青蒿鳖甲汤治疗肺部疾病的研究进展

Qinghao Biejiatang Treats Lung Diseases:A Review

青蒿鳖甲汤出自清代吴鞠通的《温病条辨》,由青蒿、鳖甲、知母、牡丹皮、生地黄5味药组成,具有养阴透热之功效,常用于阴虚内热证的治疗。正气虚损,邪毒入侵,耗伤肺阴,虚热内生,为肺癌、肺炎等肺部疾病的病机之一,其治则为养阴益气,清肺透热。因此,青蒿鳖甲汤之功效基本契合肺部疾病之治则,故广泛应用于肺部疾病治疗,如肺癌癌性发热、咯血或合并骨转移及肺结核、社区获得性肺炎、新型冠状病毒感染合并肺炎等,疗效显著。基础实验表明,其机制可能为通过多靶点通路发挥调节炎症反应、维持免疫平衡、调节肠道菌群、抗肿瘤、调节激素分泌、调节脂类代谢、抗氧化等作用。此外,青蒿鳖甲汤单味药的主要有效活性成分青蒿素、木犀草素、谷甾醇、豆甾醇、鳖甲多糖、梓醇、芍药苷、槲皮素、丹皮酚、没食子酸、知母皂苷、芒果苷等也具有良好的抗肿瘤、抗氧化、抗病毒、炎症调节和免疫调节的作用。该文通过对青蒿鳖甲汤治疗肺部疾病的临床研究和基础研究进行综述,以期为该方的临床应用提供理论依据。

Qinghao Biejiatang,first recorded in the Detailed Analysis of Warm Diseases(《温病条辨》)written by WU Jutong in the Qing Dynasty,is composed of Artemisiae Annuae Herba,Trionycis Carapax,Rehmanniae Radix,Anemarrhenae Rhizoma,and Moutan Cortex.With the effects of nourishing Yin and relieving heat,this prescription is often used to treat the syndrome of Yin deficiency and internal heat.The deficiency of healthy Qi,invasion of pathogenic toxins,loss of lung Yin,and generation of deficiency-heat are pathogenesis of lung cancer,pneumonia and other lung diseases,the treatment of which usually follows the principles of nourishing Yin,reinforcing healthy Qi,clearing lung,and eliminating heat.With the effects basically in accordance with the treatment principles of lung diseases,Qinghao Biejiatang is widely used in the treatment of lung diseases such as lung cancer-associated fever,hemoptysis or combined with bone metastasis,tuberculosis,community-acquired pneumonia,and pneumonia caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Basic experiments have shown that Qinghao Biejiatang may exert the therapeutic effects by reducing inflammation,maintaining immune balance,regulating intestinal flora,hormone secretion,lipid metabolism,and inhibiting tumor and oxidative damage.In addition,the main active ingredients of this prescription include artemisinin,luteolin,sitosterol,stigmasterol,polysaccharides,catalpol,paeoniflorin,quercetin, paeonol, gallic acid, timosaponin, and mangiferin, which have anti-tumor, anti-oxidant, anti-virus,inflammation-regulating, and immunomodulatory activities. The paper reviewed the clinical and basic studies ofQinghao Biejiatang in the treatment of lung diseases, aming to provide a theoretical basis for the clinical application.