Article(id=1308468372899909827, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1308468301072458736, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2025-0435, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1744732800000, receivedDateStr=2025-04-16, revisedDate=1754323200000, revisedDateStr=2025-08-05, acceptedDate=null, acceptedDateStr=null, onlineDate=1789892770265, onlineDateStr=2026-09-20, pubDate=1765468800000, pubDateStr=2025-12-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1789892770265, onlineIssueDateStr=2026-09-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1789892770265, creator=13701087609, updateTime=1789892770265, updator=13701087609, issue=Issue{id=1308468301072458736, tenantId=1146029695717560320, journalId=1189982191388893191, year='2025', volume='60', issue='12', pageStart='3545', pageEnd='3798', issueExtLink='null', onlineDate='null', pubDate='1765468800000', pubDateStr='2025-12-12', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1789892753141, creator='13701087609', updateTime=1789893218933, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1308470254842175559, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1308468301072458736, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1308470254842175560, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1308468301072458736, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3701, endPage=3711, ext={EN=ArticleExt(id=1308468373076070596, articleId=1308468372899909827, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=Research progress of plant essential oil and drug delivery system in the treatment of atopic dermatitis, columnId=1190335348648547107, journalTitle=Acta Pharmaceutica Sinica, columnName=Reviews, runingTitle=null, highlight=null, articleAbstract=

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by recurrent episodes and unbearable itching, imposing a heavy physical and psychological burden on patients. The pathogenesis of AD is complex, involving multiple factors such as environmental triggers, immune dysregulation, skin olfactory receptors, impaired epidermal barrier, and skin-gut microbiome imbalance. First-line clinical chemical drugs, such as glucocorticoids, can alleviate inflammation and itching to some extent, but relapse after discontinuation and drug resistance remain significant challenges, and effective treatments are still lacking. In recent years, research on essential oils extracted from natural plants for AD treatment has increased, demonstrating notable efficacy, high safety, and no drug resistance. This article explores the pathogenesis of AD, summarizes the therapeutic effects and mechanisms of plant essential oils in AD treatment, and discusses how drug delivery systems can improve the physical properties of essential oils, aiming to provide insights for developing novel AD therapies.

, authors=Yi-han WANG1, Yong-ji LI1, Jin-jin DOU2, Xuan LIU3, Wei-peng SONG3, Xi-wu ZHANG4, 5, *, authorsList=Yi-han WANG, Yong-ji LI, Jin-jin DOU, Xuan LIU, Wei-peng SONG, Xi-wu ZHANG, authorCompany=null, correspAuthors=Xi-wu ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1308468373898154187, articleId=1308468372899909827, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=植物精油及药物递送系统对特应性皮炎治疗的研究进展, columnId=1190335349655180086, journalTitle=药学学报, columnName=综述, runingTitle=null, highlight=null, articleAbstract=

特应性皮炎(atopic dermatitis, AD) 是一种慢性炎症皮肤病, 其病情反复发作和难以忍受的瘙痒, 给AD患者的身心带来了沉重的负担。AD发病机制复杂, 涉及环境、免疫失调、皮肤嗅觉受体、表皮屏障受损及皮肤与肠道微生物失调等多个因素。临床一线药品, 如糖皮质激素虽能一定程度缓解炎症和瘙痒, 但停药后易复发以及易产生耐药性, 目前尚缺乏有效的治疗方法。近年来, 从天然植物中提取精油治疗AD的研究日益增多, 且疗效显著、安全性高及无耐药性。本文以AD的发病机制为切入点, 总结植物精油治疗AD作用及作用机制, 以及药物递送系统改善精油物理特性, 以期为开发新型AD治疗方法提供参考。

, authors=王一寒1, 李永吉1, 窦金金2, 刘萱3, 宋伟鹏3, 张喜武4, 5, *, authorsList=王一寒, 李永吉, 窦金金, 刘萱, 宋伟鹏, 张喜武, authorCompany=null, correspAuthors=张喜武, authorNote=

#共同第一作者.

作者贡献:

王一寒、李永吉负责文献检索和筛选、数据的整理分析及初稿撰写; 窦金金负责指导相关疾病机制分析; 刘萱、宋伟鹏负责文章的构思与设计; 张喜武负责论文的审阅和指导修改。所有作者阅读并认可终稿。

, correspAuthorsNote=
张喜武, Tel: 15104530682, E-mail:
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植物精油及药物递送系统对特应性皮炎治疗的研究进展
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王一寒 1 , 李永吉 1 , 窦金金 2 , 刘萱 3 , 宋伟鹏 3 , 张喜武 4, 5, *
药学学报 | 综述 2025,60(12): 3701-3711
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药学学报 |综述 2025 , 60 (12) : 3701 -3711
植物精油及药物递送系统对特应性皮炎治疗的研究进展
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王一寒1, 李永吉1, 窦金金2, 刘萱3, 宋伟鹏3, 张喜武4, 5, *
作者信息
  • 1黑龙江中医药大学药学院, 黑龙江 哈尔滨 150040
  • 2黑龙江中医药大学附属第四医院, 黑龙江 哈尔滨 150077
  • 3黑龙江中医药大学基础医学院, 黑龙江 哈尔滨 150040
  • 4经方与现代中药融合创新全国重点实验室, 黑龙江 哈尔滨 150040
  • 5黑龙江中医药大学实验实训中心, 黑龙江 哈尔滨 150040
通讯作者:
张喜武, Tel: 15104530682, E-mail:
作者简介:

#共同第一作者.

作者贡献:

王一寒、李永吉负责文献检索和筛选、数据的整理分析及初稿撰写; 窦金金负责指导相关疾病机制分析; 刘萱、宋伟鹏负责文章的构思与设计; 张喜武负责论文的审阅和指导修改。所有作者阅读并认可终稿。

Research progress of plant essential oil and drug delivery system in the treatment of atopic dermatitis
Yi-han WANG1, Yong-ji LI1, Jin-jin DOU2, Xuan LIU3, Wei-peng SONG3, Xi-wu ZHANG4, 5, *
Affiliations
  • 1School of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin 150040, China
  • 2The Fourth Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150077, China
  • 3School of Basic Medical Sciences, Heilongjiang University of Chinese Medicine, Harbin 150040, China
  • 4National Key Laboratory of Classical Prescription and Modern TCM Integration and Innovation, Harbin 150040, China
  • 5Experimental and Practical Training Center, Heilongjiang University of Chinese Medicine, Harbin 150040, China
出版时间: 2025-12-12 doi: 10.16438/j.0513-4870.2025-0435
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特应性皮炎(atopic dermatitis, AD) 是一种慢性炎症皮肤病, 其病情反复发作和难以忍受的瘙痒, 给AD患者的身心带来了沉重的负担。AD发病机制复杂, 涉及环境、免疫失调、皮肤嗅觉受体、表皮屏障受损及皮肤与肠道微生物失调等多个因素。临床一线药品, 如糖皮质激素虽能一定程度缓解炎症和瘙痒, 但停药后易复发以及易产生耐药性, 目前尚缺乏有效的治疗方法。近年来, 从天然植物中提取精油治疗AD的研究日益增多, 且疗效显著、安全性高及无耐药性。本文以AD的发病机制为切入点, 总结植物精油治疗AD作用及作用机制, 以及药物递送系统改善精油物理特性, 以期为开发新型AD治疗方法提供参考。

植物精油  /  特应性皮炎  /  药物递送系统  /  作用机制  /  嗅觉受体

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by recurrent episodes and unbearable itching, imposing a heavy physical and psychological burden on patients. The pathogenesis of AD is complex, involving multiple factors such as environmental triggers, immune dysregulation, skin olfactory receptors, impaired epidermal barrier, and skin-gut microbiome imbalance. First-line clinical chemical drugs, such as glucocorticoids, can alleviate inflammation and itching to some extent, but relapse after discontinuation and drug resistance remain significant challenges, and effective treatments are still lacking. In recent years, research on essential oils extracted from natural plants for AD treatment has increased, demonstrating notable efficacy, high safety, and no drug resistance. This article explores the pathogenesis of AD, summarizes the therapeutic effects and mechanisms of plant essential oils in AD treatment, and discusses how drug delivery systems can improve the physical properties of essential oils, aiming to provide insights for developing novel AD therapies.

plant essential oil  /  atopic dermatitis  /  drug delivery system  /  mechanism of action  /  olfactory receptor
王一寒, 李永吉, 窦金金, 刘萱, 宋伟鹏, 张喜武. 植物精油及药物递送系统对特应性皮炎治疗的研究进展. 药学学报, 2025 , 60 (12) : 3701 -3711 . DOI: 10.16438/j.0513-4870.2025-0435
Yi-han WANG, Yong-ji LI, Jin-jin DOU, Xuan LIU, Wei-peng SONG, Xi-wu ZHANG. Research progress of plant essential oil and drug delivery system in the treatment of atopic dermatitis[J]. Acta Pharmaceutica Sinica, 2025 , 60 (12) : 3701 -3711 . DOI: 10.16438/j.0513-4870.2025-0435
特应性皮炎(atopic dermatitis, AD) 是一种常见的慢性炎症性皮肤病, 其特点在于表皮屏障功能的损害以及免疫反应异常[1]。近年来, 由于城市化和工业化, 皮肤经常暴露在病原体和环境风险中, 包括污染物、颗粒物和重金属, 使得AD的患病率上升, 在全球范围儿童患病率高达20%, 成人可达10%, 是皮肤病中难以治愈且负担较重的疾病之一[2]。AD患者临床表现为皮肤发红、瘙痒难耐、肿胀, 并伴有表皮剥落及皮肤干燥等症状[3]。瘙痒作为AD的核心症状, 对患者的生活质量、社会心理健康状态、工作效率以及治疗费用均产生负面影响[4]。相关研究表明, AD严重影响患者睡眠质量, 进而损害神经认知功能[5], 同时患者常伴随焦虑、抑郁和自尊心低下, 导致AD患者患双相情感障碍的风险较健康人高出1.49倍[6]。因此, 越来越多的临床医生和科研人员致力于探究AD的多元病因, 并研发出针对性的治疗方案, 不断推动AD治疗与预防领域的进步与发展。
大量研究表明, AD的发病与炎性细胞因子失衡有关, 涉及角质形成细胞、单核细胞及B细胞等[7]。角质形成细胞可分泌多种细胞因子(如促炎因子、免疫调节因子及趋化因子), 并在肿瘤坏死因子α (tumor necrosis factor-α, TNF-α) 和干扰素-γ的协同刺激下激活核转录因子-κB (nuclear factor-κ B, NF-κB) 信号通路、丝裂原活化蛋白激酶(mitogen-activated protein kinase, MAPK) 信号通路与Janus酪氨酸蛋白激酶/信号转导及转录激活因子(Janus kinase/signal transducer and activator of transcription, JAK/STAT) 等多种信号通路[8]。同时, 白介素(interleukin, IL)-4和IL-13水平升高会激活辅助性T细胞(T helper cell, Th) 免疫反应, 导致Th1/Th2失衡, 过度Th1反应激活M1极化巨噬细胞, 加重AD[9]。此外, IL-1β在AD中促进皮肤炎症并诱导IL-6产生, 而IL-1β和IL-18可能通过NOD样受体热蛋白结构域相关蛋白3 (NOD-like receptor family pyrin domain containing 3, NLRP3) 炎症小体激活介导AD表型, 最终引发细胞焦亡, 导致AD和痤疮等皮肤病[10]。炎症介质(如组胺) 释放后刺激神经末梢引发瘙痒, 患者抓挠导致皮肤屏障受损[11], 使得空气污染物中的有机成分更容易激活角质形成细胞中的芳香烃受体(aryl hydrocarbon receptor, AhR)。AhR的激活诱导神经营养因子表达, 引起异常性瘙痒、表皮神经纤维过度增生和炎症反应, 形成恶性循环, 最终加重AD症状[12]。
此外, 临床数据表明, AD患者皮肤微生物多样性减少(丙酸杆菌、链球菌及棒状杆菌数量下降) 以及金黄色葡萄球菌和马拉色菌等菌群过度增殖导致的皮肤微生物失衡[13]。例如, 对轻、中、重度AD患者与健康人的皮肤微生物检测结果发现, 轻度AD病灶上金黄色葡萄球菌含量高出健康人的40.2倍, 而在重度病灶中, 金黄色葡萄球菌的增长率高达368.3倍[14]。进一步研究揭示, 金黄色葡萄球菌能分泌多种蛋白酶, 加速皮肤角质层的分解, 削弱AD患者的皮肤屏障[15]。更易受微生物和过敏原的感染, 促使活性氧(reactive oxygen species, ROS) 的产生[16], 并降低皮肤丝聚蛋白(filaggrin, FLG) 和天然保湿因子水平, 减少角质层脂质, 进而增加皮肤对有害物质的敏感性[17, 18]。
此外, 肠道菌群的失衡也是AD的发病机制之一[19]。相关研究表明, 肠道与皮肤之间存在着双向的生物联系通道, 即“肠道-皮肤轴”, 肠道菌群能够通过免疫、代谢及神经内分泌通路对皮肤产生影响[20]。例如, 对比28名AD患者与23名健康人的粪便及血清样本后发现, AD患者的肠道微生物多样性及血清中多数代谢物水平显著低于健康人[21]。此外, 肠道菌群失衡会减少肠道内的乳酸杆菌和双歧杆菌等厌氧菌数量, 进而影响短链脂肪酸(short-chain fatty acids, SCFAs) 的生成[22]。SCFAs作为维护肠黏膜屏障的重要成分, 其减少会损害屏障功能, 增加肠道通透性, 导致肠漏现象, 使得微生物产物(如脂多糖) 更易进入血液循环, 引发低度全身炎症反应, 并激活Th2通路[23]; 另一方面, 肠道泄漏的细菌和产物能与皮肤受体相互作用, 对皮肤及其共生细菌产生直接或间接影响, 进而促进AD的发展[24]。
除了上述诱因外, AD的发病与肺脏功能紧密相关, 与“肺主皮毛”中医理论一致[25]。AD患者皮肤屏障受损, 导致全身免疫系统失衡从而影响呼吸道, 导致肺菌群失衡, 促进胸腺基质淋巴细胞生成素(thymic stromal lymphopoietin, TSLP) 的生成, 一旦TSLP进入血液循环并到达皮肤, 会激发或加重AD的炎症反应[17]。此外, AD患者并发哮喘的几率较高[26]。研究还发现, 小鼠肺组织受损时会迅速分泌IL-33[27], 而皮肤角质形成细胞受损或感染金黄色葡萄球菌也会释放IL-33[28]。然而, 关于肺脏与AD关联的具体研究仍然有限, 有待进一步深入探讨。
综上, AD的发病机制和病理特征是一个复杂的过程, 涉及皮肤屏障、炎症及氧化因子、皮肤菌群、肠道菌群和肺脏功能等多个方面的相互作用(图1)。
随着对天然植物活性成分的深入研究, 植物精油因其卓越的抗炎、抗氧化及抗菌特性, 在皮肤病的辅助治疗和皮肤护理中展现出独特价值[29]。精油是芳香植物中天然存在的挥发性、脂溶性及芳香成分的复杂混合物, 主要从植物的叶、花、皮、根茎、种子及果皮等部位的分泌细胞、空腔、油室和腺毛等特殊结构中提取获得[30]。在化学组成上, 精油主要包含以下几类物质: 萜烯类化合物(如单萜、倍半萜和二萜)、含氧衍生物(包括醇类、酚类、醛类、酮类、酯类等)、苯丙烷代谢途径生成的芳香族化合物(如肉桂醛、丁香酚), 以及含氮、含硫的特殊成分[31]。在物理特性方面, 多数精油在室温下呈现无色或淡黄色的液态, 且密度低于水(仅少数例外, 如肉桂油)[32]。在应用价值上, 精油具有双重功效: 一方面可作为治疗性药物, 用于皮肤病治疗和痤疮防治; 另一方面也广泛应用于日常皮肤护理, 发挥抗氧化、抗菌和保湿等功效[33]。这种多功能的特性使其在医药和皮肤病领域都具有重要价值。
在精油提取领域, 主要采用两大类方法: 传统方法(水蒸馏、蒸汽蒸馏、水扩散、溶剂提取) 和现代先进技术(超临界流体提取、亚临界液体提取、无溶剂微波提取)[34]。目前大多数精油仍采用操作简便且易于分离有效成分的传统方法如: 蒸汽蒸馏或水蒸馏法进行提取, 尤其适合薄荷、薰衣草等草本植物精油的提取。而对于柑橘类水果果皮等原料, 则普遍采用冷压法或压榨法进行提取, 可完整保留柑橘精油特有的清新香气成分。此外, 对于玫瑰、橙花、晚香玉和茉莉等不耐受高温蒸汽或无法冷压处理的植物原料, 则需采用溶剂萃取法进行提取[35]。相比之下, 先进技术因提取时间短、能耗低、溶剂用量少且二氧化碳排放少正逐步成为精油提取技术升级的主要方向。
AD的核心病理特征包括Th2型炎症反应和皮肤屏障功能障碍。多项研究表明, 植物精油可通过多靶点干预直接缓解AD症状。例如Sato等[36]通过建立XRE-NanoLuc报告基因系统的人角质形成细胞AD模型, 发现薰衣草精油能显著抑制6-甲酰基吲哚[3, 2-b]咔唑诱导的神经营养因子Artemin神经生长因子(一种与AD神经高敏相关的神经营养因子) 表达[抑制率达(78.3 ± 5.2)%], 缓解瘙痒和炎症, 同时通过角质形成细胞和树突状细胞活化实验证实其几乎不引起皮肤致敏反应(致敏评分 < 0.8), 表明薰衣草精油可直接调控污染物诱导的异生物质反应通路发挥抗AD特性, 且该细胞模型可替代动物实验用于AD药物评估。
虽然糖皮质激素外用制剂(如二丙酸倍他米松) 仍是AD的一线治疗方案, 但长期使用可能导致皮肤萎缩、毛细血管扩张、色素紊乱等多种不良反应[37]。为克服这一局限性, Liana等[38]将红花山姜根茎精油与糖皮质激素联用, 开发出具有协同治疗效应的纳米乳(nanoemulsion, NE) 系统。该研究采用超声辅助法制备的NE粒径小于20 nm, 包封效率超过95%, 不仅能维持精油活性成分的稳定性, 还显著提升了治疗效果: 使5-脂氧合酶抑制率提升32.7%, 一氧化氮释放抑制效果增强41.5%, 同时促进角质细胞中兜甲蛋白(loricrin, LOR) 和FLG表达, 分别增加58%和63%, 显著改善皮肤屏障功能。此外, 该复合制剂对金黄色葡萄球菌的抑制效果提高2.3倍, 且表现出更低的细胞毒性。这一发现为开发高效低毒的AD治疗方案提供了新思路。
精油可有效解决AD患者因角质层增厚导致的药物渗透难题。其作用机制主要体现在3个方面: 首先, 通过解构角质细胞间规则排列的脂质层; 其次, 改变细胞间蛋白质构象; 最后, 优化药物分配特性。值得注意的是, 精油在皮肤代谢迅速(t1/2 < 4 h), 无体内蓄积风险, 安全性显著优于传统合成促渗剂。典型如薰衣草和薄荷精油, 能使亲脂药物透皮效率提高2.1~3.8倍(P < 0.01), 且皮肤刺激指数仅为合成制剂的20%~33%[39]。最新研究Yang等[40]采用闪提-微波联用技术开发的丹参/肉桂/冰片复方精油, 经气相色谱-质谱联用鉴定含特征性萜类物质, 通过SEM/HE/CLSM多模态成像证实可使角质细胞间隙增宽(42.7 ± 5.3)%, 体外和活体实验均显示1.5%浓度对疏水性成分的促渗效果最优(较对照组提升220%), 且作用时效较亲水成分缩短44%。这些发现为开发新一代天然透皮给药系统提供了重要依据。
鉴于AD患者数量持续增长和现有治疗药物的局限性, 寻找一种高效且不良反应低的治疗方案变得尤为迫切。而精油作为天然的抗炎剂、氧化剂和抑菌剂, 凭借小分子和亲脂特性, 精油能迅速渗透皮肤深层, 是治疗不同皮肤病局部递送的理想药物[41]。此外, 精油特有的气味对人类的情绪和交感神经系统的应激反应具有重要影响[42], 通过嗅觉系统吸入精油可快速(15 min内) 调节自主神经功能(如血压、脉搏率及大脑活动) 并促进神经突生长与神经递质平衡, 从而缓解焦虑、疼痛及睡眠障碍, 显著改善患者的生理、心理及情绪健康状态, 最终提升其生活质量[35] (图2)。值得注意的是, 全球1.75万种植物可以产生精油, 但其中只有约300种被商业化。这说明精油在治疗各种皮肤病方面具有很大的潜力[43]。
直接降低促炎因子水平和快速修复受损皮肤是治疗AD的有效手段。Huang等[44]通过2, 4-二硝基氯苯(2, 4-dinitrochlorobenzene, DNCB) 诱导AD小鼠模型, 并使用青蒿精油(Artemisia annua L. essential oil, AAEO) 和阳性药丁酸氢化可的松乳膏(hydrocortisone butyrate cream, HBC) 治疗, 结果发现AAEO逆转了DNCB诱导的FLG和LOR水平下降, 减少表皮厚度和肥大细胞浸润, 而HBC对FLG和LOR的影响较弱。此外, AAEO通过抑制MAPK/NF-κB信号通路, 降低TNF-α、IL-1β和IL-6的mRNA表达, 证明其局部应用可抑制炎症并恢复皮肤屏障功能。同样, Li等[45]通过DNCB诱导建立AD小鼠模型, 并用不同浓度迷迭香精油(Rosmarinus officinalis essential oil, EORO) 治疗, 发现EORO通过调节JAK/STAT/NF-κB信号通路, 降低血清IL-6和TNF-α水平, 减少皮肤中磷酸化Janus激酶1、CD4+细胞、IL-4、p-P65/P65和p-STAT3/STAT3的表达, 并显著改善表皮增厚、水肿、角化过度及炎性细胞浸润, 且疗效随浓度增加而增强。此外, Kim等[46]通过薄荷精油(Mentha arvensis essential oil, MAEO) 处理脂多糖和三磷酸腺苷诱导的巨噬细胞和DNCB诱导的AD小鼠模型, 发现MAEO显著降低NLRP3炎症小体介导的IL-1β和IL-18产生, 减轻表皮增厚、肥大细胞浸润及背侧皮肤IL-1β表达, 并降低血浆免疫球蛋白E (immunoglobulin E, IgE) 和TSLP水平, 同时有效调节AD病灶中NLRP3过表达、巨噬细胞的浸润和炎症小体形成, 显著改善小鼠的AD症状。
有害细菌, 尤其是金黄色葡萄球菌的增殖会加剧AD症状, 因此清除这些细菌是改善AD的关键。精油作为一种天然亲脂物质, 能够破坏细菌质膜结构, 增加膜通透性, 导致细菌内容物外泄, 最终致其死亡[47]。例如, 荆芥和牛至精油均能显著抑制耐甲氧西林金黄色葡萄球菌, 其中荆芥精油通过选择性靶向细菌膜, 对细菌膜造成显著损伤并干扰其氨基酸代谢[48]。Mrani等[49]通过分子对接研究发现, 依兰精油对皮肤病治疗具有潜在靶点, 且对金黄色葡萄球菌的抑菌直径为14.5 mm, 最小抑菌质量浓度为0.04 mg·mL-1。此外, 鼠尾草和假洋甘菊精油也能抑制金黄色葡萄球菌, 其中假洋甘菊精油通过与细菌DNA旋转酶B的结合位点结合, 抑制其活性[50, 51]。在实际应用中, 互生叶白千层精油乳膏能够减少金黄色葡萄球菌感染小鼠伤口的有害菌数量, 降低感染程度并促进伤口愈合[52]。
炎症反应所产生的氧化自由基在AD发病机制中起关键作用, 过量氧化自由基会导致脂质过氧化, 损伤皮肤细胞并释放炎症因子, 从而引发免疫系统失衡。因此, 清除过量氧化自由基是治疗AD的重要策略。研究表明, 薰衣草和百里香以2∶1比例混合的精油使用21天, 可显著降低AD模型小鼠的超氧自由基水平、肥大细胞脱颗粒及表皮厚度[53]。Zhang等[54]构建了金黄色葡萄球菌代谢物刺激的皮肤炎症细胞损伤模型, 发现葡萄柚精油能显著促进人永生化角质形成细胞增殖, 减少代谢物诱导的ROS产生, 并抑制IL-1和环氧合酶-2表达上调。在3D表皮模型中, 葡萄柚精油还能恢复代谢物引起的LOR和FLG含量下降。大量实验已证实精油具有抗氧化特性, 如蜡梅精油可降低丙二醛和ROS水平, 同时增强肠道组织中的超氧化物歧化酶(superoxide dismutase, SOD) 活性[55]。茶树精油通过增强SOD和抗坏血酸过氧化物酶活性, 并抑制脂氧合酶, 发挥抗氧化作用[56]。然而, 目前通过AD动物模型或临床AD患者验证精油抗氧化特性的研究较少, 未来仍需进一步探索。
嗅觉受体(olfactory receptor, ORs) 在多种皮肤细胞(如角质细胞、黑素细胞、成纤维细胞) 中广泛分布, 当皮肤(人体最大防护器官) 暴露于外界气味刺激时, ORs被激活并发挥关键功能, 包括促进伤口修复、调控毛发生长、影响黑色素瘤进展, 以及参与AD的病理机制[57]。例如, Tham等[58]发现AD患者皮肤中异位OR10G7表达显著升高, 可能参与AD发病或与相关感觉化学感受通路有关, 为ORs作为AD治疗新靶点提供支持。进一步的研究中, Adipietro等[59]确定了包括丁香酚在内的4种OR10G7配体。丁香酚作为丁香精油的主要活性成分, 具有抗氧化、抗菌和抗炎等多重功效[60]。
尽管现有研究尚未充分阐明精油通过ORs干预AD的具体机制, 但其在情绪调节方面的多通路作用已得到较多验证。精油凭借优异的血脑屏障穿透能力, 其活性成分可同时通过嗅觉传导(刺激嗅黏膜) 和肺部吸收(进入体循环) 双重途径影响中枢神经系统, 不仅能上调单胺类神经递质和脑源性神经营养因子的表达, 还可促进海马区神经发生, 这种独特的“双通道-多靶点”作用模式既避免了传统抗抑郁药的局限性, 又能同步调控下丘脑-垂体-肾上腺轴, 从而为AD患者常见的焦虑抑郁共病提供了“皮肤局部治疗-中枢情绪调节”的协同干预策略[61, 62]。例如, 吸入佛手柑精油能放松身心、改善睡眠、缓解心理压力症状[63]。薰衣草精油则能针对中枢杏仁核γ-氨基丁酸神经元产生促进睡眠的作用[64]。在临床中薰衣草精油已作为芳香疗法的主要应用精油。柑橘精油通过改善小鼠的嗅觉功能、神经刺激, 来缓解焦虑行为[65]。这些发现为利用精油改善AD患者心理压力提供了有力证据。
精油虽源自天然植物, 但其经蒸馏提纯后浓度可提高百倍, 具有显著生物活性。但其潜在毒性不容忽视, 局部使用时易导致光敏反应(尤以柑橘类精油的光毒性最为显著, 可造成永久性皮肤损伤)、黏膜刺激等不良反应, 需通过正确稀释和规范使用来降低风险[66, 67]。例如, Geier等[68]通过对2010~2019年间德国皮肤病信息网络10 930例患者的回顾性研究发现, 在接受测试的12种精油中有8.3%的患者出现致敏反应, 其中依兰精油(3.9%)、柠檬草精油(2.6%)、茉莉精油(1.8%)、檀香油(1.8%)、丁香精油(1.6%) 和橙花精油(1.1%) 的阳性反应率超过1%, 并证实女性、腿部皮炎患者、40岁以上人群及按摩师/美容师等职业接触人群具有更高的致敏风险。由于精油监管体系在全球范围内尚未统一, 各国采取不同管理模式: 美国食品药品监督管理局(Food and Drug Administration, FDA) 按产品用途分类监管, 欧盟遵循化妆品法规, 澳大利亚治疗商品管理局(Therapeutic Goods Administration, TGA) 则依据治疗用途进行规范, 而世界卫生组织等国际组织通过制定标准和安全指南促进全球协调[69]。这种多元化的监管格局反映了精油作为跨界产品的复杂性, 也凸显了在享受其益处的同时必须重视安全评估和合理使用的重要性。在实际应用中, 精油通常需用基础油(如植物油、固定油或脂肪)、乳霜基质或凝胶进行稀释, 推荐浓度范围一般为2%~5%。对于刺激性较强的精油, 其最大稀释浓度应降至0.5%以确保使用安全[70]。
天然植物精油因其卓越药理特性, 在治疗AD等皮肤疾病方面展现出巨大潜力[71]。然而, 精油的易挥发、水溶性差、生物利用度低及稳定性不足等特性, 极大限制了精油在实际应用中的范围和效果。为了克服以上缺陷, 近10年来, 科研人员广泛采用药物递送系统来封装精油。通过将精油包裹在载体内部, 可以有效防止精油因光、热等因素导致的降解, 提高精油的生物利用度及稳定性, 同时赋予精油缓释和靶向释放的能力, 进一步拓宽精油的应用场景[72]。
随着载体技术的飞速发展, 多种类型的药物递送系统应运而生, 包括但不限于: 脂质体(liposom, LS)、固体脂质纳米粒(solid lipid nanoparticle, SLN) 和纳米结构脂质载体(nanostructured lipid carrier, NLC); 乳液递送系统, 如纳米乳液(NE)、微乳液(microemulsion, ME) 和Pickering乳液(Pickering emulsion, PE); 微胶囊(microcapsule, MC) 和纳米胶囊(nanocapsule, NC); 纳米凝胶(nanogel, NG); 以及壳聚糖(chitosan, CS)、环糊精(cyclodextrin, CD) 和聚合物胶束(polymeric micelle, PM) 等(图3)。因此, 深入探究精油与药物递送系统之间的联系, 有助于更充分地利用精油的药理作用, 为AD的治疗提供新的思路和解决方案。
多项临床研究表明, 特定植物精油在AD治疗中展现出显著疗效。例如, 月见草精油可使96%的AD患者皮损面积、严重程度等指标显著改善(P < 0.000 01), 且安全性良好[73]。乳膏剂是治疗AD的常用类型, Fitzi等[74]通过一项开放多中心临床试验评估了含10%茶树油的标准化乳膏对53只犬慢性皮炎的治疗效果, 结果显示每日两次、连续4周使用该制剂后82%的患犬获得良好或极佳治疗效果(P = 0.05), 主要临床症状显著减轻甚至消失(P = 0.001), 且仅出现两例可能与该制剂相关的局部不良反应。Lu等[75]开发了含1%茶树油的卡波姆凝胶制剂, 该制剂不仅具有显著的抗炎(抑制率46.15%, P < 0.01) 和广谱抗菌(金黄色葡萄球菌、大肠杆菌和绿脓杆菌) 作用, 还通过了严格的溶血实验(半数致死浓度= 456 157 mg·L-1) 和皮肤刺激试验(刺激积分0.036~0.125)。Thursday Plantation茶树油药用凝胶(编号: 55740) 是经澳大利亚治疗用品管理局认证的外用抗菌制剂, 其活性成分为20%高浓度茶树精油, 同时加入松油烯-4-醇。该凝胶制剂以卡波姆940为凝胶基质, 配合乙醇、肉豆蔻酸异丙酯、聚山梨酯60及外消旋樟脑等辅料, 经三乙醇胺调节pH值后形成稳定体系。已经在临床适用于浅表性皮肤感染的辅助治疗及炎症性皮肤病的止痒消炎。Lee等[76]通过建立DNCB诱导的AD小鼠模型, 每日局部应用3%德国洋甘菊精油(70 μL, 每周6次) 持续4周, 发现该精油能显著降低血清IgE水平(4周时)、免疫球蛋白G1 (immunoglobulin G1, IgG1) 水平(较2周时降低) 和组胺水平(2周时), 并显著减少瘙痒频率, 证实德国洋甘菊精油通过调节Th2细胞活化发挥免疫调节作用, 从而缓解AD症状。基于此, 德国洋甘菊精油的核心活性成分α-红没药醇, 凭借其卓越的抗炎和皮肤修复特性已成为MAS063DP霜的关键活性物质并通过了FDA和欧洲药品管理局医疗器械认证, 专门用于缓解成人和儿童轻度至中度AD及接触性皮炎症状[77]。这款由皮肤科医生推荐的治疗产品, 充分展现了植物精油在皮肤疾病治疗领域的临床应用价值。
然而, 精油固有的挥发性与皮肤渗透限制制约了其临床转化, 这促使研究者通过递送系统优化其性能。针对精油固有的挥发性与渗透性限制, 纳米包封等新型递送系统通过提高稳定性、溶解度和协同效应, 为精油的临床应用提供了新的解决方案[78]。
药物递送系统作为提升精油疗效的关键手段, 其核心优势之一在于显著提高精油的渗透性和溶解性, 以此来提高精油活性[79]。例如, Xu等[80]通过相转变法制备了洋甘菊精油NE液(CVO-NEs), 得到球形纳米颗粒, 在利用白及多糖包封形成CVO-NEGs。体内研究表明, CVO-NEGs显著减轻AD模型小鼠的皮肤损伤、表皮厚度和肥大细胞浸润, 抑制IgG产生并降低TNF-α、IL-4和IFN-γ表达。流式细胞术结果显示, CVO-NEGs控制Th1/Th2免疫失衡, 减少Th2过度激活引起的超敏反应, 证明了NEGs的制备增强了精油在AD治疗中的生物活性。此外, Alsakhawy等[81]将柠檬草精油(lemongrass essential oil, LGO) 封装在玉米醇溶蛋白-酪蛋白酸钠纳米颗粒中, 与纯LGO相比, 纳米颗粒的包裹显著增加了LGO对表皮葡萄球菌细胞壁通透性和细胞内酶泄漏量, 其药效活性提高2~4倍。Vase等[82]发现, 茶树精油与CS结合后, 在较低浓度下也可达到与纯精油相当的抗铜绿假单胞菌和金黄色葡萄球菌的效果。Manzoor等[83]将薰衣草、罗勒和丁香精油制备成ME, 发现ME在低于纯精油的浓度下对金黄色葡萄球菌和大肠杆菌表现出显著的抗菌活性, 提高精油抗菌效率并降低其使用量。此外, Satrialdi等[84]采用乳化超声法将丁香精油负载到NLC中。结果表明, CO-NLC (IC50 = 18.28 ± 2.63 µg·mL-1) 比游离精油(IC50 = 22.74 ± 0.57 µg·mL-1) 表现出显著的自由基清除活性, 增强了精油的抗氧化活性。
在治疗AD的过程中, 将精油与载体相结合, 可以实现缓慢释放的效果, 从而确保精油保持在治疗所需的浓度, 以此达到长期治疗效果。Elsewedy等[85]将治疗AD的药物夫西地酸与肉桂精油联合负载到NE中, 并将其整合到凝胶基质中。研究发现, 肉桂精油的体外释放可持续6 h, 释放率为52.0%, 且在室温(25 ℃) 和冷藏(4 ℃) 条件下储存3个月仍保持稳定。体外抑菌实验结果表明, 肉桂精油显著增强了夫西地酸的抗菌作用, 这为AD的治疗提供了新的思路。Silva-Flores等[86]通过纳米沉淀法将迷迭香和薰衣草精油封装到聚合物NC中。结果表明, 与纯精油相比, NC封装显著提高精油在皮肤角质层中的沉积率。Chen等[87]采用薄膜分散法封装丁香精油, 结合冻融法嵌入酪蛋白, 并通过后插入法将抗体偶联至LS表面, 制备出一种精准靶向细菌的蛋白酶激活抗菌LS。控释实验表明, 空肠弯曲菌的外分泌蛋白酶可水解酪蛋白并在LS上形成孔洞, 实现细菌依赖性的丁香精油释放, 显著延长抗菌效果, 该LS兼具缓释和靶向特性。
众多研究表明, 载体为封装的精油提供了屏蔽环境, 以保持稳定性, 防止在运输或制造过程中由外界环境引起的氧化降解。例如, Peng等[88]以乳清蛋白为乳化剂制备出含有山苍子的精油NE (LCEO-NE), 稳定性研究表明, LCEO-NE在4和25 ℃下储存可保持完整性长达4周。与纯精油相比, LCEO-NE表现出优异的抑菌和抗氧化特性, 并验证了LCEO-NE在有效浓度范围内的安全性。Yang等[89]采用复合凝固法和原位聚合法相结合制备出茶树精油的复合MC。热重分析显示, 显著提升了精油的热稳定性, 在人体正常皮肤环境中, 具备良好的缓释特性并保持长期稳定的抗氧化能力。
精油因其亲脂性特性, 直接涂抹于皮肤时容易引发光毒性、刺激性及过敏反应, 这对于皮肤屏障功能已经受损的AD患者而言尤为不利。通过与载体结合, 精油对皮肤的刺激性可以得到有效减轻。牛至精油具有抗菌、抗炎等功效, 但直接应用存在刺激性和光敏性等风险[90]。Kamenova等[91]将牛至精油封装到PM中, 随后整合到羟丙基纤维素水凝胶体系中。研究结果显示, 与纯精油相比, 即使在最高测试浓度下也未观察到细胞毒性作用。Wang等[92]通过转相乳化法制备洋甘菊精油的微乳, 并应用DNCB诱导小鼠AD模型验证, 发现与MREO相比ME降低了精油对小鼠的皮肤刺激性。Essid等[93]制备出肉桂精油CS纳米颗粒, 实验结果显示, 精油-CS纳米颗粒细胞毒性较纯精油降低4倍。此外, 负载天竺葵和柠檬草精油的CS降低了纯精油对小鼠单核巨噬细胞白血细胞的毒性, 也表现出优于纯CS或精油本身的活性[94]。
植物精油及其递送系统在AD治疗中展现出多靶点干预潜力, 通过抗炎(如抑制Th2型炎症反应)、抗菌(如针对金黄色葡萄球菌)、抗氧化及修复皮肤屏障等多重机制发挥治疗作用。然而, 精油固有的高挥发性、低水溶性和不稳定性严重制约了其临床应用, 这一瓶颈促使药物递送系统(如NE、LS) 的发展, 通过封装技术显著提升了精油的稳定性、渗透性和靶向性, 同时降低了其刺激性风险。临床研究已证实, 经递送系统优化的精油制剂(如茶树油NE、薰衣草精油LS) 不仅能显著改善AD症状, 与传统药物(如糖皮质激素) 联用还可产生协同增效作用, 减少激素用量。但当前仍面临标准化生产不足、长期安全性数据缺乏等挑战, 特别是高浓度精油可能导致的皮肤刺激和过敏反应需要严格把控。值得注意的是, 精油通过嗅觉受体调控情绪的作用机制尚未完全阐明, 这为未来研究提供了重要方向。
针对AD患者尤其是儿童, 植物精油的生物活性与自身的香气具有多方面的治疗作用, 可以提高患者的依从性, 并降低治疗成本, 为患者带来福音。尽管现有研究证实了精油的临床价值, 但在实际推广中仍面临诸多挑战。精油成分的复杂性及释放机制尚未完全清晰, 同时, 精油质量和活性成分含量易受植物生长阶段、提取部位及提取技术等多种因素影响。另外, 尽管药物递送系统能够有效减少精油可能引发的光毒性、眼部刺激和皮肤过敏等不良反应, 但单一载体的稳定性存在不足, 而两种或多种载体联合使用又会增加成本[95]; 此外, 在载体的制备过程中, 可能会残留有害溶剂或表面活性剂。因此, 需改进现有的载体技术, 以提高包封效率、优化缓慢释放和控释性能, 并减少有害溶剂和材料的使用, 同时探索新型的载体材料。更重要的是, 当前研究多局限于体外实验, 亟需建立从实验室到临床的完整验证体系, 确保实验结果与临床治疗效果保持一致, 以此建立起一个从实验室验证到临床应用评估的完整体系。未来发展方向应包括: 建立标准化的精油提取和质量控制规范; 开发新型环保载体材料以提高递送效率; 加强透皮给药机制研究和临床转化; 深入探索精油通过“皮肤-脑轴”调控情绪的作用机制; 推动全球统一的监管标准制定。通过多学科协同创新, 植物精油有望成为AD综合治疗方案中的重要组成部分, 以其天然特性提高患者依从性, 并为开发安全有效、经济可行的新型疗法提供可能, 最终造福广大AD患者群体。

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2025年第60卷第12期
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doi: 10.16438/j.0513-4870.2025-0435
  • 接收时间:2025-04-16
  • 首发时间:2026-09-20
  • 出版时间:2025-12-12
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  • 收稿日期:2025-04-16
  • 修回日期:2025-08-05
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    1黑龙江中医药大学药学院, 黑龙江 哈尔滨 150040
    2黑龙江中医药大学附属第四医院, 黑龙江 哈尔滨 150077
    3黑龙江中医药大学基础医学院, 黑龙江 哈尔滨 150040
    4经方与现代中药融合创新全国重点实验室, 黑龙江 哈尔滨 150040
    5黑龙江中医药大学实验实训中心, 黑龙江 哈尔滨 150040

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2种不同金属材料的力学参数
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属
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种数
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species
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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