
浏览全部资源
扫码关注微信
1.甘肃中医药大学中西医结合学院,兰州 730000
2.甘肃省中医院脾胃病诊疗中心,兰州 730050
硕士研究生。研究方向:中西医结合防治消化道疾病。E-mail:1794993738@qq.com
副主任医师,硕士生导师,硕士。研究方向:胆胰疾病内镜治疗、消化道疾病的中西医结合诊治。E-mail:18298470326@163.com
收稿:2025-05-30,
修回:2025-09-23,
录用:2025-09-24,
纸质出版:2025-10-30
移动端阅览
李莹,张早育,邓蓉,等.香连丸治疗溃疡性结肠炎的临床及分子机制研究进展 [J].中国药房,2025,36(20):2609-2614.
LI Ying,ZHANG Zaoyu,DENG Rong,et al.Research progress on clinical and molecular mechanisms of Xianglian pills in the treatment of ulcerative colitis[J].ZHONGGUO YAOFANG,2025,36(20):2609-2614.
李莹,张早育,邓蓉,等.香连丸治疗溃疡性结肠炎的临床及分子机制研究进展 [J].中国药房,2025,36(20):2609-2614. DOI: 10.6039/j.issn.1001-0408.2025.20.22.
LI Ying,ZHANG Zaoyu,DENG Rong,et al.Research progress on clinical and molecular mechanisms of Xianglian pills in the treatment of ulcerative colitis[J].ZHONGGUO YAOFANG,2025,36(20):2609-2614. DOI: 10.6039/j.issn.1001-0408.2025.20.22.
溃疡性结肠炎(UC)是一种慢性肠道自身免疫性疾病,以腹痛、腹泻、黏液便和血便等为主要临床表现,发病机制复杂。经典名方香连丸(XLP)近年来被广泛应用于UC的临床治疗,其不良反应较少,患者耐受性好,具有明显临床应用潜力,但其临床研究、分子机制方面的证据尚未得以全面整合。本文通过系统综述XLP在UC治疗中的临床研究及分子机制发现,XLP及其加减方与化学药联用,可显著改善UC患者症状、减轻肠道炎症,效果优于单用化学药。该方改善UC的分子机制涉及调节泛凋亡、免疫反应、相关信号通路(缺氧诱导因子1α、核因子κB等)、肠道菌群和修复肠黏膜屏障等,其组方药材、单体和活性成分还可通过调节Wnt/
β
-联蛋白、Janus激酶/信号转导及转录活化因子等多条信号通路来阻碍辅助性T细胞17分化,恢复M1/M2型细胞平衡,减轻UC肠道损伤。
Ulcerative colitis (UC) is a chronic intestinal autoimmune disease, with clinical manifestations
including abdominal pain, diarrhea, mucus and bloody stools, and its pathogenesis is complex. The classic prescription Xianglian pills (XLP) has been widely used in the clinical treatment of UC in recent years. It has few adverse reactions, good patient tolerance, and shows significant potential for clinical application. However, there is currently no comprehensive integration of evidence on its clinical research and molecular mechanisms. Through a systematic review of the clinical research and molecular mechanisms of XLP in the treatment of UC, it is found that XLP and its modified formulas, when used in combination with chemical drugs, can significantly improve the symptoms of UC patients and reduce intestinal inflammation, with superior efficacy compared to chemical drugs alone. Its mechanism of action involves regulating pan-apoptosis, immune response, signaling pathways (hypoxia-inducible factor-1α, nuclear factor-κB, etc.), intestinal flora, and repairing the intestinal mucosal barrier. Its medicinal materials, monomers and active components can also prevent the differentiation of helper T cells 17 and restore the balance of M1/M2 cells through regulating multiple pathways such as Wnt/
β
-catenin and Janus kinase/signal transducer and activator of transcription, thereby reducing intestinal damage in UC.
YU Y R , RODRIGUEZ J R . Clinical presentation of Crohn’s,ulcerative colitis,and indeterminate colitis:symptoms,extraintestinal manifestations,and disease phenotypes [J ] . Semin Pediatr Surg , 2017 , 26 ( 6 ): 349 - 355 .
KOBAYASHI T , SIEGMUND B , LE BERRE C , et al . Ulcerative colitis [J ] . Nat Rev Dis Primers , 2020 , 6 : 74 .
Inflammatory Bowel Disease Group , Chinese Society of Gastroenterology , Chinese Medical Association , Inflammatory Bowel Disease Quality Control Center of China . 2023 Chinese national clinical practice guideline on diagnosis and management of ulcerative colitis [J ] . Chin Med J(Engl) , 2024 , 137 ( 14 ): 1642 - 1646 .
中国中西医结合学会 . 溃疡性结肠炎中西医结合诊疗指南 [J ] . 中国中西医结合杂志 , 2024 , 44 ( 9 ): 1029 - 1035 .
卢敏 , 熊山 , 牟艳玲 . 香连丸的化学成分和药理作用研究进展 [J ] . 化学工程师 , 2018 , 32 ( 12 ): 68 - 71 .
蔡薇 . 中药黄连毒性及其影响因素分析 [J ] . 临床合理用药杂志 , 2017 , 10 ( 17 ): 84 - 85 .
宋德琴 , 黄雪婷 , 杜冉 , 等 . 基于网络药理学和分子对接探讨香连丸治疗腹泻作用机制 [J ] . 中国中医药图书情报杂志 , 2025 , 49 ( 1 ): 38 - 43 .
郑强 . 美沙拉嗪联合香连丸对溃疡性结肠炎患者细胞因子及免疫细胞的影响 [J ] . 中国生化药物杂志 , 2016 , 36 ( 6 ): 148 - 150 .
朱怀平 , 谢彬 . 联用美沙拉嗪与香连丸治疗溃疡性结肠炎的效果研讨 [J ] . 当代医药论丛 , 2017 , 15 ( 23 ): 127 - 128 .
GUO H M , ZHANG J Z , GAO W Y , et al . Gastrointestinal effect of methanol extract of Radix Aucklandiae and selected active substances on the transit activity of rat isolated intestinal strips [J ] . Pharm Biol , 2014 , 52 ( 9 ): 1141 - 1149 .
杨晓庆 , 张俊 , 黄振 , 等 . 香连化滞丸联合美沙拉嗪治疗溃疡性结肠炎的临床研究 [J ] . 现代药物与临床 , 2022 , 37 ( 9 ): 2044 - 2048 .
关成冶 . 香连化滞丸联合抗生素治疗溃疡性结肠炎的临床观察 [J ] . 安徽卫生职业技术学院学报 , 2017 , 16 ( 4 ): 50 - 51 .
马嘉仪 , 杨琰 , 张竞研 , 等 . 基于UPLC-Q-TOF-MS/MS技术分析香连丸的化学成分与小鼠体内的入血成分及代谢产物 [J ] . 南京中医药大学学报 , 2024 , 40 ( 5 ): 510 - 520 .
刘昌顺 , 胡艳楠 , 夏婷 , 等 . 香连丸中8种功效成分在小鼠体内的组织分布 [J ] . 世界科学技术-中医药现代化 , 2021 , 23 ( 3 ): 686 - 692 .
DICARLO M , TETI G , VERNA G , et al . Quercetin exposure suppresses the inflammatory pathway in intestinal organoids from Winnie mice [J ] . Int J Mol Sci , 2019 , 20 ( 22 ): 5771 .
MOPARTHI L , KOCH S . Wnt signaling in intestinal inflammation [J ] . Differentiation , 2019 , 108 : 24 - 32 .
LUO Z Y , HU Y X , QIU C W , et al . Coptidis Rhizoma processed with Evodia rutaecarpa improves the effect on ulcerative colitis by increasing intestinal energy metabolites alpha-ketoglutarate and Lactobacillus reuteri [J ] . Phytomedicine , 2023 , 121 : 155115 .
HARRIS C , FRASER CUMMINGS J R . JAK1 inhibition and inflammatory bowel disease [J ] . Rheumatology (Oxford) , 2021 , 60 ( Suppl. 2 ):ii45-ii51.
LIU C S , XIA T , LUO Z Y , et al . Network pharmacology and pharmacokinetics integrated strategy to investigate the pharmacological mechanism of Xianglian pill on ulcera-tive colitis [J ] . Phytomedicine , 2021 , 82 : 153458 .
LI J Y , XIAO J , GAO M , et al . IRF/type Ⅰ IFN signaling serves as a valuable therapeutic target in the pathogenesis of inflammatory bowel disease [J ] . Int Immunopharmacol , 2021 , 92 : 107350 .
TIAN Y , YANG C M , YAO Q Y , et al . Procyanidin B2 activates PPARγ to induce M2 polarization in mouse macrophages [J ] . Front Immunol , 2019 , 10 : 1895 .
ZHOU H F , YANG C , LI J Y , et al . Quercetin serves as the major component of Xianglian pill to ameliorate ulcerative colitis via tipping the balance of STAT1/PPARγ and dictating the alternative activation of macrophage [J ] . J Ethnopharmacol , 2023 , 313 : 116557 .
LEE S , KARKI R , WANG Y Q , et al . AIM2 forms a complex with pyrin and ZBP1 to drive PANoptosis and host defence [J ] . Nature , 2021 , 597 ( 7876 ): 415 - 419 .
何红霞 , 范恒 , 杨佳 . 香连丸对溃疡性结肠炎小鼠泛凋亡途径的影响 [J ] . 华中科技大学学报(医学版) , 2024 , 53 ( 6 ): 717 - 722 .
YANG Z H , LIN S S , FENG W Y , et al . A potential therapeutic target in traditional Chinese medicine for ulcerative colitis:macrophage polarization [J ] . Front Pharmacol , 2022 , 13 : 999179 .
WANG S L , LIU G H , LI Y R , et al . Metabolic reprogramming induces macrophage polarization in the tumor microenvironment [J ] . Front Immunol , 2022 , 13 : 840029 .
ZHANG J X , HU Y X , LIU Y , et al . Xianglian pill alle-viates ulcerative colitis by inhibiting M1 macrophage polari-zation via modulation of energy metabolite itaconate [J ] . Phytomedicine , 2024 , 135 : 156179 .
WU D S , CAO H , ZHANG Y , et al . Shaoyaotang treats ulcerative colitis by inhibiting HIF-1α and regulating Th17/Treg balance [J ] . Chin J Exp Tradit Med Formulae , 2021 , 27 ( 16 ).
杨乐 , 徐梦婷 , 蔡琳玲 , 等 . UHPLC-TOF-MS结合网络药理学与实验验证探讨香连丸治疗溃疡性结肠炎的作用机制 [J ] . 中国药学杂志 , 2023 , 58 ( 12 ): 1084 - 1092 .
WANG J Q , JEELALL Y S , FERGUSON L L , et al . Toll-like receptors and cancer:MyD88 mutation and inflammation [J ] . Front Immunol , 2014 , 5 : 367 .
DAI Y X , LU Q L , LI P Y , et al . Xianglian pill attenuates ulcerative colitis through TLR4/MyD88/NF-κB signaling pathway [J ] . J Ethnopharmacol , 2023 , 300 : 115690 .
NIGHOT P K , HU C A , MA T Y . Autophagy enhances intestinal epithelial tight junction barrier function by tar-geting claudin-2 protein degradation [J ] . J Biol Chem , 2015 , 290 ( 11 ): 7234 - 7246 .
BENTO C F , RENNA M , GHISLAT G , et al . Mammalian autophagy:how does it work? [J ] . Annu Rev Biochem , 2016 , 85 : 685 - 713 .
Frontiers Editorial Office . Retracted:Xianglian pill suppresses inflammation and protects intestinal epithelial barrier by promoting autophagy in DSS induced ulcerative colitis mice [J ] . Front Pharmacol , 2023 , 14 : 1289227 .
GUO X Y , LIU X J , HAO J Y . Gut microbiota in ulcera-tive colitis:insights on pathogenesis and treatment [J ] . J Dig Dis , 2020 , 21 ( 3 ): 147 - 159 .
LIU C S , HU Y X , LUO Z Y , et al . Xianglian pill modulates gut microbial production of succinate and induces regulatory T cells to alleviate ulcerative colitis in rats [J ] . J Ethnopharmacol , 2023 , 303 : 116007 .
CHANG J , LEONG R W , WASINGER V C , et al . Impaired intestinal permeability contributes to ongoing bowel symptoms in patients with inflammatory bowel di-sease and mucosal healing [J ] . Gastroenterology , 2017 , 153 ( 3 ): 723 - 731.e1 .
YANG L J , ZHANG Q , HUANG J Y , et al . Xianglian pill ameliorates antibiotic-associated diarrhea by restoring intestinal microbiota and attenuating mucosal damage [J ] . J Ethnopharmacol , 2021 , 264 : 113377 .
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
 公网安备50010302001817
 公网安备50010302001817