摘要
慢性阻塞性肺疾病合并肌肉衰减综合征的病机为肺脾亏虚,以补益肺脾、培土生金为治疗原则.研究发现,该病发病机制与蛋白质代谢通路异常、炎症、内分泌因子异常、线粒体功能异常、Ca2+稳态失衡、卫星细胞激活与衰减等有关,补益肺脾法可能是通过改善骨骼肌蛋白质代谢异常、骨骼肌线粒体功能异常、骨骼肌Ca2+稳态失衡、肌肉卫星细胞激活、营养不良发挥作用.但目前研究仍存在一些不足,比如肺脾气虚的物质基础及相互影响机制仍不明确;临床研究多侧重于方药的有效性,对长期使用的安全性缺乏报道;实验研究以动物为主,相关的体外研究较少.今后可加强对肺脾相关的物质基础及相互影响机制的研究;对长期治疗的药物安全性进行随访;以体外培养的细胞为研究对象,证明中医药可以对慢性阻塞性肺疾病细胞内部发生作用,从细胞层面解释中医药的治疗机制.
Abstract
The pathogenesis of chronic obstructive pulmonary disease(COPD)with muscle atrophy syndrome in TCM is considered to be due to lung-spleen qi deficiency,and it can be treated with methods of reinforcing the lung and spleen and banking up earth to bene-fit metal,etc.Current research has found that its pathogenesis is related to abnormal protein metabolic pathways,inflammation,abnormal endocrine factors,abnormal mitochondrial function,calcium homeosta imbalance,activation and dysfunction of satellite cells,etc.The re-inforcing the lung and spleen method may work by improving abnormal protein metabolism in skeletal muscle,abnormal mitochondrial function in skeletal muscle,calcium homeosta imbalance in skeletal muscle,activation of satellite cells in muscle,and malnutrition.However,there are still some limitations in the current research,such as the material basis and mutual influence mechanism of spleen-lung qi deficiency are still unclear;the research is mostly focused on the effectiveness of formulas,with few reports on the safety of long-term use;and the experimental studies are mostly conducted on animals,with fewer in vitro studies.In the future,it is necessary to strengthen the research on the material basis and mutual influence mechanism of the lung and spleen,and follow up the drug safety of long-term treatment.By studying the effects of TCM on COPD cells cultured in vitro,it is needed to prove that TCM can exert its effects on the cells within the COPD,and explain the mechanism of its treatment from the cellular level.
基金项目
山西省中医药管理局中医药科研项目(2020ZYYZ025)
山西中医药大学重点学科建设项目(1006Z3)
国家科技期刊平台
NSTL
万方数据