桂枝及肉桂治痹的中医认识与现代药学研究进展
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摘要
桂枝、肉桂是治疗痹证的常用中药,相关的古籍记载众多、繁杂。桂枝气薄,走而不守,温通之力强,可祛风散寒化瘀,常配伍辛温、辛热之品,治疗实痹、初痹;肉桂气厚,守而不走,温补之力强,善温补肾阳,多配伍温补之品,治疗虚痹、久痹。现代药学研究发现二药活性成分大体相同,肉桂的活性成分多于桂枝。其治疗痹证的机制主要体现在:通过抑制核转录因子-κB(NF-κB),丝裂原活化蛋白激酶(MAPK),两面神激酶/信号转导子和转录激活子(JAK/STAT)等信号通路发挥抗炎或免疫调节作用;通过抑制成纤维细胞、破骨细胞、骨髓间充质干细胞等细胞的增殖,促进成骨细胞的增殖,发挥调节细胞增殖的作用;通过清除氧自由基发挥抗氧化作用;通过调节瞬时感受器电位通道A1和V1亚型(TRPA1,TRPV1)发挥调节疼痛的作用;通过调节肠道激素-1(GLP-1)分泌、改善胰岛素抵抗等发挥增加糖脂代谢、减重的作用。主要活性成分肉桂醛体内代谢不稳定,易被氧化成肉桂酸。二药及其所含成分的毒性相对较小。现梳理二药的古籍记载、中医对二药治痹功效的认识,综述近年来相关药化、药理、药代、毒理的研究成果,并分析相关的问题,旨在为进一步研究与应用提供依据。
Cinnamomi Ramulus and Cinnamomi Cortex are widely used to treat paralysis in traditional Chinese medicine( TCM). There are numerous and complicated relative records in ancient literatures. Doctors often use Cinnamomi Ramulus to dispel wind and cold,remove blood stasis and combine with warm-natured and heat-natured herbs to treat excess paralysis and early-stage paralysis. And Cinnamorni Cortex is used to warm and invigorate kidney Yang and combine with warm-benefiting herbs to treat deficiency paralysis and chronicle paralysis. However,modern pharmaceutical studies reported that their active substances are almost the same. The active substances in Cinnamomi Cortex are more than those in Cinnamomi Ramulus. The mechanisms of treating paralysis include: suppressing inflammation and regulating immunity by down-regulating nuclear factors( NF)-κB,mitogen activated protein kinase( MAPK),Janus kinase-signal transducers/activators of transcription( JAK/STAT) signaling pathways,regulating cell proliferation by inhibiting the proliferation of fibroblasts,osteoclasts and bone marrow mesenchymal stem cells and promoting the proliferation of osteoblast, resisting oxidation by scavenging oxygen free radicals,regulating pain by mediating TRPA1 and TRPV1,and enhancing substance metabolism and losing weight by regulating the secretion of intestinal hormones( Ghrelin,GLP-1) and improving insulin resistance. The main active ingredient Cinnamaldehyde is unstable in vivo and easily oxidized to cinnamic acid. The toxicity of the two medicines and their components are relatively low. This paper reviews and analyses relative records in ancient literatures,traditional Chinese medicine cognition of their effects in treating paralysis,the achievements and problems of chemical, pharmacological, pharmacokinetic and toxicological researches in recent years,with the aim to provide theoretical basis for further research and application.
Cinnamomi Ramulus and Cinnamomi Cortex are widely used to treat paralysis in traditional Chinese medicine( TCM). There are numerous and complicated relative records in ancient literatures. Doctors often use Cinnamomi Ramulus to dispel wind and cold,remove blood stasis and combine with warm-natured and heat-natured herbs to treat excess paralysis and early-stage paralysis. And Cinnamorni Cortex is used to warm and invigorate kidney Yang and combine with warm-benefiting herbs to treat deficiency paralysis and chronicle paralysis. However,modern pharmaceutical studies reported that their active substances are almost the same. The active substances in Cinnamomi Cortex are more than those in Cinnamomi Ramulus. The mechanisms of treating paralysis include: suppressing inflammation and regulating immunity by down-regulating nuclear factors( NF)-κB,mitogen activated protein kinase( MAPK),Janus kinase-signal transducers/activators of transcription( JAK/STAT) signaling pathways,regulating cell proliferation by inhibiting the proliferation of fibroblasts,osteoclasts and bone marrow mesenchymal stem cells and promoting the proliferation of osteoblast, resisting oxidation by scavenging oxygen free radicals,regulating pain by mediating TRPA1 and TRPV1,and enhancing substance metabolism and losing weight by regulating the secretion of intestinal hormones( Ghrelin,GLP-1) and improving insulin resistance. The main active ingredient Cinnamaldehyde is unstable in vivo and easily oxidized to cinnamic acid. The toxicity of the two medicines and their components are relatively low. This paper reviews and analyses relative records in ancient literatures,traditional Chinese medicine cognition of their effects in treating paralysis,the achievements and problems of chemical, pharmacological, pharmacokinetic and toxicological researches in recent years,with the aim to provide theoretical basis for further research and application.
引文
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