泽泻降血脂研究概况
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摘要
泽泻利水渗湿,泄热,化浊降脂,具有显著降脂作用。泽泻水提取物、醇提取物均具有降脂作用,主要为泽泻醇类物质在降脂过程中作用关键,以泽泻醇A最为主要;可能与基因干预、氧化还原、改善微循环及外周阻力,抑制三酰甘油吸收等有关。涉及泽泻方剂众多,降脂研究以出自《金匮要略》的泽泻汤(泽泻五两,白术二两)最为广泛,降脂作用与组方及药物配伍比例等均有关。泽泻汤水煎剂可抑制实验小鼠Hmgcr、Srebf2等基因表达,调节胆固醇合成与代谢基因表达,抑制胆固醇合成,从而降低TC、TG水平,起到降脂作用。泽泻与白术配比动物实验5:2比例降血脂效果最明显,2:1次之;亦有临床报告1:1配比疗效优于5:2。单味泽泻水煎剂和复方煎剂均能影响胆固醇代谢与基因表达,泽泻汤降脂优于单纯泽泻水提取物,单味白术水煎剂对胆固醇代谢基因表达无影响,白术可加强泽泻降脂功效,临床治疗常根据具体病情辨证加减,效果显著。未来可深入挖掘泽泻及相关复方治疗高血脂症等代谢疾病的独特优势,探索作用机制。
Alisma orientalis has remarkable effect of reducing lipid by diffusing moisture, releasing heat,removing turbidity and reducing lipid. The water extract and alcohol extract of alisma orientalis have the effect of lowering lipid, which is mainly the key of alisma alcohol in the process of lowering lipid, and alisma alcohol A is the most important. It may be related to gene intervention, redox, improving microcirculation and peripheral resistance, and inhibiting the absorption of triglyceride. There are many prescriptions related to Alisma orientalis. The research on lipid-lowering is most extensive in alisma orientalis decoction from "Synopsis of the Golden Chamber". The effect of lipid-lowering is related to the proportion of prescriptions and medicines. Alisma orientalis decoction can inhibit the expression of Hmgcr, Srebf2 and other genes,regulate the expression of cholesterol synthesis and metabolism genes, inhibit cholesterol synthesis, thereby reducing the levels of TC and TG, and play a role in reducing lipid. The 5 : 2 ratio of alisma orientalis and atractylodes macrocephala has the most obvious effect on reducing blood lipid, followed by 2 : 1 ratio. There are also clinical reports that the 1 : 1 ratio is better than 5 :2 ratio. Both single alisma orientalis decoction and compound decoction can affect cholesterol metabolism and gene expression. Alisma orientalis decoction is superior to pure alisma orientalis water extract in reducing lipid content. Single Baizhu decoction has no effect on gene expression of cholesterol metabolism. Baizhu can enhance the effect of reducing lipid content of alisma orientalis. Clinical treatment is often based on specific disease differentiation. In the future, the unique advantages of alisma orientalis and its related compound prescriptions in the treatment of metabolic diseases such as hyperlipidemia can be further explored, and the mechanism of action can be explored.
Alisma orientalis has remarkable effect of reducing lipid by diffusing moisture, releasing heat,removing turbidity and reducing lipid. The water extract and alcohol extract of alisma orientalis have the effect of lowering lipid, which is mainly the key of alisma alcohol in the process of lowering lipid, and alisma alcohol A is the most important. It may be related to gene intervention, redox, improving microcirculation and peripheral resistance, and inhibiting the absorption of triglyceride. There are many prescriptions related to Alisma orientalis. The research on lipid-lowering is most extensive in alisma orientalis decoction from "Synopsis of the Golden Chamber". The effect of lipid-lowering is related to the proportion of prescriptions and medicines. Alisma orientalis decoction can inhibit the expression of Hmgcr, Srebf2 and other genes,regulate the expression of cholesterol synthesis and metabolism genes, inhibit cholesterol synthesis, thereby reducing the levels of TC and TG, and play a role in reducing lipid. The 5 : 2 ratio of alisma orientalis and atractylodes macrocephala has the most obvious effect on reducing blood lipid, followed by 2 : 1 ratio. There are also clinical reports that the 1 : 1 ratio is better than 5 :2 ratio. Both single alisma orientalis decoction and compound decoction can affect cholesterol metabolism and gene expression. Alisma orientalis decoction is superior to pure alisma orientalis water extract in reducing lipid content. Single Baizhu decoction has no effect on gene expression of cholesterol metabolism. Baizhu can enhance the effect of reducing lipid content of alisma orientalis. Clinical treatment is often based on specific disease differentiation. In the future, the unique advantages of alisma orientalis and its related compound prescriptions in the treatment of metabolic diseases such as hyperlipidemia can be further explored, and the mechanism of action can be explored.
引文
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[24]黄晓飞,周蕾,彭晓辉,等.泽泻汤及其乙醇部位对高血症大鼠血脂及血脂代谢相关酶的影响[J].湖北中医药大学学报,2013,15(6):3-6.
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[27]朱广伟,张贵君,汪萌.不同配伍比例的泽泻汤降血脂作用研究[J]中华中医药学刊,2015,18(1):189-191.
[28]徐小妹,林文津,张亚敏,等.泽泻汤降脂作用与肠道微生态的相关性探讨[J].中国实验方剂学杂志,2017,23(3):124-129.
[29]林高城,陈云欢,杨莉惠,等.不同比例配伍泽泻汤对高脂血症大鼠血脂代谢及炎症因子影响[J].中国卫生标准管理,2018,9(19)124-126.
[30]徐小妹,林文津,张亚敏,等.泽泻汤对高脂血症大鼠肝脏线粒体蛋白质组的影响[J].福建医药杂志,2016,38(3):53-57.
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[32]高艳琼,延华,金瑞瑞.泽泻汤治疗高脂血症的临床疗效观察[J].西部中医药,2015,28(9):88-90.
[33]陈莉莉.加味泽泻汤治疗原发性高脂血症的疗效观察[J].辽宁中医杂志,2001,28(3):148.
[34]赵润生,邢玉敏,张永志,等.泽泻汤加味治疗痰浊阻遏型高脂血症55例临床观察[J].甘肃中医学院学报,2015,32(4):42-45.
[35]吕少锋,曹克强,培杨.泽泻汤加味治疗高脂血症120例临床观察[J].中医药临床杂志,2005,17(5):454-455.
[2]汪俊军,张春妮.胆固醇酯转运蛋白基因变异与血脂和动脉粥样硬化性心血管病的关系[J].医学研究生学报,2007,20(1):76-79.
[3]郭改会,张沛然.高脂血症的诊断及治疗[J].中国临床医生,2012,40(3):21-23.
[4]周仲瑛.中医内科学[M].北京:中国中医药出版社,2004:418.
[5]张洪,马红斌,蔡鸿生.降脂中药浅谈[J].时珍国医国药,1995,5(1):34-35.
[6]高学敏.中药学[M].北京:中国中医药出版社,2007:214.
[7]倪朱谟.本草汇言[M].郑金生,点校.北京:中医古籍出版社,2005:76.
[8]寇宗奭.本草衍义[M].梁茂新,范颖,点评.北京:中国医药科技出版社,2018:116.
[9]常敏毅.日华子本草辑注[M].北京:中国医药科技出版社,2015:89.
[10]邓迎娜.泽泻降脂活性组分的制备及其制剂研究[D].南昌:南昌大学,2007.
[11]邱东凤.泽泻化学成分研究[D].兰州:兰州大学,2009.
[12]郁相云,钟建华,张旭.泽泻降血脂药理作用及物质基础研究[J].中国中医药现代远程教育,2010,8(11):250.
[13]张春海,毛缜,马丽,等.泽泻水提取物、醇提取物对小鼠脂代谢影响的比较[J].江苏师范大学学报(自然科学版),2005,23(2):68-70.
[14]李淑子,金在久,张善玉.泽泻不同提取物对高脂血症小鼠血脂及脂质过氧化的影响[J].中国实用医药,2008,3(32):7-9.
[15]李魁,王梅玉.泽泻降脂米酒及降脂效果研究[J].中国酿造,2000(1):15-17.
[16]钱文彬,庞红,薛大权,等.泽泻水提物、醇提物的制备及对小白鼠降脂作用的研究[J].数理医药学杂志,2007,20(6):836-838.
[17]罗奋熔.泽泻降糖降脂及抗炎作用研究[D].福州:福建中医药大学,2015.
[18]许文,郑春松,吴水生.计算机模拟筛选泽泻降血脂作用的化学成分[J].康复学报,2016,20(3):34-35.
[19]陈兴娟,尹萌萌,魏建梁,等.泽泻在心血管疾病治疗中的应用[J].长春中医药大学学报,2014,30(4):620-622.
[20]许丹.泽泻的降血脂活性成分研究[D].沈阳:辽宁中医学院,2000.
[21]张仲景.金匮要略方论[M].北京:人民卫生出版社,2012:50.
[22]乐智勇.泽泻汤降血脂作用机理研究[D].武汉:湖北中医药大学,2012.
[23]彭敏.泽泻汤对血脂调节的胆固醇相关基因mRNA表达变化研究[D].武汉:湖北中医药大学,2011.
[24]黄晓飞,周蕾,彭晓辉,等.泽泻汤及其乙醇部位对高血症大鼠血脂及血脂代谢相关酶的影响[J].湖北中医药大学学报,2013,15(6):3-6.
[25]魏治鹏.代谢综合征中的郁和瘀[J].辽宁中医杂志2006,33(7):803-804.
[26]胡雪峰,成忠煌,王松迪,等.泽泻汤降血脂作用的研究[J].时珍国医国药,2011,22(9):2703-2704.
[27]朱广伟,张贵君,汪萌.不同配伍比例的泽泻汤降血脂作用研究[J]中华中医药学刊,2015,18(1):189-191.
[28]徐小妹,林文津,张亚敏,等.泽泻汤降脂作用与肠道微生态的相关性探讨[J].中国实验方剂学杂志,2017,23(3):124-129.
[29]林高城,陈云欢,杨莉惠,等.不同比例配伍泽泻汤对高脂血症大鼠血脂代谢及炎症因子影响[J].中国卫生标准管理,2018,9(19)124-126.
[30]徐小妹,林文津,张亚敏,等.泽泻汤对高脂血症大鼠肝脏线粒体蛋白质组的影响[J].福建医药杂志,2016,38(3):53-57.
[31]高源.泽泻汤在高脂血症治疗中的应用效果观察[J].世界最新医学信息文摘(电子版),2016,16(61):239.
[32]高艳琼,延华,金瑞瑞.泽泻汤治疗高脂血症的临床疗效观察[J].西部中医药,2015,28(9):88-90.
[33]陈莉莉.加味泽泻汤治疗原发性高脂血症的疗效观察[J].辽宁中医杂志,2001,28(3):148.
[34]赵润生,邢玉敏,张永志,等.泽泻汤加味治疗痰浊阻遏型高脂血症55例临床观察[J].甘肃中医学院学报,2015,32(4):42-45.
[35]吕少锋,曹克强,培杨.泽泻汤加味治疗高脂血症120例临床观察[J].中医药临床杂志,2005,17(5):454-455.