左金丸及其主要单体成分抗结直肠癌机制的研究进展

Anti-colorectal Cancer Mechanism of Zuojinwan and Its Main Monomer Components:A Review

左金丸为中医经典名方,记载于《丹溪心法》,由黄连和吴茱萸以6:1比例配伍而成,主治肝火胁痛、胃脘痛、呕吐吞酸等症。现代对左金丸的药理研究很多,尤其是消化道方面,对消化道癌症亦有其独到作用,其抗肿瘤研究主要集中在肠癌、胃癌等。结直肠癌是世界上第3大常见的癌症类型,也是第2大最致命的恶性肿瘤。目前已有多项研究表明左金丸抗结直肠癌的基础药理研究包括结直肠癌的增殖、细胞凋亡、侵袭、能量代谢、表观遗传学和耐药性。生物碱类为左金丸主要活性成分,如小檗碱、吴茱萸碱、黄连碱、巴马汀、吴茱萸次碱等。相较于左金丸对结直肠癌的作用,除无小檗碱对耐药性及吴茱萸碱对能量代谢的研究外,小檗碱和吴茱萸碱还有对肿瘤血管生成、肿瘤促进性炎症反应和肠道菌群的研究。而且黄连碱、巴马汀、吴茱萸次碱可分别调节结直肠癌细胞增殖、凋亡、转移,结直肠癌细胞增殖、凋亡、肿瘤促进性炎症反应,结直肠癌细胞增殖、凋亡、迁移和侵袭。此外,还有研究显示小檗碱和吴茱萸碱联用对结直肠癌细胞的生长、迁移和侵袭有协同增效作用,亦可减弱吴茱萸碱诱导的心脏损伤。因此对近年来左金丸及其主要单体成分抗结直肠癌机制的研究进行归纳总结,以期为今后临床新型高效低毒抗结直肠癌药物研发提供理论依据,为临床实践奠定坚实基础。

Zuojinwan is a classic Chinese medicine prescription recorded in the Danxi's Experiential Therapy,with Coptidis Rhizoma and Euodiae Fructus in a ratio of 6∶1.It can treat symptoms such as liver fire hypochondriac pain,stomach duct pain,vomiting,and acid swallowing.There are many pharmacological studies on Zuojinwan in modern times,especially in the digestive tract,but the prescription also has its unique effect on digestive tract cancer,and its anti-tumor studies mainly focus on colorectal cancer and gastric cancer.Colorectal cancer is the third most common type of cancer in the world and the second deadliest malignancy.At present,a number of studies have shown that the basic pharmacological studies of anti-colorectal cancer by Zuojinwan include the proliferation,apoptosis,invasion,energy metabolism,epigenetics,and drug resistance of colorectal cancer.Alkaloids are the main active ingredients of Zuojinwan,such as berberine,evodiamine,coptisine,palmatine,and rutaecarpine.Compared with the effect of Zuojinwan on colorectal cancer,studies on the effect of berberine and evodiamine on tumor angiogenesis,tumor-promoting inflammation,and intestinal flora are carried out,except the studies on the resistance of berberine and the effect of evodiamine on energy metabolism.In addition,coptisine,palmatine,and rutaecarpine can regulate the proliferation,apoptosis,and metastasis of colorectal cancer cells,the proliferation and apoptosis of colorectal cancer cells,tumor-promoting inflammatory response,and the proliferation,migration,and invasion of colorectal cancer cells,respectively.Moreover,other studies have shown that the combination of berberine and evodiamine can have a synergistic effect on the growth,migration,and invasion of colorectal cancer cells and can reduce the cardiac toxicity induced by evodiamine.Therefore,this paper summarizes the studies on the anti-colorectal cancer mechanism of Zuojinwan and its main monomer components in recent years,so as to provide a theoretical basis for future clinical research and development of new high-efficiency and low-toxicity anti-colorectal cancer drugs and lay a solid foundation for clinical practice.