葛根芩连汤治疗溃疡性结肠炎研究进展

Research Progress of Gegen Qinlian Decoction(葛根芩连汤)in the Treatment of Ulcerative Colitis

溃疡性结肠炎(ulcerative colitis,UC)是一种慢性复发性的结肠和直肠的炎症性疾病,其典型表现为腹痛、腹泻、黏液脓血便和吸收障碍等,属中医“肠澼”“痢疾”“滞下”“泄泻”“脏毒”等范畴。葛根芩连汤出自《伤寒论》,善清胃肠湿热,亦可调和气血,原方由葛根、黄芩、黄连和炙甘草4味中药组成,是治疗UC的经典良方。临床应用方面,主要通过葛根芩连汤加减、联合其他方剂、联合西药、联合灌肠、联合针灸等方式治疗UC患者,其优势体现在改善肠道黏膜屏障功能损伤,减少肠道炎症反应,缓解腹泻、腹痛、脓血便、里急后重、肛门灼热等症状,降低复发率,减少不良反应等,有效提高了UC患者的生活质量。作用机制方面,葛根芩连汤治疗UC主要与调节自身免疫、降低炎性细胞因子、调节T细胞、抗氧化应激、改善肠道菌群失调,调节IL-6/JAK2/STAT3、TLR4/NF-κB、Notch、Nrf2等信号通路有关。葛根芩连汤中单味药有效成分的研究表明,黄芩苷、黄芩多糖、葛根素、小檗碱、甘草酸二铵、甘草次酸等是治疗UC的主要有效成分。文章检索近年来国内外文献,从临床应用研究和实验机制研究两个方面综述葛根芩连汤治疗UC的研究进展,以期为葛根芩连汤治疗UC的遣方用药及后续研究葛根芩连汤治疗UC的作用机制提供参考依据,发挥中医药治疗UC的优势。

Ulcerative colitis(UC)is a chronic and recurrent inflammatory disease of the colon and rectum.Its typical manifestations are abdominal pain,diarrhea,mucous purulent and bloody stool and absorption disorder.It belongs to the category of“Changpi”“dysentery”“Zhixia”“diarrhea”“Zangviscera toxin”and so on.Gegen Qinlian Decoction(葛根芩连汤),originating from Treatise on Febrile Disease,is effective in clearing damp-heat in the gastrointestinal tract and harmonizing Qi and blood.The original prescription is composed of Gegen(Puerariae Lobatae Radix),Huangqin(Scutellariae Radix),Huanglian(Coptidis Rhizoma),Zhigancao(Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle),which is a classic prescription for the treatment of UC.Clinical application,mainly through Modified Gegen Qinlian Decoction,combined with other formulas,combined with western medicine,combined with enema,combined with acupuncture and other methods to treat patients with UC,its advantages lie in improving the impairment of intestinal mucosal barrier function,reducing intestinal inflammatory responses,alleviating symptoms such as diarrhea,abdominal pain,stool with pus and blood,tenesmus,fever and anal burning,lowering the recurrence rate,minimizing adverse reactions,effectively enhancing the quality of life for patients with UC.In terms of action mechanism,Gegen Qinlian Decoction in the treatment of UC is mainly related to regulating autoimmunity,reducing inflammatory cytokines,regulating T cells,antioxidant stress,improving intestinal flora imbalance,regulating IL-6/JAK2/STAT3,TLR4/NF-κB,Notch,Nrf2 and other signal pathways.The study on the effective components of Gegen Qinlian Decoction shows that baicalin,Scutellaria baicalensis polysaccharide,puerarin,berberine,diammonium glycyrrhizinate and glycyrrhetinic acid are the main effective components in the treatment of UC.This article reviews the literature at home and abroad in recent years,and summarizes the research progress of Gegen Qinlian Decoction in the treatment of UC from two aspects of clinical application research and experimental mechanism research,in order to provide reference basis for the use of Gegen Qinlian Decoction in the treatment of UC and the followup study of the mechanism of Gegen Qinlian Decoction in the treatment of UC,and to give full play to the advantages of traditional Chinese medicine in the treatment of UC.