中国中药杂志

2020, v.45(06) 1287-1296

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促胆汁分泌和排泄的中药研究进展
Advances in research of traditional Chinese medicine for promoting bile secretion and excretion

李渊;高晓霞;秦雪梅;
LI Yuan;GAO Xiao-xia;QIN Xue-mei;Modern Research Center for Traditional Chinese Medicine, Shanxi University;

摘要(Abstract):

利胆药指能促进胆汁分泌和排泄,加强胆囊收缩,促进胆囊排空的药物。临床上主要用于治疗胆囊炎、胆结石、胆汁淤积、胆道感染和黄疸型肝炎等疾病。中草药作为我国的传统医药,资源广泛,成本低,具有毒副作用小或无,动物体不易产生抗药性等优点。随着科学技术的进步和中医药的快速发展,中药在利胆方面的研究取得了不少成果。中药利胆主要通过促进胆汁分泌,调节SCP2 mRNA,FXR,BSEP及外排转运蛋白,溶解胆固醇,促进奥狄括约肌舒张,改变胆汁成分等发挥作用。在临床上常运用中药汤剂、中药制剂,中药联合针刺、耳穴按压、泡浴、西药等治疗胆系疾病,且中药联合使用治疗的有效率明显高于复方、西药、针灸和泡浴等单独使用。还有总攻疗法和新型疗法也被运用到临床治疗中,中药取得的临床效果显著。现以文献综述的方式,总结近15年来具有利胆作用的单味药以及复方的药理作用及机制和在临床中的应用,同时也发现一些目前所存在的问题并进行了展望。
Cholagogic traditional Chinese medicines refer to those that can promote bile secretion and excretion, strengthen gallbladder contraction and promote gallbladder emptying. They are mainly used to treat cholecystitis, gallstones, cholestasis, biliary tract infection, jaundice hepatitis and other diseases in clinical application. As a traditional medicine in our country, Chinese herbal medicines have many advantages, such as extensive resources, low cost, little or no toxic and side effects, and in addition, it is not easy for animals to produce drug resistance. With the progress of science and technology and the rapid development of traditional Chinese medicine, many achievements have been made in the research of cholagogic traditional Chinese medicines. Traditional Chinese medicine plays a cholagogic role mainly by promoting bile secretion, regulating SCP2 mRNA, FXR, BSEP and efflux transporter protein, dissolving cholesterol, promoting the relaxation of Oddi′s sphincter and changing the composition of bile, etc. Traditional Chinese medicine decoction, traditional Chinese medicine preparation, Chinese medicine combined with acupuncture, ear acupoint pressing, soaking bath, western medicine and alike are often used to treat biliary system diseases in clinical practice. The effective rate of combination of traditional Chinese medicine and other methods was significantly higher than that of compound prescription, western medicine, acupuncture and soaking bath alone. General attack therapy and new therapies are also used in clinical treatment. The clinical effect of traditional Chinese medicine is remarkable. By means of literature review, the pharmacological effects, mechanism and clinical application of Chinese herbal medicines and compound prescriptions with gallbladder-promoting effect in the past 15 years were summarized in this paper. At the same time, some existing problems were found and prospects were expected.

关键词(KeyWords): 中药;天然药;利胆;复方;临床应用
traditional Chinese medicine;natural medicine;choleretic;compound prescription;clinical application

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81473415);; 国家国际科技合作专项(2017ZX09301047);; 地产中药功效物质研究与利用山西省重点实验室项目(201605D111004);; 山西省重点研发计划项目(201803D31019)

作者(Author): 李渊;高晓霞;秦雪梅;
LI Yuan;GAO Xiao-xia;QIN Xue-mei;Modern Research Center for Traditional Chinese Medicine, Shanxi University;

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