中药治疗冠心病患者长期服用小剂量阿司匹林所致胃黏膜损伤的研究进展

Zhenmin Zhang, Xuexian Dong, Juju Shang, Yingjie Zhou
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摘要

阿司匹林广泛用于治疗和预防冠心病(CHD)。它通过抑制环氧化酶-1 (COX-1)的活性,在抗血小板聚集中发挥重要作用。另一方面,COX-1活性的降低抑制胃粘膜中前列腺素(PG)的产生,导致胃黏膜血流量减少,粘膜屏障减弱。这使得胃粘膜更容易受到伤害。我们通常用抑制胃酸分泌的药物治疗长期使用低剂量阿司匹林(LDA)引起的胃黏膜损伤。然而,这些药物不能改善胃粘膜血流量和胃粘膜屏障的作用。而且长期使用这些药物会导致多种不良反应,如消化不良、骨质疏松、营养缺乏等。本文综述了中药治疗LDA所致胃黏膜损伤的研究进展。发现西洋参皂苷、黄芪甲苷A、铁皮石斛多糖、白芨、经花胃康胶囊、丹红注射液等中药成分或制剂可提高胃黏膜PG水平,增加胃黏膜血流量,从而改善胃黏膜屏障作用。这为冠心病患者长期应用LDA引起的胃黏膜损伤的防治提供了一定的思路。
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Research progress of traditional Chinese medicine in the treatment of gastric mucosa injury caused by long-term use of low dose aspirin in patients with coronary heart disease
Aspirin is widely used in the treatment and prevention of coronary heart disease (CHD). It plays an important role in anti-platelet aggregation by inhibiting the activity of cyclooxygenase-1 (COX-1). On the other hand, the decrease of COX-1 activity inhibits the production of prostaglandin (PG) in gastric mucosa, which leads to the decrease of gastric mucosal blood flow and the weakening of mucous barrier. That makes the gastric mucosa more vulnerable to injury. We usually treat gastric mucous injury caused by long-term use of low-dose-aspirin (LDA) with drugs that inhibit gastric acid secretion. However, these drugs cannot improve gastric mucosal blood flow and the effect of gastric mucous barrier. And the long-term use of these drugs can lead to a variety of adverse reactions, such as dyspepsia, osteoporosis, nutritional deficiency and so on. This paper reviews the research progress of traditional Chinese medicine (TCM) in the treatment of gastric mucosa injury caused by LDA. It was found that Panax quinquefolius ( Xiyangshen ) saponins, Astragaloside A, Dendrobium officinale ( Tiepishihu ) polysaccharide, Bletilla Striata ( Baiji ), Jinghua Weikang capsule, Danhong injection and other TCM components or preparations can increase the level of PG in gastric mucosa and increase the blood flow of gastric mucosa, so as to improve the effect of gastric mucous barrier. This provides a certain idea for the prevention and treatment of gastric mucosa injury caused by long-term application of LDA in patients with CHD.
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