半夏泻心汤治疗慢性萎缩性胃炎的机制研究进展

Research Progress on the Mechanisms of Banxia Xiexin Decoration(半夏泻心汤)in the Treatment of Chronic Atrophic Gastritis

慢性萎缩性胃炎是公认的胃癌前病变,既往研究显示其病理状态正处于“炎-癌”转换的关键时期。早期识别并恰当干预是截断病程、逆转萎缩、防止癌变的核心环节。现代医学和中医传统医学均对此疾病展开了大量研究,以期可以挖掘其内在机制,从而提高临床疗效。大量研究显示中医中药在防治萎缩性胃炎方面表现出了卓越的优势,尤其以“半夏泻心汤”为代表的经典方剂研究最为深入。越来越多的基础及临床研究从不同角度阐述了“半夏泻心汤”治疗萎缩性胃炎的内在机制,但其散乱地分散在大量文献中,缺少系统的归纳及整理,给后续研究者从整体上了解“半夏泻心汤”治疗此疾病的内在机制造成了一定困扰。文章将从“半夏泻心汤”对胃蛋白酶及胃泌素水平的调节、辅助根除幽门螺杆菌、调控炎症、凋亡、血管新生等多种生物学过程以及靶向抑制PD-1、改善胃内微环境等5个方面,将近年来以“半夏泻心汤”为核心方剂治疗慢性萎缩性胃炎的相关机制研究做一综述,以期为后续研究提供参考。

Chronic atrophic gastritis(CAG)is recognized as a precancerous lesion of gastric cancer,and previous studies have shown that its pathological state is at a critical stage of transition from inflammation to cancer.Early recognition and appropriate intervention are crucial in interrupting the disease progression,reversing atrophy,and preventing carcinogenesis.Extensive research has been conducted on this condition by both modern medicine and traditional Chinese medicine,aiming to explore its underlying mechanisms and improve clinical efficacy.Numerous studies have demonstrated the remarkable advantages of traditional Chinese medicine and herbal medicine in the prevention and treatment of CAG,with a particular focus on the in-depth investigation of classic formulas such as“Banxia Xiexin Decoration(半夏泻心汤)”.Increasing amounts of basic and clinical research have elucidated the underlying mechanisms of“Banxia Xiexin Decoration”in treating CAG from different perspectives.However,these findings are scattered across a large number of literature sources,lacking systematic summarization and organization,which poses challenges for researchers to comprehensively understand the mechanisms of“Banxia Xiexin Decoration”in treating this disease.In this paper,we aim to provide a comprehensive review of recent research on the mechanisms of“Banxia Xiexin Decoration”in treating CAG,with a focus on five aspects:regulation of gastric protease and gastrin levels,assisting in the eradication of Helicobacter pylori,modulation of inflammation,apoptosis,and angiogenesis,as well as targeted inhibition of PD-1 and improvement of the gastric microenvironment.By presenting the relevant mechanistic studies of“Banxia Xiexin Decoration”as a core formula for treating CAG,we hope to provide a reference for future research in this field.