[關鍵詞]
[摘要]
新型冠狀病毒肺炎(coronavirus disease 2019,COVID-19)臨床以發(fā)熱、乏力、干咳為主要表現(xiàn),少部分患者可因“細胞因子風暴”在中低熱甚至無明顯發(fā)熱病程中快速進展為急性呼吸窘迫綜合征、膿毒性休克、代謝性酸中毒和凝血功能障礙,甚至多器官功能衰竭而導致重癥患者死亡。遺體微創(chuàng)病理檢查發(fā)現(xiàn)COVID-19與2003年的嚴重急性呼吸綜合征(SARS)和2015年國內(nèi)的中東呼吸綜合征(MERS)有相似之處。從中醫(yī)藥干預細胞因子風暴治療SARS重癥文獻分析入手,運用數(shù)據(jù)挖掘和網(wǎng)絡藥理學方法,探討中醫(yī)藥治療重癥COVID-19與干預細胞因子風暴密切相關的作用路徑和潛在的機制靶點,以期為臨床針對“細胞因子風暴”這一關鍵病理過程,進行精準的組方潛藥、科學的聯(lián)合用藥、靶向的篩選新藥提供參考,有效地遏制COVID-19患者細胞因子風暴的發(fā)生和發(fā)展,促進其良好的臨床轉歸。
[Key word]
[Abstract]
The primary clinical manifestations of coronavirus disease 2019 (COVID-19) are fever, fatigue and dry cough. Several clinical studies reported that some patients with low or medium fever, or even without obvious symptom, rapidly progressed to severe or critical illness, including severe acute respiratory syndrome, septic shock, coagulation disorders and intractable metabolic acidosis. These patients were usually associated with significant elevated serum levels of a profile of cytokines, which is similar to SARS-2003 and MERS-2015, indicating the occurrence of cytokine storm. In the present review, we summarized previous advances in the treatment of severe cases of SARS by using traditional Chinese medicines (TCM), especially those TCM targeting cytokine storm, based on literature mining. By using data mining and network pharmacology, we also investigated underlying mechanisms and biological pathways involved in the inhibitory effects of TCM against cytokine storm. This review not only provides novel insights in the precise application of TCM, appropriate integrative use of TCM in combination with western medicine, but also contributes to the discovery of novel drugs or new therapeutic strategies targeting cytokine storm to suppress progression of COVID-19 and to improve clinical prognosis and outcomes.
[中圖分類號]
R183.3;R285.6
[基金項目]
北京市雙一流課題(1000061020074);泰山學者工程專項經(jīng)費項目(ts201511107)