extract,and compound Chinese medicine prescriptions all directly or indirectly inhibit the expression of inflammatory factors by regulating the above signaling pathways,thereby suppressing the occurrence of deep vein thrombosis after total knee arthroplasty.Therefore,Chinese medicine can reduce postoperative complications and promote postoperative recovery of patients at low cost with small side effects.This article summarizes the research on Chinese medicine intervention on deep vein thrombosis-related signaling pathways after total knee arthroplasty,which is expected to lay a basis for the in-depth study and clinical application of Chinese medicine in deep vein thrombosis.