镇痛中药的研究进展
Research Progress of Analgesic Chinese Medicine
DOI: 10.12677/pi.2025.143019, PDF,   
作者: 周春燕, 张梦焦, 李 霁*:昆明医科大学药学院暨云南省天然药物药理重点实验室,云南 昆明;云南省现代生物医药产业学院,云南 昆明;刘 勤:云南省食品药品监督检验研究院生物制品检定所,云南 昆明;刘玉苹*:昆明医科大学药学院暨云南省天然药物药理重点实验室,云南 昆明
关键词: 镇痛中药活性成分应用领域药学研究Analgesic Traditional Chinese Medicine Active Ingredient Application Field Pharmaceutical Research
摘要: 疼痛是医学领域重点关注问题,WHO推荐的西医药物缓解疼痛存在局限性,开发新型镇痛药物成为重要方向。中医药在疼痛治疗中不良反应少,长期使用安全性高,日益受到关注。中药活性成分包括生物碱类、黄酮类、皂苷类和香豆素等,具有多靶点作用特点。镇痛中药广泛应用于神经性疼痛的系统调控、偏头痛的递质网络调节、原发性痛经的多维度干预等领域。本文从上述两方面以及药学研究方面(物质基础、质量控制、药效作用及药物代谢动力学)进行阐述,为开发新型镇痛药物提供参考。
Abstract: Pain is a key issue in the medical field. The western medicine recommended by the WHO for pain relief has limitations. Developing new analgesic drugs has become an important direction. Traditional Chinese medicine which has fewer adverse reactions in pain treatment and high safety for long-term use is increasingly attracting attention. The analgesic active ingredients of traditional Chinese medicine include alkaloids, flavonoids, saponins, coumarins, and so on. They have the characteristics of multi-target action. In addition, this analgesic Chinese medicine is widely used in the systematic regulation of neuropathic pain, the regulation of neurotransmitter networks in migraines, and multi-dimensional intervention in primary dysmenorrhea, etc. This article elaborates on the above two aspects and the pharmaceutical research aspects (material basis, quality control, pharmacological effects, and pharmacokinetics), in order to provide a reference for the development of new analgesic drugs.
文章引用:周春燕, 刘勤, 张梦焦, 刘玉苹, 李霁. 镇痛中药的研究进展[J]. 药物资讯, 2025, 14(3): 154-161. https://doi.org/10.12677/pi.2025.143019

参考文献

[1] Raja, S.N., Carr, D.B., Cohen, M., Finnerup, N.B., Flor, H., Gibson, S., et al. (2020) The Revised International Association for the Study of Pain Definition of Pain: Concepts, Challenges, and Compromises. Pain, 161, 1976-1982. [Google Scholar] [CrossRef] [PubMed]
[2] Zhu, X., Jia, Z., Zhou, Y., Wu, J., Cao, M., Hu, C., et al. (2024) Current Advances in the Pain Treatment and Mechanisms of Traditional Chinese Medicine. Phytotherapy Research, 38, 4114-4139. [Google Scholar] [CrossRef] [PubMed]
[3] Kong, X., Chen, Z., Xia, Y., Liu, E.Y.L., Ren, H., Wang, C., et al. (2020) Dehydrocorydaline Accounts the Majority of Anti‐Inflammatory Property of Corydalis Rhizoma in Cultured Macrophage. Evidence-Based Complementary and Alternative Medicine, 2020, Article ID: 4181696. [Google Scholar] [CrossRef] [PubMed]
[4] Alhassen, L., Dabbous, T., Ha, A., Dang, L.H.L. and Civelli, O. (2021) The Analgesic Properties of Corydalis Yanhusuo. Molecules, 26, Article No. 7498. [Google Scholar] [CrossRef] [PubMed]
[5] Wang, F.L., Wang, H., Wang, J.H., Wang, D.X., Gao, Y., Yang, B., et al. (2021) Analgesic and Anti‐Inflammatory Activities of Sophocarpine from Sophora viciifolia Hance. BioMed Research International, 2021, Article ID: 8893563. [Google Scholar] [CrossRef] [PubMed]
[6] Turabekova, M.A., Rasulev, B.F., Levkovich, M.G., Abdullaev, N.D. and Leszczynski, J. (2008) Aconitum and Delphinium Sp. Alkaloids as Antagonist Modulators of Voltage-Gated Na+ Channels. AM1/DFT Electronic Structure Investigations and QSAR Studies. Computational Biology and Chemistry, 32, 88-101. [Google Scholar] [CrossRef] [PubMed]
[7] Ou, S., Zhao, Y., Xiao, Z., Wen, H., Cui, J. and Ruan, H. (2011) Effect of Lappaconitine on Neuropathic Pain Mediated by P2X3 Receptor in Rat Dorsal Root Ganglion. Neurochemistry International, 58, 564-573. [Google Scholar] [CrossRef] [PubMed]
[8] 吴攀锋, 方居正. 马钱子药理毒理作用及减毒机理研究进展[J]. 江苏中医药, 2024, 56(3): 81-85.
[9] Anjaneyulu, M. and Chopra, K. (2004) Quercetin Attenuates Thermal Hyperalgesia and Cold Allodynia in STZ-Induced Diabetic Rats. Indian Journal of Experimental Biology, 42, 766-769.
[10] Çivi, S., Emmez, G., Dere, Ü.A., Börcek, A.Ö. and Emmez, H. (2016) Effects of Quercetin on Chronic Constriction Nerve Injury in an Experimental Rat Model. Acta Neurochirurgica, 158, 959-965. [Google Scholar] [CrossRef] [PubMed]
[11] Borghi, S.M., Mizokami, S.S., Pinho-Ribeiro, F.A., Fattori, V., Crespigio, J., Clemente-Napimoga, J.T., et al. (2018) The Flavonoid Quercetin Inhibits Titanium Dioxide TiO2-Induced Chronic Arthritis in Mice. The Journal of Nutritional Biochemistry, 53, 81-95. [Google Scholar] [CrossRef] [PubMed]
[12] Chen, S., Xue, W., Wu, Z., Lu, D., Zheng, L., Zhou, M., et al. (2025) Quercetin, a Compound of the Total Flavonoids of Periploca forrestii Schltr., Ameliorates Rheumatoid Arthritis by Targeting TNF-α. Journal of Inflammation Research, 18, 2879-2898. [Google Scholar] [CrossRef] [PubMed]
[13] Hernandez‐Leon, A., Fernández‐Guasti, A. and González‐Trujano, M.E. (2015) Rutin Antinociception Involves Opioidergic Mechanism and Descending Modulation of Ventrolateral Periaqueductal Grey Matter in Rats. European Journal of Pain, 20, 274-283. [Google Scholar] [CrossRef] [PubMed]
[14] Sun, C., Wei, J. and Bi, L. (2017) Rutin Attenuates Oxidative Stress and Proinflammatory Cytokine Level in Adjuvant Induced Rheumatoid Arthritis via Inhibition of NF-κB. Pharmacology, 100, 40-49. [Google Scholar] [CrossRef] [PubMed]
[15] Zheng, R., Shen, H., Li, J., Zhao, J., Lu, L., Hu, M., et al. (2023) Qi Gong Wan Ameliorates Adipocyte Hypertrophy and Inflammation in Adipose Tissue in a PCOS Mouse Model through the Nrf2/HO-1/Cyp1b1 Pathway: Integrating Network Pharmacology and Experimental Validation in Vivo. Journal of Ethnopharmacology, 301, Article ID: 115824. [Google Scholar] [CrossRef] [PubMed]
[16] Pinho-Ribeiro, F.A., Zarpelon, A.C., Fattori, V., Manchope, M.F., Mizokami, S.S., Casagrande, R., et al. (2016) Naringenin Reduces Inflammatory Pain in Mice. Neuropharmacology, 105, 508-519. [Google Scholar] [CrossRef] [PubMed]
[17] Kaku, T., Miyata, T., Uruno, T., Sako, I. and Kinoshita, A. (1975) Chemico-Pharmacological Studies on Saponins of Panax ginseng C. A. Meyer. II. Pharmacological Part. Arzneimittelforschung, 25, 539-547.
[18] Li, Y., Chen, C., Li, S. and Jiang, C. (2019) Ginsenoside Rf Relieves Mechanical Hypersensitivity, Depression‐Like Behavior, and Inflammatory Reactions in Chronic Constriction Injury Rats. Phytotherapy Research, 33, 1095-1103. [Google Scholar] [CrossRef] [PubMed]
[19] Lee, G., Choi, J., Nam, Y., Song, M., Kim, J.K., Kim, W.J., et al. (2019) Identification and Characterization of Saikosaponins as Antagonists of Transient Receptor Potential A1 Channel. Phytotherapy Research, 34, 788-795. [Google Scholar] [CrossRef] [PubMed]
[20] Ahmadimoghaddam, D., Zarei, M., Mohammadi, S., Izadidastenaei, Z. and Salehi, I. (2021) Bupleurum falcatum L. Alleviates Nociceptive and Neuropathic Pain: Potential Mechanisms of Action. Journal of Ethnopharmacology, 273, Article ID: 113990. [Google Scholar] [CrossRef] [PubMed]
[21] 郭玺, 刘盼茹, 唐乙朝, 等. 三七皂苷成分及临床药理作用研究进展[J]. 南京中医药大学学报, 2024, 40(9): 985-992.
[22] Chen, W.-Y., et al. (2021) Comparison of Plasma and Pulmonary Availability of Chlorogenic Acid, Forsythiaside a and Baicalin after Intratracheal and Intravenous Administration of Shuang-Huang-Lian Injection. Journal of Ethnopharmacology, 274, Article ID: 114082. [Google Scholar] [CrossRef] [PubMed]
[23] Wang, S., Zang, W., Zhao, X., Feng, W., Zhao, M., He, X., et al. (2013) Effects of Borneol on Pharmacokinetics and Tissue Distribution of Notoginsenoside R1 and Ginsenosides Rg1 and Re in Panax notoginseng in Rabbits. Journal of Analytical Methods in Chemistry, 2013, Article ID: 706723. [Google Scholar] [CrossRef] [PubMed]
[24] Wu, G. and Wu, H. (2014) Analgesia Synergism of Essential Oil from Pericarp of Zanthoxylum schinifolium and Verapamil. Evidence-Based Complementary and Alternative Medicine, 2014, Article ID: 505876. [Google Scholar] [CrossRef] [PubMed]
[25] 王丽赟, 孙健, 陈梦莹, 等. 不同产区白芷遗传多样性和品质特征[J]. 浙江农林大学学报, 2023, 40(1): 30-37.
[26] 韩彦琪, 孟凡翠, 许浚, 等. 基于网络药理学方法的元胡止痛滴丸治疗原发性痛经的配伍合理性研究[J]. 中草药, 2017, 48(3): 526-532.
[27] 齐鑫, 陈欣, 安文博, 等. 基于HMGB1/TLR4/NF-κB信号通路研究藁本内酯衍生物抑制IL-1β诱导的大鼠软骨细胞凋亡和炎症反应的作用机制[J]. 中国中药杂志, 2024, 49(4): 1007-1016.
[28] Latief, N., Anand, S., Lingaraju, M.C., Balaganur, V., Pathak, N.N., Kalra, J., et al. (2015) Effect of Trimeric Myricetin Rhamnoside (TMR) in Carrageenan‐Induced Inflammation and Caecal Ligation and Puncture‐Induced Lung Oxidative Stress in Mice. Phytotherapy Research, 29, 1798-1805. [Google Scholar] [CrossRef] [PubMed]
[29] Guo, W., Zhang, J. and Feng, Y. (2024) Treatment of Neuropathic Pain by Traditional Chinese Medicine: An Updated Review on Their Effect and Putative Mechanisms of Action. Phytotherapy Research, 38, 2962-2992. [Google Scholar] [CrossRef] [PubMed]
[30] 文蕊鑫, 王泽, 陈玥雯, 等. 基于药物转运体的元胡止痛方药效成分延胡索乙素、巴马汀、原阿片碱、欧前胡素和异欧前胡素跨血脑屏障机制研究[J]. 药物评价研究, 2023, 46(3): 552-558.
[31] Gao, C., Zhao, Y., Yang, T., Gao, X. and Meng, C. (2023) Duhuo Jisheng Decoction Alleviates Neuroinflammation and Neuropathic Pain by Suppressing Microglial M1 Polarization: A Network Pharmacology Research. Journal of Orthopaedic Surgery and Research, 18, Article No. 629. [Google Scholar] [CrossRef] [PubMed]
[32] Guo, Q., Mizuno, K., Okuyama, K., Lin, N., Zhang, Y., Hayashi, H., et al. (2020) Antineuropathic Pain Actions of Wu-Tou Decoction Resulted from the Increase of Neurotrophic Factor and Decrease of CCR5 Expression in Primary Rat Glial Cells. Biomedicine & Pharmacotherapy, 123, Article ID: 109812. [Google Scholar] [CrossRef] [PubMed]
[33] 徐俊涛, 王丽, 王莹, 等. 基于EphrinBs/EphBs通路探讨桃红四物汤治疗带状疱疹后遗神经痛大鼠模型的作用机制[J]. 天津医药, 2021, 49(2): 147-152.
[34] Rajapakse, T. and Davenport, W.J. (2019) Phytomedicines in the Treatment of Migraine. CNS Drugs, 33, 399-415. [Google Scholar] [CrossRef] [PubMed]
[35] 温维, 张梅奎. 中药治疗偏头痛的研究进展[J]. 中国现代医药杂志, 2013, 15(12): 111-114.
[36] 魏燕飞. 疏肝活血法治疗月经期偏头痛56例[J]. 光明中医, 2017, 32(23): 3437-3439.
[37] Liu, L., Li, H., Wang, Z., Yao, X., Xiao, W. and Yu, Y. (2024) Exploring the Anti-Migraine Effects of Tianshu Capsule: Chemical Profile, Metabolic Behavior, and Therapeutic Mechanisms. Phytomedicine, 131, Article ID: 155766. [Google Scholar] [CrossRef] [PubMed]
[38] Cao, K., Han, F., Lin, A., Yang, W., Zhao, J., Zhang, H., et al. (2016) Zhengtian Capsule versus Flunarizine in Patients with Migraine: A Multi-Center, Double-Blind, Double-Dummy, Randomized Controlled, Non-Inferior Clinical Trial. BMC Complementary and Alternative Medicine, 16, Article No. 356. [Google Scholar] [CrossRef] [PubMed]
[39] Harel, Z. (2012) Dysmenorrhea in Adolescents and Young Adults: An Update on Pharmacological Treatments and Management Strategies. Expert Opinion on Pharmacotherapy, 13, 2157-2170. [Google Scholar] [CrossRef] [PubMed]
[40] Lee, H., Choi, T., Myung, C., Lee, J.A. and Lee, M.S. (2016) Herbal Medicine (Shaofu Zhuyu Decoction) for Treating Primary Dysmenorrhea: A Systematic Review of Randomized Clinical Trials. Maturitas, 86, 64-73. [Google Scholar] [CrossRef] [PubMed]
[41] Li, G., Liu, A., Lin, M., Liao, S. and Wen, Z. (2020) Chinese Herbal Formula Siwutang for Treating Primary Dysmenorrhea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Maturitas, 138, 26-35. [Google Scholar] [CrossRef] [PubMed]
[42] Lee, H.W., Jun, J.H., Kil, K., Ko, B., Lee, C.H. and Lee, M.S. (2016) Herbal Medicine (Danggui Shaoyao San) for Treating Primary Dysmenorrhea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Maturitas, 85, 19-26. [Google Scholar] [CrossRef] [PubMed]
[43] Man, S., Zhang, X., Xie, L., Zhou, Y., Wang, G., Hao, R., et al. (2024) A New Insight into Material Basis of Rhizoma Paridis Saponins in Alleviating Pain. Journal of Ethnopharmacology, 323, Article ID: 117642. [Google Scholar] [CrossRef] [PubMed]
[44] 李家琦, 高远, 张文平, 等. 中药活性成分镇痛机制及其应用[J]. 生命的化学, 2024, 44(11): 2054-2066.
[45] 蒋运斌, 黄婷, 陈瑞鑫, 等. 基于“以药制药”理念探讨甘草制对细辛毒效的影响[J]. 西南大学学报(自然科学版), 2023, 45(7): 97-106.
[46] Li, B., Ge, J., Liu, W., Hu, D. and Li, P. (2021) Unveiling Spatial Metabolome of Paeonia suffruticosa and Paeonia lactiflora Roots Using MALDI MS Imaging. New Phytologist, 231, 892-902. [Google Scholar] [CrossRef] [PubMed]
[47] Huang, Y., Ma, J., Bian, Y., Bai, Q., Gao, Y., Di, S., et al. (2024) TRPV1 Analgesics Disturb Core Body Temperature via a Biased Allosteric Mechanism Involving Conformations Distinct from That for Nociception. Neuron, 112, 1815-1831.e4. [Google Scholar] [CrossRef] [PubMed]
[48] 国家药典委员会. 中华人民共和国药典: 一部[M]. 北京: 中国医药科技出版社, 2020.
[49] 张璟, 陈蒙蒙, 蒲时, 等. 雷公藤中雷公藤甲素、雷公藤吉碱和次碱的高效液相色谱-电喷雾串联质谱分析方法[J]. 农药学学报, 2018, 20(2): 197-203.
[50] 国家药典委员会. 中华人民共和国药典: 四部[M]. 北京: 中国医药科技出版社, 2020.
[51] Wang, J.B. and Mantsch, J.R. (2012) l-Tetrahydropalamatine: A Potential New Medication for the Treatment of Cocaine Addiction. Future Medicinal Chemistry, 4, 177-186. [Google Scholar] [CrossRef] [PubMed]
[52] Chen, Z., Hu, L., Liao, Y., Zhang, X., Yang, Z., Hu, C., et al. (2020) Different Processed Products of Curcumae Radix Regulate Pain-Related Substances in a Rat Model of Qi Stagnation and Blood Stasis. Frontiers in Pharmacology, 11, Article No. 242. [Google Scholar] [CrossRef] [PubMed]
[53] 钟杰, 王海南, 马越鸣. 中药药物代谢动力学在中药新药研究中的作用[J]. 中国临床药理学与治疗学, 2010, 15(3): 241-246.