| 2,197 | 3 | 57 |
| 下载次数 | 被引频次 | 阅读次数 |
乌梅丸载于我国东汉时期的一部中医经典《伤寒杂病论》:“蛔厥者，乌梅丸主之。又主久利”,该方由乌梅、细辛、桂枝、黄连、黄柏、当归、干姜、附子、人参、蜀椒10种中药组成，其主要功效为暖肝调中，清上温下。临床研究中多以其加减方或联合西药治疗溃疡性结肠炎、肠易激综合征、慢性萎缩性胃炎、胃食管反流病、胃癌、肠息肉等多个消化系统疾病。现代药理学显示，乌梅丸治疗胃肠疾病发挥着抗炎、抗氧化、保护胃黏膜、抗肿瘤、抗溃疡等重要药理作用。借助文献报道，从该方临床报道、方剂组成中各药物有效成分与消化系统疾病药理研究、动物实验报道等三方面进行归纳总结，根据相关报道中该方的有效成分，总结出该方药物运用于常见消化系统疾病的主要有效成分，并通过其药理成分阐释该方的组方配伍规律，以期为乌梅丸临床应用及相关研究的开展提供参考。
Abstract：Wumei Pill(乌梅丸) is recorded in Treatise on Cold Damage and Miscellaneous Diseases which is a traditional Chinese medicine classic during the Eastern Han Dynasty in China. It is said that “for those who suffer from roundworms and convulsions, Wumei Pill is the main treatment method. It also can treat long-term diarrhea.” This formula is composed of 10 Chinese herbal medicines, including Wumei(Mume Fructus),Xixin(Asari Herba),Guizhi(Cinnamomi Ramulus),Huanglian(Coptidis Rhizoma),Huangbai(Phellodendri Cortex),Danggui(Angelicae Sinensis Radix),Ganjiang(Zingiberis Rhizoma),Fuzi(Aconiti Lateralis Preparata Radix),Renshen(Ginseng Radix) and Shujiao(Zanthoxyli Pericarpium). Its main efficacy is to warm liver and regulate the middle, clear the upper and warm the lower parts. In clinical research, its modified formulae or combination with Western medicine are often used to treat multiple digestive system diseases such as ulcerative colitis, irritable bowel syndrome, chronic atrophic gastritis, gastroesophageal reflux disease, gastric cancer and intestinal polyps. Modern pharmacology shows that Wumei Pill plays important pharmacological roles in the treatment of gastrointestinal diseases, including anti-inflammatory, antioxidant, gastric mucosal protection, anti-tumor and anti ulcer effects. This article used literature reports to summarize and generalize the effective ingredients of the formula from three aspects: clinical reports, pharmacological research on digestive system diseases and animal experiment reports. Based on the effective ingredients of the formula in relevant reports, the main effective ingredients of the formula used in common digestive system diseases were summarized, and the compatibility rules of the formula were explained through its pharmacological ingredients, in order to provide reference for the clinical application and related research of Wumei Pill.
[1] 王颖，赵冠宇，薛淑萍，等.乌梅丸及其类方治疗胃肠疾病的临床与基础研究进展[J].中药药理与临床，2023,39(3):122-128.
[2] 杨梅，柳华，代二庆.乌梅丸治疗消化系统疾病应用概述[J].天津中医药大学学报，2015,34(2):125-128.
[3] 覃优.艾灸联合乌梅丸治疗慢性萎缩性胃炎临床观察[J].实用中医药杂志，2017,33(8):884.
[4] 杨静波，赵长普，张娟.乌梅丸对慢性萎缩性胃炎患者血清炎症指标、免疫功能的影响[J].中国实验方剂学杂志，2018,24(1):158-162.
[5] 周燕，李保良，姚李吉，等.乌梅丸改善非糜烂性胃食管反流病主要症状的临床观察[J].中药材，2016,39(5):1169-1172.
[6] 王茜茜，李华岳.加减乌梅丸方联合穴位针刺对胃食管反流病患者食管动力的影响[J].中国中医药现代远程教育，2018,16(23):42-44.
[7] 张成晶，朱许丽，张颖慧，等.基于寒热错杂病机中医药在胃癌各阶段防治中的研究[J].中国中医基础医学杂志，2018,24(4):510-512,532.
[8] 初世荣.乌梅丸加减治疗胃癌45例疗效观察[J].中医临床研究，2018,10(34):5-9.
[9] 李克亚，陆文洪，王真权，等.乌梅丸联合美沙拉嗪对寒热错杂型溃疡性结肠炎患者的临床疗效[J].中成药，2022,44(11):3493-3497.
[10] 王福英，王静敏，丁震环，等.中西医结合治疗寒热错杂型溃疡性结肠炎54例临床观察[J].中国民族民间医药，2021,30(17):110-112.
[11] 杨静，刘超，朱凤池，等.乌梅丸加减辨证治疗成人溃疡性结肠炎疗效及预后观察[J].四川中医，2022,40(4):80-82.
[12] 魏文先，翟玉云，邹颖.乌梅丸加减对溃疡性结肠炎患者炎性因子的影响[J].中医学报，2017,32(11):2208-2211.
[13] 陈利民，陶琦，牛聪慧，等.痛泻要方治疗腹泻型肠易激综合征基础与临床研究进展[J].实用中医内科杂志，2023,37(7):108-111.
[14] 苏良伟，郑欢，黄马养，等.乌梅丸治疗腹泻型肠易激综合征的Meta分析[J].中国中医急症，2019,28(9):1554-1558.
[15] 黄秀杰，涂云，潘婧，等.乌梅丸联合匹维溴铵治疗腹泻型肠易激综合征(寒热错杂)随机平行对照研究[J].实用中医内科杂志，2019,33(5):42-45.
[16] 马军，韩棉梅，宋雨鸿.乌梅丸联合中药敷贴治疗寒热错杂型肠易激综合征疗效及对Th1/Th2细胞因子的影响[J].陕西中医，2017,38(2):156-158.
[17] 钟玲玲，舒鹏.乌梅丸加减治疗多发性大肠息肉经验谈[J].环球中医药，2017,10(2):240-242.
[18] 李烨，周佳钰，宋思源，等.从厥阴病论治肠息肉[J].山东中医杂志，2023,42(2):190-194.
[19] 徐燕，赵辉，欧强，等.乌梅丸预防炎性增生性结肠息肉内镜术后再发的疗效观察[J].名医，2021(19):57-58.
[20] 曾英.乌梅丸加减防治大肠息肉术后再发的临床观察[J].中医临床研究，2018,10(4):110-111.
[21] 杨琦，彭植强.逍遥散合乌梅丸煎剂加减治疗大肠癌康复期胃肠功能紊乱的临床效果观察[J].临床合理用药杂志，2020,13(17):76-77.
[22] 苏晓宇.加减乌梅丸方对预防早期结直肠癌内镜下治疗后复发的临床观察[D].南京：南京中医药大学，2018.
[23] 代秋颖.加减乌梅丸预防大肠腺瘤经内镜下治疗后复发的临床研究[D].北京：北京中医药大学，2019.
[24] 张君成，梁华，王燕，等.乌梅药理作用研究进展[J].辽宁中医药大学学报，2021,23(8):122-126.
[25] MORGAN L V,PETRY F,SCATOLIN M,et al.Investigation of the anti-inflammatory effects of stigmasterol in mice:insight into its mechanism of action[J].Behav Pharmacol,2021,32(8):640-651.
[26] SHI Y J,LENG Y F,LIU D S,et al.Research advances in protective effects of ursolic acid and oleanolic acid against gastrointestinal diseases[J].Am J Chin Med,2021,49(2):413-435.
[27] SHENG Q S,LI F,CHEN G P,et al.Ursolic acid regulates intestinal microbiota and inflammatory cell infiltration to prevent ulcerative colitis[J].J Immunol Res,2021,2021:6679316.
[28] LI J,DAI C,SHEN L.Ursolic acid inhibits epithelial-mesenchymal transition through the axl/NF-κB pathway in gastric cancer cells[J].Evid Based Complement Alternat Med,2019,2019:2474805.
[29] OU J M,WANG R,LI X L,et al.Comparative analysis of free amino acids and nucleosides in different varieties of mume fructus based on simultaneous determination and multivariate statistical analyses[J].Int J Anal Chem,2020,2020:4767605.
[30] 杨亚湉，王瑞，钱程程，等.乌梅化学成分、药理作用研究进展及质量标志物预测[J].中成药，2023,45(5):1583-1588.
[31] 周瑞，项昌培，张晶晶，等.黄连化学成分及小檗碱药理作用研究进展[J].中国中药杂志，2020,45(19):4561-4573.
[32] HABTEMARIAM S.Berberine pharmacology and the gut microbiota:a hidden therapeutic link[J].Pharmacol Res,2020,155:104722.
[33] 李彩虹，周克元.黄连活性成分的作用及机制研究进展[J].时珍国医国药，2010,21(2):466-468.
[34] 谈丽华.黄连中黄连碱及表小檗碱抗幽门螺杆菌作用机制研究[D].广州：广州中医药大学，2019.
[35] 田华，闫平慧，张锋利.黄连素对Hp相关性大鼠胃黏膜炎症及ERK1/2表达的影响[J].西部中医药，2019,32(8):1-4.
[36] 吴玉娟，王懿萍，姜延伟，等.黄连多糖含量测定及抗氧化活性研究[J].时珍国医国药，2008,19(8):1906-1908.
[37] 吉文岳，冯心池，邱峰，等.黄连多糖药理作用研究进展[J].药物评价研究，2021,44(3):638-643.
[38] 黄华艺，查锡良.黄酮类化合物抗肿瘤作用研究进展[J].中国新药与临床杂志，2002,21(7):428-433.
[39] LUO X P,YU Z L,YUE B,et al.Obacunone reduces inflammatory signalling and tumour occurrence in mice with chronic inflammation-induced colorectal cancer[J].Pharm Biol,2020,58(1):886-897.
[40] SU S,WANG X,XI X N,et al.Phellodendrine promotes autophagy by regulating the AMPK/mTOR pathway and treats ulcerative colitis[J].J Cell Mol Med,2021,25(12):5707-5720.
[41] HU L L,WANG J,WU N,et al.Utilizing network pharmacology and experimental validation to investigate the underlying mechanism of phellodendrine on inflammation[J].PeerJ,2022,10:e13852.
[42] ZHU L,GU P,SHEN H.Protective effects of berberine hydrochloride on DSS-induced ulcerative colitis in rats[J].Int Immunopharmacol,2019,68:242-251.
[43] LIU J F,HUANG X F,LIU D D,et al.Demethyleneberberine induces cell cycle arrest and cellular senescence of NSCLC cells via c-Myc/HIF-1α pathway[J].Phytomedicine,2021,91:153678.
[44] 徐锋，王德健，王凤，等.桂枝挥发油的药理作用研究进展[J].中华中医药杂志，2016,31(11):4653-4657.
[45] 许源，宿树兰，王团结，等.桂枝的化学成分与药理活性研究进展[J].中药材，2013,36(4):674-678.
[46] 丁媛媛，赵钢涛，杨凡，等.桂皮醛及其代谢产物肉桂酸体外抗柯萨奇病毒B3 的作用机制研究[J].中国病原生物学杂志，2010,5(5):321-324,328,封2.
[47] 李丽萍.桂枝的药理作用分析及其临床应用研究[J].中国医药指南，2017,15(4):180-181.
[48] 王小丽.桂枝的药理作用分析及其临床应用研究[J].临床医药文献电子杂志，2016,3(55):11025-11026.
[49] 黄敬群，王四旺，罗晓星，等.桂皮醛对裸鼠人胃癌细胞移植瘤生长及凋亡的影响[J].解放军药学学报，2006,22(5):343-346.
[50] 黄敬群，罗晓星，王四旺，等.桂皮醛抗肿瘤活性及对S180荷瘤小鼠免疫功能的影响[J].中国临床康复，2006,10(11):107-110.
[51] 吴柯楠，梁艳妮，张东博，等.桂皮醛对DSS诱导的溃疡性结肠炎小鼠的保护作用研究[J].天然产物研究与开发，2021,33(1):1-7,40.
[52] 周静，杨卫平.干姜的临床应用及药理研究进展[J].云南中医中药杂志，2011,32(2):70-72.
[53] 黄雪松，宴日安，吴建中.姜酚的生物活性述评[J].暨南大学学报(自然科学与医学版),2005,26(3):434-439.
[54] 张云玲，郑一敏，胡少南，等.6-姜酚对幽门螺杆菌的抑菌作用研究[J].现代食品科技，2013,29(6):1259-1261,1305.
[55] SHENG Y Y,WU T L,DAI Y Y,et al.6-gingerol alleviates inflammatory injury in DSS-induced ulcerative colitis mice by regulating NF-κB signaling[J].Ann Palliat Med,2020,9(4):1944-1952.
[56] 梁娜，桑亚新，刘卫华，等.干姜姜辣素对脂多糖诱导巨噬细胞炎症的抑制作用[C]//中国食品科学技术学会第十四届年会暨第九届中美食品业高层论坛论文摘要集.镇江：中国食品科学技术学会，20172017:2.
[57] 余玲.“黄连-干姜”药对用于治疗溃疡性结肠炎研究进展[J].亚太传统医药，2022,18(11):230-235.
[58] RASHIDIAN A,MEHRZADI S,GHANNADI A R,et al.Protective effect of ginger volatile oil against acetic acid-induced colitis in rats:a light microscopic evaluation[J].J Integr Med,2014,12(2):115-120.
[59] 何瑞坤，戴庆玲，黄焕迪，等.3味山姜属中药挥发油对胃溃疡寒证大鼠胃黏膜损伤修复作用及机制研究[J].辽宁中医药大学学报，2022,24(4):42-47.
[60] 袁国荣，袁见，朱莹杰.人参皂苷Rg3对人胃腺癌BGC-823细胞皮下移植瘤的抑制作用及机制研究[J].中华中医药学刊，2022,40(7):168-172.
[61] WANG C Z,YAO H Q,ZHANG C F,et al.American ginseng microbial metabolites attenuate DSS-induced colitis and abdominal pain[J].Int Immunopharmacol,2018,64:246-251.
[62] CHEN X Q,XU T T,LV X Y,et al.Ginsenoside Rh2 alleviates ulcerative colitis by regulating the STAT3/miR-214 signaling pathway[J].J Ethnopharmacol,2021,274:113997.
[63] 张佩佩，申玉芹，林泓兵，等.人参多糖免疫调节作用研究进展[J].新乡医学院学报，2021,38(9):890-892,896.
[64] 王晓慧.人参多糖联合植物乳杆菌抗氧化及免疫调节活性研究[D].长春：吉林农业大学，2015.
[65] 任明，郝筱诗，叶伶艳，等.人参多糖的提取分离及其体外抗肿瘤作用[J].吉林大学学报(医学版),2014,40(4):812-815.
[66] NIU X W,ZHANG J J,NI J R,et al.Network pharmacology-based identification of major component of Angelica sinensis and its action mechanism for the treatment of acute myocardial infarction[J].Biosci Rep,2018,38(6):20180519.
[67] 金阳，葛金环，刘思琦，等.当归多糖的化学结构、药理作用及构效关系研究进展[J].中医药信息，2022,39(2):69-77.
[68] WONG V K C,YU L,CHO C H.Protective effect of polysaccharides from Angelica sinensis on ulcerative colitis in rats[J].Inflammopharmacology,2008,16(4):162-167.
[69] 朱丽娟，宋润泽，罗慧英，等.当归挥发油对人结直肠癌HCT-116细胞增殖、迁移及凋亡的作用[J].中成药，2022,44(10):3321-3325.
[70] 王凤龙，刘员，张来宾，等.当归抗炎镇痛作用研究进展[J].中国实验方剂学杂志，2021,27(15):197-209.
[71] 李燕，张瑞丽，范磊，等.蒿本内酯对三硝基苯磺酸诱导溃疡性结肠炎大鼠的保护作用及机制[J].中国临床药理学杂志，2018,34(20):2424-2426.
[72] CHOI Y K,CHO G S,HWANG S,et al.Methyleugenol reduces cerebral ischemic injury by suppression of oxidative injury and inflammation[J].Free Radic Res,2010,44(8):925-935.
[73] ZHOU J F,MA X Y,CUI Y,et al.Methyleugenol protects against t-BHP-triggered oxidative injury by induction of Nrf2 dependent on AMPK/GSK3β and ERK activation[J].J Pharmacol Sci,2017,135(2):55-63.
[74] 高颖，房德敏.乌头类药物抗炎作用机制的研究进展[J].天津药学，2016,28(3):70-72.
[75] 朱瑞丽，易浪，董燕，等.附子中3种乌头原碱对巨噬细胞的抗炎作用[J].广州中医药大学学报，2015,32(5):908-913.
[76] ZHANG Z C,SHEN P,LIU J X,et al.In vivo study of the efficacy of the essential oil of Zanthoxylum bungeanum pericarp in dextran sulfate sodium-induced murine experimental colitis[J].J Agric Food Chem,2017,65(16):3311-3319.
[77] 丁晓洁，孙喜灵，于晓飞，等.乌梅丸对腹泻型肠易激综合征模型大鼠肠道菌群和炎症因子的影响[J].辽宁中医杂志，2019,46(6):1296-1299.
[78] 张静.乌梅丸及其拆方对溃疡性结肠炎模型大鼠结肠黏膜病理变化的影响[J].中医学报，2017,32(12):2404-2407.
[79] MA N X,SUN W,WU J,et al.Compound Wumei Powder inhibits the invasion and metastasis of gastric cancer via cox-2/PGE2-PI3K/AKT/GSK3β/β-catenin signaling pathway[J].Evid Based Complement Alternat Med,2017,2017:3039450.
[80] WANG J,DING K,WANG Y H,et al.Wumei pill ameliorates AOM/DSS-induced colitis-associated colon cancer through inhibition of inflammation and oxidative stress by regulating S-adenosylhomocysteine hydrolase- (AHCY-) mediated hedgehog signaling in mice[J].Oxid Med Cell Longev,2022,2022:4061713.
基本信息:
DOI：10.13193/j.issn.1673-7717.2025.01.023
中图分类号:R285
引用信息:
[1]任娜,韩秀珍,刘溦溦等.乌梅丸及其单味药有效成分在消化系统疾病中的研究进展[J].中华中医药学刊,2025,43(01):128-133.DOI:10.13193/j.issn.1673-7717.2025.01.023.
基金信息:
国家自然科学基金青年科学基金项目(81904122); 江苏省老年医学临床技术应用研究项目(LD2021004)