肺水转运蛋白与中医“肺主行水”理论的相关性探讨
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摘要
中医学认为,肺为华盖,主行水、通调水道,为"水之上源"。现代医学认为,肺水转运机制包括被动转运和主动转运,被动转运借助肺组织内的压力和张力,而主动转运主要依赖肺水转运蛋白进行。对主动转运的三个主要蛋白,即水通道蛋白(AQP)、钠离子通道蛋白(ENaC)和钠-钾-ATP酶(Na~+-K~+-ATPase)进行归纳论述,并从病证结合、方药反证角度阐述"肺主行水"与肺水转运蛋白之间的相关性,以更好地辅助理解中医学"肺主行水""通调水道"等概念。
In traditional Chinese medicine theory,the lung is the canopy,governing water metabolism,regulating water pathway,and is the "upper source of water". Modern medicine believes that the mechanism of lung water transport includes passive and active transport. Passive transport depends on the pressure and tension in the lung tissue. Active transport mainly depends on lung water transport protein. Three major kinds of proteins of active transport,namely aquaporin( AQP),sodium channel protein( ENaC) and Na~+-K~+-ATPase were summarized and discussed. And from the perspective of combination of disease and syndrome,prescription and drugs,the relationship between lung water transport protein and the theory of"lung governing water metabolism"was explained,so as to better understand the concept of "lung governing water metabolism"in traditional Chinese medicine.
In traditional Chinese medicine theory,the lung is the canopy,governing water metabolism,regulating water pathway,and is the "upper source of water". Modern medicine believes that the mechanism of lung water transport includes passive and active transport. Passive transport depends on the pressure and tension in the lung tissue. Active transport mainly depends on lung water transport protein. Three major kinds of proteins of active transport,namely aquaporin( AQP),sodium channel protein( ENaC) and Na~+-K~+-ATPase were summarized and discussed. And from the perspective of combination of disease and syndrome,prescription and drugs,the relationship between lung water transport protein and the theory of"lung governing water metabolism"was explained,so as to better understand the concept of "lung governing water metabolism"in traditional Chinese medicine.
引文
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[20]丁伟伟,杨程,童佳兵,等.阳和平喘颗粒对哮喘大鼠肺组织AQP1和AQP5表达的影响[J].南京中医药大学学报,2016,32(1):41-44.
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[22]赖鹏华,单晓梅,卢大为,等.三仁汤对湿热应激小鼠肺组织黏蛋白5AC、水通道蛋白1、水通道蛋白5表达的影响[J].中医杂志,2017,58(5):410-413.
[23]廉富,苏景深,刘恩顺,等.通腑泻肺方对ALI/ARDS大鼠AQP-1/αENaC表达的影响[J].天津中医药,2018,35(6):442-444.
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[25]赵燕,何婧,管弦,等.黄芪注射液对急性肺损伤小鼠钠通道表达的影响[J].南方医科大学学报,2012,32(11):1603-1605,1609.
[26]童佳兵,王浩,李泽庚,等.小青龙汤对肺源性心脏病大鼠血浆AngⅡ、ALD、Na+-K+-ATPase含量和血浆中AT1和AT2mRNA的表达影响[J].世界科学技术-中医药现代化,2015,17(10):2104-2108.
[2]李玉梅,戴春来,李恒,等.水通道蛋白与肺水肿关系的研究进展[J].中国实验诊断学,2010,14(10):1675-1676.
[3]张宁,刘树民,于栋华,等.水通道蛋白与中医学水液代谢的相关性探索[J].时珍国医国药,2017,28(5):1170-1172.
[4]VERKMAN AS.Role of aquaporins in lung liquid physiology[J].Respir Physiol Neurobiol,2007,159(3):324-330.
[5]YAMATE T,UMEKAWA T,IGUCHI M,et al.Detection of osteopontin as matrix protein in calcium-containing urinary stones[J].Hinyokika Kiyo,1997,43(9):623-627.
[6]HUMMLER E,BARKER P,GATZY J,et al.Early death due to defective neonatal lung liquid clearance inα-ENaCdeficient mice[J].Nat Genet,1996,12(3):325-328.
[7]丁新民,段蕴铀.肺泡内水肿液清除及其干预机制的研究进展[J].国际呼吸杂志,2006,25(7):546-550.
[8]姚泰.生理学[M].北京:人民卫生出版社,2010:21-22.
[9]MUTLU GM,SZNAJDER JI.Mechanisms of pulmonary edema clearance[J].Am J Physiol Lung Cell Mol Physiol,2005,289(5):L685-L695.
[10]孙毅.肺胀常见证型与AQP-1、PCT的关联性研究[D].昆明:云南中医学院,2016:35.
[11]李磊磊.肺胀常见三证型与血清ADPN、AQP-5的相关性研究[D].昆明:云南中医学院,2017.
[12]韦衮政,潘承政,钱锐,等.肺胀阳虚水泛证水通道蛋白关联性研究[J].环球中医药,2015,8(1):1-5.
[13]江湧,李小兵,刘小虹,等.肺虚痰阻证模型大鼠肺组织αENaC分子表达与补肺化痰方对其影响[J].中成药,2011,33(11):1864-1868.
[14]巫莉萍,邓时贵,叶莹仪,等.大黄对肺卫失宣大鼠肺组织钠离子通道蛋白mRNA表达的影响[J].广州中医药大学学报,2014,31(2):256-259.
[15]黄海定,巫莉萍,邓时贵.大黄对肺卫失宣大鼠肺泡Ⅱ型上皮细胞超微结构及肺组织Na+-K+-ATPase活力的影响[J].中国实验方剂学杂志,2011,17(8):190-193.
[16]LI J,XU M,FAN Q,et al.TanshinoneⅡA ameliorates seawater exposure-induced lung injury by inhibiting aquaporins(AQP)1 and AQP-5 expression in lung[J].Respir Physiol Neurobiol,2011,176(1/2):39-49.
[17]许银姬,陈远彬,王丽丽,等.青天葵对内毒素致急性肺损伤大鼠肺水通道蛋白1和5表达的影响[J].中国中西医结合杂志,2010,30(8):861-866.
[18]曾伟,孙昊鑫,马广强,等.二冬膏对LPS致急性肺损伤大鼠肺组织TNF-α、IL-6及AQP-1、AQP-5的影响[J].中药药理与临床,2016,32(6):10-13.
[19]吴振起,韩冬阳,王贵帮,等.清燥救肺汤“润燥”作用的分子机制[J].中国实验方剂学杂志,2018,24(11):92-98.
[20]丁伟伟,杨程,童佳兵,等.阳和平喘颗粒对哮喘大鼠肺组织AQP1和AQP5表达的影响[J].南京中医药大学学报,2016,32(1):41-44.
[21]冯立志,单丽囡,黄纯美,等.益气化痰方对慢性阻塞性肺疾病大鼠肺泡灌洗液中AQP5、TNF-α和MUC5AC的影响[J].广州中医药大学学报,2016,33(1):80-83.
[22]赖鹏华,单晓梅,卢大为,等.三仁汤对湿热应激小鼠肺组织黏蛋白5AC、水通道蛋白1、水通道蛋白5表达的影响[J].中医杂志,2017,58(5):410-413.
[23]廉富,苏景深,刘恩顺,等.通腑泻肺方对ALI/ARDS大鼠AQP-1/αENaC表达的影响[J].天津中医药,2018,35(6):442-444.
[24]JIN B,JIN H.Oxymatrine attenuates lipopolysaccharideinduced acute lung injury by activating the epithelial sodium channel and suppressing the JNK signaling pathway[J].Exp Anim,2018,67(3):337-347.
[25]赵燕,何婧,管弦,等.黄芪注射液对急性肺损伤小鼠钠通道表达的影响[J].南方医科大学学报,2012,32(11):1603-1605,1609.
[26]童佳兵,王浩,李泽庚,等.小青龙汤对肺源性心脏病大鼠血浆AngⅡ、ALD、Na+-K+-ATPase含量和血浆中AT1和AT2mRNA的表达影响[J].世界科学技术-中医药现代化,2015,17(10):2104-2108.