中药调节炎症反应治疗胃食管反流病的研究进展

Advance in Treatment of Gastroesophageal Reflux Disease with Traditional Chinese Medicine by Regulating Inflammation

胃食管反流病(GERD)是一种慢性消化系统疾病,大约有20%的人群受到此病的困扰。除了反酸、烧心的常见症状以外,GERD可导致食管黏膜的长期炎症,增加患者发展为食管癌的风险。在治疗GERD方面,质子泵抑制剂(PPIs)因其能够有效抑制胃酸分泌而成为一线治疗药物。然而,长期使用PPIs可能会引起一系列并发症,如营养素吸收不良、肠道感染风险增加、骨折风险上升等,这些问题使得患者和医生都在寻求更为安全和有效的治疗选择。近年来的研究发现,GERD的发病机制之一是食管上皮细胞受到刺激后引发的持续性炎症反应。这种炎症反应不仅加剧了食管黏膜的损伤,还可能导致病情的慢性化和复杂化。因此,开发新的抗炎治疗方案成为了当前的研究热点。中草药方因其独特的抗炎和抗氧化特性,为GERD的治疗提供了新的思路。中草药方通常由多种草药组成,这些草药在中医理论指导下配伍使用,旨在调和人体的气血阴阳,达到治疗疾病的目的。在众多治疗GERD的中草药方中,黄连、柴胡、吴茱萸、甘草和白术等药材被广泛使用,他们在抑制炎症反应、调节免疫功能和改善氧化应激方面显示出显著的疗效。尽管中草药方在治疗GERD方面展现出潜力,但是目前关于其确切的循证医学证据仍然不足。该文综述这些药方成分的抗炎机制与GERD的治疗前景,以展望中草药在GERD治疗中的抗炎价值。

Gastroesophageal reflux disease(GERD)is a prevalent chronic digestive disorder,affecting about 20%of the population.In addition to the typical symptoms of acid regurgitation and pyrosis,GERD can lead to chronic esophageal mucosal inflammation,thereby increasing the risk of esophageal carcinoma.Proton pump inhibitors(PPIs)have emerged as the primary pharmacological intervention due to their efficacy in reducing gastric acid production.However,the long-term use of PPIs is associated with various complications,including malabsorption of nutrients,heightened susceptibility to enteric infections,and an elevated risk of fractures.These concerns have driven the pursuit of safer and more efficacious therapeutic alternatives by both patients and healthcare providers.Recent studies have highlighted the role of persistent inflammation triggered by irritation of the esophageal epithelial cells in the pathogenesis of GERD.Such inflammation not only exacerbates mucosal damage but also contributes to the chronicity and complexity of the disease.Consequently,the development of novel anti-inflammatory therapeutic strategies has become a focus in contemporary research.Chinese herbal medicine prescriptions,with distinctive anti-inflammatory and antioxidant properties,offer a promising avenue for the management of GERD.These prescriptions,composed of a variety of herbal medicines,are prescribed in accordance with the traditional Chinese medicine(TCM)principle of harmonizing Qi,blood,and Yin-Yang,thereby addressing the underlying disease processes.Among the numerous Chinese herbal medicine prescriptions for GERD,ingredients such as Coptidis Rhizoma,Bupleuri Radix,Euodiae Fructus,Glycyrrhizae Radix et Rhizoma,and Atractylodis Macrocephalae Rhizoma are commonly utilized for their effects of inhibiting inflammation,modulating immune functions,and alleviating oxidative stress.Despite the potential in treating GERD,concrete evidence-based medical proof of these prescriptions remains limited.This review summarizes the anti-inflammatory mechanisms and prospects of Chinese herbal medicines in treating GERD,providing an outlook on the value of these medicines in the anti-inflammatory management of GERD.