中医药对重症急性胰腺炎细胞因子影响的研究进展
Research Progress on the Effect of Traditional Chinese Medicine on Inflammatory Factors of Severe Acute Pancreatitis
DOI: 10.12677/TCM.2023.122073, PDF,    国家自然科学基金支持
作者: 覃鹏恩, 黄梦遥, 谭 琦, 钟 丽, 李德文, 谢章瑜：广西中医药大学，广西 南宁；陈国忠*：广西中医药大学第一附属医院，广西 南宁
关键词: 重症急性胰腺炎；中医药；细胞因子；治疗；综述；Sever Acute Pancreatitis； Traditional Chinese Medicine； Cytokines； Treatment； Review
摘要: 重症急性胰腺炎(SAP)是一种起病急、进展快、治疗或手术费用高的常见临床严重消化系统疾病，病情进展中易出现多器官功能衰竭和全身炎症反应综合征，治疗手术难度系数大，预后差，死亡率高。中医药在调节SAP病情进展中相关细胞因子效果显著，且中医疗法具有治疗途径多、成本低、副作用少等突出优点，是治疗重症急性胰腺炎的有效补充疗法。探索中医药对SAP细胞因子靶向治疗方案及中医药临床治疗与调控作用机制，将能为SAP未来的防治带来科学的新思路。
Abstract: Severe acute pancreatitis is a common clinical digestive disease with rapid onset, rapid progres-sion and high treatment cost. Systemic inflammatory response syndrome and multiple organ failure are prone to occur in the progression of the disease, with high difficulty of treatment, poor prognosis and high mortality. Chinese medicine has a significant effect on regulating the progression of SAP related cytokines, and Chinese medicine therapy has many therapeutic approaches, low cost, fewer side effects and other advantages, which is an effective complementary therapy for severe acute pancreatitis. Research on the influence of TCM on the course of SAP and the mechanism of action will bring new ideas for the prevention and treatment of SAP in the future.
文章引用：覃鹏恩, 陈国忠, 黄梦遥, 谭琦, 钟丽, 李德文, 谢章瑜. 中医药对重症急性胰腺炎细胞因子影响的研究进展[J]. 中医学, 2023, 12(2): 481-489. https://doi.org/10.12677/TCM.2023.122073

参考文献

[1] Lee, P.J. and Papachristou, G.I. (2019) New Insights into Acute Pancreatitis. Nature Reviews Gastroenterology & Hepatology, 16, 479-496. [Google Scholar] [CrossRef] [PubMed]
[2] Gao, L., Dong, X., Gong, W., Huang, W., et al. (2021) Acinar Cell NLRP3 Inflammasome and Gasdermin D (GSDMD) Activation Mediates Pyroptosis and Systemic Inflammation in Acute Pancreatitis. British Journal of Pharmacology, 178, 3533-3552. [Google Scholar] [CrossRef] [PubMed]
[3] Boxhoorn, L., Voermans, R.P., Bouwense, S.A., Bruno, M.J., et al. (2020) Acute Pancreatitis. The Lancet, 396, 726-734. [Google Scholar] [CrossRef] 
[4] Wang, X.D., Yu, W.L. and Sun, Y. (2021) Activation of AMPK Restored Impaired Autophagy and Inhibited Inflammation Reaction by Up-Regulating SIRT1 in Acute Pancreatitis. Life Sciences, 277, 119435. [Google Scholar] [CrossRef] [PubMed]
[5] Bansod, S., Chilvery, S., Saifi, M.A., et al. (2021) Borneol Protects against Cerulein-Induced Oxidative Stress and Inflammation in Acute Pancreatitis Mice Model. Environmental Toxicology, 36, 530-539. [Google Scholar] [CrossRef] [PubMed]
[6] 汤国军, 童骎, 胡丛岗, 吴俊, 姚叶峰. 急性胰腺炎患者腹腔感染血清炎症因子与Ghrelin及影响因素分析[J]. 中华医院感染学志, 2019, 29(4): 586-588+593.
[7] 崔乃强. 中西医结合治疗胰腺炎临床与基础研究[M]. 武汉: 华中科技大学出版社, 2009: 91.
[8] 吴瑕, 彭飞燕, 张天彬, 陈国忠. 清解化攻法浅析[J]. 辽宁中医杂志, 2020, 47(6): 43-45.
[9] 宋杰, 银艳桃, 雷力民, 林寿宁, 王建超, 廖健思. 中医药从“瘀”论治急性胰腺炎微循环障碍研究进展[J]. 辽宁中医药大学学报, 2020, 22(8): 62-66.
[10] Ou, X., Hua, Y., Liao, X., et al. (2018) Cognitive Impairments Induced by Severe Acute Pancreatitis Are Attenuated by Berberine Treatment in Rats. Molecular Medicine Reports, 18, 3437-3444. [Google Scholar] [CrossRef] [PubMed]
[11] Du, D., Hu, L., Wu, J., et al. (2017) Neuroinflammation Contributes to Autophagyflux Blockage in the Neurons of Rostral Ventrolateral Medulla in Stress-Induced Hypertension Rats. Journal of Neuroinflammation, 14, 169. [Google Scholar] [CrossRef] [PubMed]
[12] 曹东升. 甘遂对重症急性胰腺炎患者炎症细胞因子影响的研究[D]: [硕士学位论文]. 广州: 广州中医药大学, 2014.
[13] 赵祥. 甘遂对重症急性胰腺炎炎症“瀑布效应”相关因子影响的研究[D]: [硕士学位论文]. 广州: 广州中医药大学, 2016.
[14] 项红, 胡凤林, 陶旭锋, 齐心, 张金楠, 尚东. 茵陈蒿汤调控lncRNA PVT1/miRNA-30a-5p信号通路对重症急性胰腺炎大鼠模型的保护作用[J]. 临床肝胆病杂志, 2021, 37(1): 147-152.
[15] 张洁慧, 肖铁刚, 阙任烨, 赵思宇, 傅志泉. 大承气汤治疗胃肠功能障碍的临床及作用机制研究进展[J]. 中国中西医结合消化杂志, 2019, 27(1): 72-76.
[16] 付娟, 陆俊, 宋倩, 姜朝丽, 李志. 柴黄清胰活血颗粒对重症急性胰腺炎患者血清炎症因子的影响及机制研究[J]. 西南军医, 2021, 23(3): 215-218.
[17] Liu, Y., Chen, X.D., Yu, J., et al. (2017) Deletion of XIAP Reduces the Severity of Acute Pancreatitis via Regulation of Cell Death and Nuclear Factor-κB Activity. Cell Death & Disease, 8, e2685. [Google Scholar] [CrossRef] [PubMed]
[18] Wang, B., Zhao, K.L., Hu, W.J., et al. (2019) Macrophage Migration Inhibitor Promoted the Intrahepatic Bile Duct Injury in Rats with Severe Acute Pancreatitis. Digestive Diseases and Sciences, 64, 759-772. [Google Scholar] [CrossRef] [PubMed]
[19] Song, G., Ma, Z., Liu, D., et al. (2019) Bone Marrow-Derived Mesenchymal Stem Cells Ameliorate Severe Acute Pancreatitis by Inhibiting Necroptosis in Rats. Molecular and Cellular Biochemistry, 459, 7-19. [Google Scholar] [CrossRef] [PubMed]
[20] Zhao, X., Jin, B., Yang, B., et al. (2017) Gadolinium Chloride Ameliorates Acute Lung Injury Associated with Severe Acute Pancreatitis in Rats by Regulating CYLD/NF-κB Signaling. Biochemical and Biophysical Research Communications, 492, 255-261. [Google Scholar] [CrossRef] [PubMed]
[21] 黄力强, 曾悦, 庄倩, 罗静雅, 王璐璐, 范玲, 熊玉霞. 大黄游离蒽醌抑制NLRP3/Caspase-1通路改善大鼠重症急性胰腺炎肝损伤的研究[J]. 中药药理与临床, 2021, 37(5): 54-59.
[22] Zhang, X.H., Li, M.L., Wang, B., et al. (2014) Caspase-1 Inhibition Alleviates Acute Renal Injury in Rats with Severe Acute Pancreatitis. World Journal of Gastroenterology, 20, 10457-10463. [Google Scholar] [CrossRef] [PubMed]
[23] Strowig, T., Henao-Mejia, J., Elinav, E. and Flavell, R. (2012) Inflammasomes in Health and Disease. Nature, 481, 278-286. [Google Scholar] [CrossRef] [PubMed]
[24] Ding, J., Wang, K., Liu, W., et al. (2016) Erratum: Pore-Forming Activity and Structural Autoinhibition of the Gasdermin Family. Nature, 540, 150. [Google Scholar] [CrossRef] [PubMed]
[25] Lin, T., Song, J., Pan, X., et al. (2021) Downregulating Gasdermin D Reduces Severe Acute Pancreatitis Associated with Pyroptosis. Medical Science Monitor, 27, e927968. [Google Scholar] [CrossRef] 
[26] Lin, T., Pan, X., Wan, Y., et al. (2021) Mechanism of Gasdermin D on Intestinal Injury in Severe Acute Pancreatitis by Mediating Pyroptosis. Chinese Critical Care Medicine, 33, 89-94.
[27] Wan, J., Chen, J., Wu, D., et al. (2018) Regulation of Autophagy Affects the Prognosis of Mice with Severe Acute Pancreatitis. Digestive Diseases and Sciences, 63, 2639-2650. [Google Scholar] [CrossRef] [PubMed]
[28] Yang, G.H. (2018) Early Chinese Medicine Intervention and Mechanism of Acute Pancreatitis. Journal of Clinical Hepatology, 34, 710-715.
[29] 宁建文. Caspase-1信号通路在重症急性胰腺炎肠黏膜屏障损伤保护中作用和分子机制研究[D]: [硕士学位论文]. 杭州: 浙江大学, 2019.
[30] Molla, M.D., Akalu, Y., Geto, Z., et al. (2020) Role of Caspase-1 in the Pathogenesis of Inflammato-ry-Associated Chronic Noncommunicable Diseases. Journal of Inflammation Research, 13, 749-764. [Google Scholar] [CrossRef] 
[31] 戴奇成, 姚常柏, 陈文娜. 丹参注射液对急性胰腺炎大鼠血清肿瘤坏死因子α变化的研究[J]. 辽宁中医药大学学报, 2016, 18(6): 29-31.
[32] 钟宏, 史勇, 李观强. TNF-α和IL-6在重症急性胰腺炎患者血清中的变化及临床意义[J]. 中国医药导报, 2012, 9(19): 157-158.
[33] Liu, G., Zhang, J., Chen, H., et al. (2014) Effects and Mechanisms of Alveolar Type II Epithelial Cell Apoptosis in Severe Pancreatitis-Induced Acute Lung Injury. Experimental and Therapeutic Medicine, 7, 565-572. [Google Scholar] [CrossRef] [PubMed]
[34] Zhang, J.-W., Zhang, G.-X., Chen, H.-L., et al. (2015) Therapeutic Effect of Qingyi Decoction in Severe Acute Pancreatitis-Induced Intestinal Barrier Injury. World Journal of Gastroenterology, 21, 3537-3546. [Google Scholar] [CrossRef] [PubMed]
[35] Jin, W. and Shen, Y. (2019) Da-Cheng-Qi Decoction Alleviates Intestinal Injury in Rats with Severe Acute Pancreatitis by Inhibiting the JAK2-STAT3 Signaling Pathway. Evi-dence-Based Complementary and Alternative Medicine, 2019, Article ID: 3909468. [Google Scholar] [CrossRef] [PubMed]
[36] Pan, L.-Y., Chen, Y.-F., Li, H.-C., et al. (2017) Dachengqi Decoction Attenuates Intestinal Vascular Endothelial Injury in Severe Acute Pancreatitis in Vitro and in Vivo. Cellular Physiology and Biochemistry, 44, 2395-2406. [Google Scholar] [CrossRef] [PubMed]
[37] 丁黎莉. 白介素-37通过髓源性抑制细胞影响急性胰腺炎炎症反应的机制研究[D]: [硕士学位论文]. 长春: 吉林大学, 2021.
[38] Rao, S.P. and Kunte, A. (2017) Interleukin-6: An Early Predictive Marker for Severity of Acute Pancreatitis. Indian Journal of Critical Care Medicine, 21, 424-428. [Google Scholar] [CrossRef] 
[39] 鲁蕾, 殷海波. 生大黄保留灌肠对急性胰腺炎患者IL-6、hs-CRP及血清内毒素的影响[J]. 中国中医基础医学杂志, 2017, 23(3): 408-410.
[40] 朱晶晶. 中药保留灌肠联合芒硝外敷辅助治疗重症急性胰腺炎的疗效观察及对TNF-α、IL-6的影响[J]. 中国中医药科技, 2022, 29(2): 242-243+349.
[41] 黄福霞, 韩晓玲, 蔡晖. 大承气汤高位灌肠改善急性胰腺炎肠黏膜屏障和炎症反应的临床研究[J]. 护理研究, 2019, 33(6): 1072-1074.
[42] Granger, J. and Remick, D. (2005) Acute Pancreatitis: Models, Markers, and Mediators. Shock, 24, 45-51. [Google Scholar] [CrossRef] [PubMed]
[43] Chen, W.C. and Nie, J.S. (2008) Genetic Polymorphism of MCP-1-2518, IL-8-251 and Susceptibility to Acute Pancreatitis: A Pilot Study in Population of Suzhou, China. World Journal of Gastroenterology, 14, 5744-5748. [Google Scholar] [CrossRef] [PubMed]
[44] 雷云洁, 杨晋辉. IL-8与自身免疫性肝病的关系[J]. 临床肝胆病杂志, 2019, 35(2): 411-413.
[45] Weitz, G., Woitalla, J., Wellhöner, P., et al. (2015) Does Etiology of Acute Pancreatitis Matter? A Review of 391 Consecutive Episodes. JOP, 16, 171-175.
[46] 嵇天一. IL-8在重症急性胰腺炎肺损伤发病机制中的作用及清胰颗粒干预的实验研究[D]: [硕士学位论文]. 大连: 大连医科大学, 2018.
[47] 李波, 陈国兵, 葛利. 中药清胰汤对于急性坏死性胰腺炎血清白细胞介素-6和8及凝血功能的影响[J]. 中华中医药学刊, 2018, 36(4): 887-889.
[48] Yoshimoto, T., Mizutani, H., Tsutsui, H., et al. (2000) IL-18 Induction of IgE: Dependence on CD4+ T Cells, IL-4 and STAT6. Nature Immunology, 1, 132-137. [Google Scholar] [CrossRef] [PubMed]
[49] Li, Z., Yu, X., Werner, J., et al. (2019) The Role of Interleukin-18 in Pancreatitis and Pancreatic Cancer. Cytokine and Growth Factor Reviews, 50, 1-12. [Google Scholar] [CrossRef] [PubMed]
[50] 莫艳波, 王静, 李新. 急性胰腺炎患者检测血清IL-18、TNF-α、IL-10的临床意义[J]. 河北联合大学学报(医学版), 2013, 15(1): 12-13. [Google Scholar] [CrossRef] 
[51] 李劼, 陈亚峰, 奉典旭. 大承气汤对胰腺白介素18表达的影响[J]. 时珍国医国药, 2020, 31(11): 2681-2684.
[52] Tian, F., Lin, T., Zhu, Q., et al. (2022) Correlation between Severity of Illness and Levels of Free Triiodothyronine, Interleukin-6, and Interleukin-10 in Patients with Acute Pancreatitis. Medical Science Monitor, 28, e933230. [Google Scholar] [CrossRef] 
[53] 解松龄, 蒋正, 赵涛, 等. 辅助性T细胞17及其细胞因子在急性胰腺炎患者诊治中的作用[J]. 中华肝胆外科杂志, 2020, 26(2): 134-138.
[54] 杨兴华. 清胰汤对大鼠急性坏死性胰腺炎IL-6, IL-10及肠道通透性影响[D]: [硕士学位论文]. 青岛: 青岛大学, 2011.
[55] 尚丽, 李秀丽, 马少未, 梁晓敏, 王芬. 加减大陷胸汤保留灌肠对急性胰腺炎患者血清肿瘤坏死因子-α与白介素-6及白介素-10水平影响研究[J]. 四川中医, 2017, 35(9): 44-47.