Department of Parasitology, Xiangya School of Medicine, Central South University Changsha, Hunan 410013, P. R. China.
Department of Integrated Traditional Chinese and Western Medicine, Institute of Integrative Medicine, Xiangya Hospital, Changsha 410008, P. R. China.
Am J Chin Med. 2024;52(4):1027-1051. doi: 10.1142/S0192415X24500423. Epub 2024 Jun 14.
The use of medicinal leeches in clinical therapy has been employed for a long time, as it was originally recognized for exerting antithrombin effects. These effects were due to the ability of the leech to continuously suck blood while attached to human skin. According to , leeches used in traditional Chinese medicine mainly consist of Whitman, Whitman, and , but the latter two species are relatively scarce. The main constituents of leeches are protein and peptide macromolecules. They can be categorized into two categories based on their pharmacological effects. One group consists of active ingredients that directly target the coagulation system, such as hirudin, heparin, and histamine, which are widely known. The other group comprises protease inhibitor components like Decorsin and Hementin. Among these, hirudin secreted by the salivary glands of the leech is the most potent thrombin inhibitor and served as the sole remedy for preventing blood clotting until the discovery of heparin. Additionally, leeches play a significant role in various traditional Chinese medicine formulations. In recent decades, medicinal leeches have been applied in fields including anti-inflammatory treatment, cardiovascular disease management, antitumor treatment, and many other medical conditions. In this review, we present a comprehensive overview of the historical journey and medicinal applications of leeches in various medical conditions, emphasizing their pharmaceutical significance within traditional Chinese medicine. This review offers valuable insights for exploring additional therapeutic opportunities involving the use of leeches in various diseases and elucidating their underlying mechanisms for future research.
医用医蛭在临床治疗中的应用由来已久，最初被认为具有抗凝血作用。这种作用源于医蛭在附着于人体皮肤时持续吸血的能力。根据记载，传统中药中使用的医蛭主要包括宽体金线蛭、茶色蛭和日本医蛭，但后两种相对较少。医蛭的主要成分是蛋白质和肽类大分子。根据其药理作用，可将它们分为两类。一类是直接针对凝血系统的活性成分，如众所周知的水蛭素、肝素和组织胺。另一类是蛋白酶抑制剂成分，如 Decorsin 和 Hementin。其中，医蛭唾液腺分泌的水蛭素是最强的凝血酶抑制剂，是预防血液凝固的唯一药物，直到肝素的发现。此外，医蛭在各种中药配方中也有重要作用。近几十年来，医蛭已应用于抗炎治疗、心血管疾病管理、抗肿瘤治疗等多个医学领域。在本次综述中，我们全面回顾了医蛭在各种医学状况下的历史发展和药用应用，强调了其在传统中药中的药物学意义。这为探索医蛭在各种疾病中的治疗潜力以及阐明其作用机制提供了有价值的思路，为未来的研究提供了参考。
