Tanaka Koichiro, Chiba Koki, Nara Kazuhiko
Department of Traditional Medicine, Faculty of Medicine, Toho University, Tokyo, Japan.
Front Nutr. 2021 Dec 24;8:760918. doi: 10.3389/fnut.2021.760918. eCollection 2021.
The concept of "blood stasis" - called yū xiě in Chinese, Oketsu in Japanese - is one of the unique pathophysiology of traditional medicine that originated in China and inherited in Korea and Japan. This concept is related to the multiple aspects of hemodynamic disorders brought on by quantitative and qualitative changes. It theorizes that the quantitative changes of "blood stasis" are related to peripheral circulatory insufficiency. When chronic qualitative changes of "blood stasis" produce stagnant blood that turns into a pathological product, it could cause inflammation and lead to organic changes. Trauma induced hematomas, that are considered to be a quantitative change of blood, are also a form of blood stasis. The basic medicine research on Keishibukuryogan (KBG)-a Japanese name in Traditional Japanese Medicine (Kampo) for one of the most common anti- "blood stasis" prescriptions, also known as gui-zhi-fu-ling-wan (GFW) in Chinese in Traditional Chinese Medicine (TCM)-indicated that the initiation of quantitative changes was closely related to loss of redox balances on endothelial function induced by oxidative stress. The following qualitative changes were related to coagulopathy, hyper viscosity; anti-platelet aggregation, lipid metabolism; a regulation of systemic leptin level and/or lipid metabolism, inflammatory factor; cyclooxygenase-1,2 (COX-1, 2), interleukin-6, 8 tumor necrosis factor-α, macrophage infiltration, hyperplasia, tissue fibrosis and sclerosis caused by transforming growth factor-β1 and fibronectin, the dysfunction of regulated cell deaths, such as, apoptosis, autophagy, ferroptosis and ovarian hormone imbalance. Clinically, KBG was often used for diseases related to Obstetrics and Gynecology, Endocrine Metabolism, Rheumatology and Dermatology. In this review, we give an overview of the mechanism and its current clinical application of KBG through a summary of the basic and clinical research and discuss future perspective.
“血瘀”的概念——中文称为“瘀血”,日文称为“瘀血(おけつ)”——是起源于中国并在韩国和日本传承的传统医学独特的病理生理学之一。这一概念与由数量和质量变化引起的血流动力学紊乱的多个方面相关。它认为“血瘀”的数量变化与外周循环不足有关。当“血瘀”的慢性质量变化产生瘀血并转化为病理产物时,可能会引发炎症并导致器质性变化。创伤性血肿被认为是血液的数量变化,也是血瘀的一种形式。对桂枝茯苓丸(KBG)的基础医学研究——桂枝茯苓丸是日本传统医学(汉方)中最常用的抗“血瘀”方剂之一,在中医(TCM)中也称为桂枝茯苓丸(GFW)——表明数量变化的起始与氧化应激诱导的内皮功能氧化还原平衡丧失密切相关。随后的质量变化与凝血病、高粘度、抗血小板聚集、脂质代谢、全身瘦素水平和/或脂质代谢的调节、炎症因子、环氧化酶-1、2(COX-1、2)、白细胞介素-6、8、肿瘤坏死因子-α、巨噬细胞浸润、增生、由转化生长因子-β1和纤连蛋白引起的组织纤维化和硬化、细胞程序性死亡功能障碍(如凋亡、自噬、铁死亡)以及卵巢激素失衡有关。临床上,桂枝茯苓丸常用于与妇产科、内分泌代谢、风湿病和皮肤病相关的疾病。在本综述中,我们通过总结基础研究和临床研究,概述了桂枝茯苓丸的作用机制及其当前的临床应用,并讨论了未来的前景。
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