肠纤维化发病机制及中药调节作用研究进展OA

Intestinal fibrosis(IF)is the core pathological change in the advanced stage of chronic intestinal diseases such as inflammatory bowel disease,characterized by excessive extracellular matrix(ECM)deposition and intestinal stenosis.Modern medicine has revealed,at the cellular and molecular levels,the synergistic effects of mesenchymal cells,immune cell populations,and mesenteric adipocytes.Meanwhile,core molecular pathways such as nuclear factor erythroid 2-related factor 2(Nrf2)drive the fibrotic process by regulating ECM metabolism,and interactions between the microbiota and the immune microenvironment further accelerate disease progression.In TCM,based on the theory of collateral disease,IF is categorized as"dysentery"and"accumulation and mass".Its pathogenesis is described as essentially due to the depletion of Qi and blood and deficiency of the collaterals,and secondarily due to collateral damage caused by dampness-heat and stasis-toxin,ultimately leading to the outcome of prolonged illness invading the collaterals and obstruction of the collaterals forming accumulations.Currently,there are no effective drugs capable of reversing IF.With the continuous development of emerging disciplines such as TCM pharmacology,molecular biology,and network pharmacology,research on the regulation of IF by single herbs,herbal monomers,and TCM compound formulas has become increasingly in-depth.TCM inhibits inflammation,oxidative stress,myofibroblast transformation,and ECM deposition through multiple targets,embodying the therapeutic principle of nourishing collaterals and tonifying deficiency,removing stasis and dredging collaterals.Although many studies have addressed the prevention and treatment of IF with TCM,systematic summaries remain lacking.This review summarizes recent advances in the mechanisms and applications of TCM in the treatment of IF,with the aim of providing a reference for the clinical application of TCM in IF.