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肝纤维化的发病机制和药物治疗现况

Pathogenesis of liver fibrosis and its treatment status

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【作者】 夏海珊陈少茹钟月春吕思敏陈丽思黄志荣吴铁邹丽宜

【Author】 XIA Haishan;CHEN Shaoru;ZHONG Yuechun;LU Simin;CHEN Lisi;HUANG Zhirong;WU Tie;ZOU Liyi;School of Pharmacy, Guangdong Medical College;

【机构】 广东医学院药学院

【摘要】 为了解目前肝纤维化的发病机制及药物治疗现状,为临床及基础研究提供科学的方法及研究方向,本文综合国内外与肝纤维化的发病及治疗的相关文献40多篇,简要地阐述了医药界治疗肝纤维化的概况以及肝纤维化的发病机制,并总结了甘草次酸的主要药理作用,发现目前对肝纤维化的发病机制主要集中在肝星形细胞(HSCs)激活和转化为肌成纤维细胞与成纤维细胞、TGF-β信号转导、PDGF受体介导的信号转导通路、TNF-α介导的信号转导通路以及COX-2、ECM介导的肝纤维化、氧化应激介导的肝纤维化发生和发展。西医疗效还不十分理想,加上药物价格昂贵,不良反应大、阻碍了肝纤维化治疗的发展。而中医药治疗肝纤维化有其独特优势,不仅从单方面治疗肝纤维化,还兼顾脾肾等器官的保护,注重整体调理,辨证论治,中药治疗还具有价格优势,不良反应少等优点,值得研究。甘草次酸具有抗炎抗免疫作用、肾上腺皮质激素样作用、抗病毒、抗氧化、体外抑菌及保肝作用,并治疗肝纤维化提供了强而有力的依据,但甘草次酸治疗肝纤维化通过哪个途径进行仍然是现代医药研究热点和未知点。

【Abstract】 To study the pathogenesis of liver fibrosis and the present situation of disease treatment, provide the sci-entific methods and research direction for clinical and basic research, this summarize integrated both at home and abroad related to the pathogenesis and treatment of liver fibrosis with 40 references to expounds the pathogenesis and treatment of liver fibrosis. And sums up the main pharmacological action of glycyrrhetinic acid. In a nutshell, the pathogenesis of hepatic fibrosis currently focused on hepatic stellate cells(HSCs) activation and into muscle fiber cells and fibroblasts, TGF-β decide signal transduction, PDGF signal transduction pathways, TNF-α mediated signal transduction pathways and COX-2, ECM mediated hepatic fibrosis and oxidative stress. On one hand, the current drug has not good effect on it, on the other hand, the expensive drug prices, side effects and adverse reactions, had hindered the development of liver fibrosis treatment. But Chinese medicine has its unique effect in treating liver fibrosis, not only from the unilateral treatment of liver fibrosis, also protect spleen kidney and other organs, and Chinese medicine treat-ment has price advantage, such as less adverse reaction, is worth studying. Glycyrrhetinic acid with good effect on an-ti-inflammatory immune function, adrenal cortical hormone kind function, antivirus, resistance to oxidation, in vitro antibacterial and protect liver function, and treatment of liver fibrosis, but the mechanism of glycyrrhetinic acid on the liver fibrosis is still unknown and worth to study.

【关键词】 肝纤维化; 发病机制; 药物治疗; 甘草次酸;

【Key words】 Liver fibrosis; Pathogenesis; Drug therapy; Glycyrrhetinic acid;

【分类号】R256.49;R364;R986;

【基金】 广东医学院科研项目(编号Q2012011)

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