Analysis on the Translational Medicine Research Ideas and Methods of Traditional Chinese Prescription Guided by Clinical Value
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摘要: 中药复方是中医临床用药的主要形式, 也是中医药传承创新发展的重要载体。由于物质基础不清、作用机制不明、质量控制不稳定、循证医学证据缺乏等瓶颈问题, 中药复方屡遭质疑, 难以获得国际认可, 临床应用和产业发展十分受限。如何科学有效开展中药复方基础研究, 使其更好为临床服务成了中医药发展迫切需要解决的难题。近年来, 转化医学浪潮的兴起为中医药的创新发展带来了新的契机和思路。该文简述了中药复方临床应用和开发面临的困境, 转化医学视角下开展复方研究的现状以及存在的主要问题, 进一步凝练研究思路与方法, 以期为源于中医临床的中药复方转化医学研究提供有益指导。Abstract: Traditional Chinese prescription is the main form of clinical medication of traditional Chinese medicine (TCM), and also the important carrier of TCM inheritance and innovation. Because of the bottle-neck problems such as unclear chemical basis, unclear function mechanism, unstable quality control and lack of evidence-based medicine, traditional Chinese prescription has been questioned frequently. It is difficult for traditional Chinese prescription to gain international approval, and its clinical application and industrial development are very limited. How to carry out the basic research of traditional Chinese prescription scientifically and effectively for better clinical application has become an urgent problem to be solved in the development of TCM. In recent years, the rising and developing of translational medicine has brought new opportunities and ideas for the innovation and development of TCM. This paper briefly described the difficulties in the clinical application and development of traditional Chinese prescription, discussed the present situation and the main problems in the translational research of TCM, and further condensed the research ideas and methods, with the purpose to provide beneficial guidance for the further research of TCM.
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[1] 商洪才, 李幼平, 张伯礼. 中医药临床疗效评价实践中的几点思考[J]. 天津中医药, 2007, 24(4): 275-277. doi: 10.3969/j.issn.1672-1519.2007.04.004 [2] 赵丹, 任现志. 中医药疗效评价方法的现状与思考[J]. 中华中医药学刊, 2011, 29(3): 623-624. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201103066.htm [3] 蔡新吉, 魏振满, 毕京峰. 逍遥丸对酒精性肝病肝郁脾虚证中医证候的疗效观察[J]. 中华中医药学刊, 2013, 31(6): 1265-1267. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201306016.htm [4] 王杰, 王传航. 益精汤联合西药治疗弱精子症脾肾两虚证的临床观察[J]. 现代中医临床, 2020, 27(6): 3-7. doi: 10.3969/j.issn.2095-6606.2020.06.002 [5] 王路, 周德勇, 蒋丽娟, 等. 决明子萘骈吡喃酮类对照提取物中主要化学成分UPLC-MSn分析及定值研究[J]. 中国中药杂志, 2019, 44(10): 2102-2109. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZY201910021.htm [6] 马飞祥, 薛培凤, 王媛媛, 等. 中药血清药物化学研究进展[J]. 中国中药杂志, 2017, 42(7): 1265-1270. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZY201707010.htm [7] SHI L, WANG R, LIU T, et al. A rapid protocol to distinguish between Citri Exocarpium Rubrum and Citri Reticulatae Pericarpium based on the characteristic fingerprint and UHPLC-Q-TOF MS methods[J]. Food Funct, 2020, 11(4): 3719-3729. doi: 10.1039/D0FO00082E [8] 梁小娜, 林娟, 李新, 等. 复方丹参片及其拆方对血管性痴呆模型大鼠学习记忆能力的改善作用和机制探讨[J]. 中草药, 2019, 50(12): 2884-2890. doi: 10.7501/j.issn.0253-2670.2019.12.021 [9] WANG J, WU MY, TAN JQ, et al. High content screening for drug discovery from traditional Chinese medicine[J]. Chin Med, 2019, 14: 5. doi: 10.1186/s13020-019-0228-y [10] HOSTIUC S, MOLDOVEANU A, DASCALU MI, et al. Translational research: The need of a new bioethics approach[J]. J Transl Med, 2016, 14: 16. doi: 10.1186/s12967-016-0773-4 [11] ZERHOUNI E. Medicine. The NIH roadmap[J]. Science, 2003, 302(5642): 63-72. doi: 10.1126/science.1091867 [12] 程海波, 沈卫星, 吴勉华, 等. 中医药转化医学研究现状与发展述评[J]. 南京中医药大学学报, 2016, 32(5): 401-404. https://www.cnki.com.cn/Article/CJFDTOTAL-NJZY201605001.htm [13] 马中良, 王旻. 青蒿素的发现及转化医学的思考[J]. 转化医学杂志, 2015, 4(6): 321-323. doi: 10.3969/j.issn.2095-3097.2015.06.001 [14] ZHU HH, HU J, LO-COCO F, et al. The simpler, the better: Oral arsenic for acute promyelocytic leukemia[J]. Blood, 2019, 134(7): 597-605. doi: 10.1182/blood.2019000760 [15] TSAI SJ. Huperzine-A, a versatile herb, for the treatment of Alzheimer's disease[J]. J Chin Med Assoc, 2019, 82(10): 750-751. doi: 10.1097/JCMA.0000000000000151 [16] WANG JR, GAO WN, GRIMM R, et al. A method to identify trace sulfated IgG N-glycans as biomarkers for rheumatoid arthritis[J]. Nat Commun, 2017, 8(1): 631. doi: 10.1038/s41467-017-00662-w [17] GUO Y, BAO C, MA D, et al. Network-based combinatorial CRISPR-Cas9 screens identify synergistic modules in human cells[J]. ACS Synth Biol, 2019, 8(3): 482-490. doi: 10.1021/acssynbio.8b00237 [18] GUO Y, NIE Q, MACLEAN AL, et al. Multiscale modeling of inflammation-induced tumorigenesis reveals competing oncogenic and oncoprotective roles for inflammation[J]. Cancer Res, 2017, 77(22): 6429-6441. doi: 10.1158/0008-5472.CAN-17-1662 [19] 刘进娜, 谢鸣, 赵静, 等. 基于系统生物学和病证结合模型对中医证候表征的研究[J]. 中国科学: 生命科学, 2016, 46(8): 913-928. https://www.cnki.com.cn/Article/CJFDTOTAL-JCXK201608003.htm [20] 张贺, 李秋忆, 樊懿萱, 等. 单病例随机对照试验在中医药临床研究中的探索与思考[J]. 中西医结合心脑血管病杂志, 2020, 18(18): 2945-2947, 2954. doi: 10.12102/j.issn.1672-1349.2020.18.001 [21] 张晓雨, 陈诗琪, 李承羽, 等. 循证中医药学理论研究与应用实践[J]. 中国循证医学杂志, 2018, 18(1): 86-91. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXZ201801014.htm [22] 王贤良, 毛静远, 侯雅竹. 病证结合、系统分段、多维指标中医临床效应评价方法建立初探[J]. 中国中西医结合杂志, 2013, 33(2): 270-273. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201302037.htm [23] 符宇, 范冠杰, 黄皓月, 等. 中医原创思维之"动态思维"[J]. 中医杂志, 2018, 59(3): 181-184. doi: 10.3969/j.issn.0411-8421.2018.03.012 [24] WANG Y, XU A. Zheng: A systems biology approach to diagnosis and treatments[J]. Science, 2014, 346(6216): S13-S15. http://smartsearch.nstl.gov.cn/paper_detail.html?id=0c5b78d5190e6c132a11abe53c8a71f3 [25] 李江, 翟静波, 商洪才, 等. 单病例随机对照试验的起源与发展[J]. 中国循证医学杂志, 2017, 17(2): 235-238. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXZ201702016.htm [26] 訾素娜, 杨佩兰, 徐敏华, 等. 清热中药在支气管扩张症稳定期作用的个体化研究[J]. 世界科学技术-中医药现代化, 2019, 21(9): 1948-1955. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX201909027.htm [27] 皇玲玲, 赵晓峰, 郭立中. 凉血化瘀方加减治疗原发性血小板增多症单病例随机对照研究[J]. 中医杂志, 2019, 60(8): 680-683. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201908012.htm [28] 符宇, 邵明义, 燕树勋, 等. 真实世界研究与中医临床疗效评价[J]. 中医杂志, 2019, 60(7): 546-550. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201907002.htm [29] 于子凯, 李刘生, 张昱, 等. 基于真实世界的加味黄芪赤风汤治疗IgA肾病的临床疗效评价[J]. 世界中医药, 2018, 13(11): 2819-2822. doi: 10.3969/j.issn.1673-7202.2018.11.039 [30] 李丹, 李爱平, 李科, 等. 液质联用技术在中药化学成分定性分析中的研究进展[J]. 药物评价研究, 2020, 43(10): 2112-2119. https://www.cnki.com.cn/Article/CJFDTOTAL-YWPJ202010034.htm [31] 谭兰芳, 陈超, 樊旭蕾, 等. 基于PK-PD模型评价脑脉通保护神经细胞的药效物质研究[J]. 中国中药杂志, 2019, 44(12): 2588-2593. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZY201912022.htm [32] 王鑫梦, 唐小涵, 李盈瑶, 等. 基于代谢组学与网络药理学分析牛筋果叶中潜在药用活性成分及机制研究[J]. 中国中药杂志, 2021, 46(14): 3625-3632. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZY202114020.htm [33] 宋慧鹏, 杨华, 高雯, 等. 中药活性成分发现关键技术研究进展[J]. 世界科学技术-中医药现代化, 2016, 18(7): 1093-1098. doi: 10.11842/wst.2016.07.002 [34] 宋亚刚, 李艳, 崔琳琳, 等. 中医药病证结合动物模型的现代应用研究及思考[J]. 中草药, 2019, 50(16): 3971-3978. doi: 10.7501/j.issn.0253-2670.2019.16.033 [35] 孙静, 赵荣华, 郭姗姗, 等. 苦参碱氯化钠注射液对人冠状病毒肺炎寒湿疫毒袭肺证小鼠病证结合模型的治疗作用[J]. 药学学报, 2020, 55(3): 366-373. https://www.cnki.com.cn/Article/CJFDTOTAL-YXXB202003003.htm [36] 赵荣华, 孙静, 郭姗姗, 等. 体外培育牛黄对人冠状病毒肺炎疫毒袭肺证小鼠病证结合模型的效用特点[J]. 中国实验方剂学杂志, 2021, 27(2): 66-73. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSFX202102012.htm [37] 王勇, 李春, 李栋, 等. 基于生物网络与病证结合的中药复方药理学研究对策[J]. 中国中西医结合杂志, 2012, 32(4): 552-555. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZXJ201204038.htm [38] 刘晓娜, 车晓青, 李德芳, 等. 基于多源信息融合的中药质量标志物与质量评价研究模式[J]. 中草药, 2019, 50(19): 4576-4581. doi: 10.7501/j.issn.0253-2670.2019.19.008 [39] 杨华, 齐炼文, 李会军, 等. 以"等效成分群"为标示量的中药质量控制体系的构建[J]. 世界科学技术-中医药现代化, 2014, 16(3): 510-513. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX201403013.htm [40] 刘昌孝, 陈士林, 肖小河, 等. 中药质量标志物(Q-Marker): 中药产品质量控制的新概念[J]. 中草药, 2016, 47(9): 1443-1457. https://www.cnki.com.cn/Article/CJFDTOTAL-ZCYO201609005.htm [41] 闫广利, 孙晖, 张爱华, 等. 基于中医方证代谢组学的中药质量标志物发现研究[J]. 中草药, 2018, 49(16): 3729-3734. doi: 10.7501/j.issn.0253-2670.2018.16.001 [42] LI K, LI J, SU J, et al. Identification of quality markers of Yuanhu Zhitong tablets based on integrative pharmacology and data mining[J]. Phytomedicine, 2018, 44: 212-219. doi: 10.1016/j.phymed.2018.03.002
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