中国中药杂志

2021, v.46(24) 6366-6376

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呼吸系统感染性疾病与组织“损伤-修复”平衡——病理特征、治疗与中医药特色
Respiratory infectious diseases and tissue "damage-repair" balance:pathological characteristics, treatment, and characteristics of traditional Chinese medicine

杨满丽;杜欣珂;阚晓溪;郝腾腾;冉庆森;
YANG Man-li;DU Xin-ke;KAN Xiao-xi;HAO Teng-teng;RAN Qing-sen;Nanjing University of Chinese Medicine;Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences;Xiyuan Hospital, China Academy of Chinese Medical Sciences;Postdoctoral Research Station, China Academy of Chinese Medical Sciences;Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences;

摘要(Abstract):

呼吸系统感染性疾病是引发重大突发公共安全事件的重要病种,构成了生命健康和社会发展的巨大威胁。对其有效管控、科学施治,是保证人类健康命运共同体行稳致远的关键基础。呼吸系统病毒感染性疾病虽病原多样,进程复杂,但其发病的共通病理基础以病灶免疫微环境"损伤-修复"的功能失衡为突出特征,继而引发后续的重要器官结构功能破坏。于是,在治疗上则自然应以抗病毒与调免疫并重,加强免疫损伤保护,促进病损组织功能修复为核心。上述论断是宿主导向疗法(host-directed therapies, HDT)的科学内核,也与中医药"人-病同治,正-邪互作"的理论不谋而合。在中西医理论的共同支持下,将呼吸系统病毒感染性疾病中"感染-免疫-损伤"完整病理链条与中医药的"正-邪"的动态变化进行整合,将治疗视角从人得的病转向得病的人,通过加强人因干预,维系免疫稳态,加强组织器官损伤保护,促进病损组织修复新生,便能够从根本上修正疾病状态下"损伤-修复"的失衡状态,改变疾病滋生的土壤,实现患者受益。该篇文章将专注呼吸系统感染性疾病共通关键的病理学过程,特别以病毒感染引发的免疫损伤为聚焦,寻求有效的防治策略,总结相关理论进展,梳理有效候选药物,提示未来研发方向,进而凸显中医药的治疗特色。
Respiratory infectious diseases are important diseases causing major public safety events, posing a great threat to life, health, and social development. Effective control and scientific treatment of the diseases is the key basis for ensuring the stability and long-term development of the community of a shared future for human health. Although the pathogens of respiratory viral infectious diseases are diverse and the process is complex, the common pathological basis of their pathogenesis is characterized by the "damage-repair" functional imbalance of the immune microenvironment of the lesions, which leads to the subsequent structural and functional destruction of important organs. Therefore, the treatment should focus on antivirus and immunological regulation, strengthen the protection against immune injury, and promote the functional repair of damaged tissues. The above conclusions are the scientific core of host-directed therapies(HDT), which coincides with "human-disease co-treatment and healthy qi and pathogen interaction" in traditional Chinese medicine(TCM) theories. Under the support of TCM and western medicine theories, the complete pathological chain "infection-immunity-injury" of respiratory viral infectious diseases is integrated with dynamic change in "healthy qi-pathogen" in TCM to transform the treatment focus from the diseases to the patients. It is possible to fundamentally correct the "damage-repair" imbalance in the disease state, change the environment for disease development, and bring benefits to patients by strengthening human intervention, maintaining immune homeostasis, enhancing the protection of tissues and organs, and promoting the repair and regeneration of damaged tissues. This study focused on the common and key pathological processes of respiratory infectious diseases, especially the immune damage caused by the viral infection, to seek effective prevention and treatment strategies, review relevant theoretical progress, summarize effective drug candidates, prospect future research and development, and highlight the therapeutic characteristics of TCM.

关键词(KeyWords): 呼吸系统感染疾病;“损伤-修复”平衡;宿主导向疗法;中医药治疗
respiratory infectious diseases;"damage-repair" balance;host-directed therapies;traditional Chinese medicine treatment

Abstract:

Keywords:

基金项目(Foundation): 国家“重大新药创制”科技重大专项(2017ZX09101002-002-002);; 中国中医科学院创新工程项目(CI2021A04803)

作者(Author): 杨满丽;杜欣珂;阚晓溪;郝腾腾;冉庆森;
YANG Man-li;DU Xin-ke;KAN Xiao-xi;HAO Teng-teng;RAN Qing-sen;Nanjing University of Chinese Medicine;Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences;Xiyuan Hospital, China Academy of Chinese Medical Sciences;Postdoctoral Research Station, China Academy of Chinese Medical Sciences;Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences;

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