Article(id=1322926126535934679, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.06.009, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339767344, onlineDateStr=2026-10-30, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339767344, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339767344, creator=13701087609, updateTime=1793339767344, updator=13701087609, issue=Issue{id=1322923782029062261, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='6', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1749484800000', pubDateStr='2025-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339208371, creator='13701087609', updateTime=1793340556755, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929437859258468, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929437859258469, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923782029062261, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=52, endPage=60, ext={EN=ArticleExt(id=1322926127769060057, articleId=1322926126535934679, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Research Progress in Modern Pharmacological Action,Formulation Design and Clinical Application of Wuzhuyu(Euodiae Fructus), columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=

Wuzhuyu(Euodiae Fructus)is one of the“three seeds and one shell”of Jiangxi's authentic medicinal materials,with a long history and wide application.The author reviewed the historical evolution of the efficacy of Wuzhuyu(Euodiae Fructus)by consulting the works of materia medica.On this basis,taking the modern research of Wuzhuyu(Euodiae Fructus)as the starting point,the literature analysis has been carried out from the aspects of modern pharmacological effects,preparation design and clinical external research.According to the current status of its research,the existing problems were analyzed.For example,the research on the modern pharmacological effects of Wuzhuyu(Euodiae Fructus)focuses on anti-tumor,anti-inflammatory,hepatoprotective,anti-Alzheimer's disease,etc.,but now the research focuses on the corresponding cell model as the research object,and there is a lack of real-world research based on clinical needs.As an important medicine for acupuncture point application,Wuzhuyu(Euodiae Fructus)is often used externally to treat stubborn diseases,and can realize the“internal and external treatment”of a variety of nervous system diseases,cardiovascular system diseases and digestive system diseases.However,at present,there are many scattered clinical external use research reports,mostly focusing on some case reports,lacking in-depth mechanism exploration,and has not yet formed a standardized treatment system,and lacks a standardized collection and sorting of the experience of external use of Wuzhuyu(Euodiae Fructus).In view of the problems of poor solubility,slow dissolution and low bioavailability of the main pharmacodynamic components such as evodiamine,rutaecarpine and limonin,it is expected to be devel-oped into a candidate drug for the effective treatment of tumors and inflammatory diseases through rational formulation design,such as nano-preparations,phospholipid complexes and inclusion complexes,but the research is limited to the bioavailability changes between the new preparation and the original drug and the quality evaluation of the preparation,and the lack of evaluation of the treatment effect of related diseases restricts the process of new drug creation.In this paper,the modern pharmacological effects,related dosage form design and clinical external use of Wuzhuyu(Euodiae Fructus)were systematically reviewed in recent years,in order to lay a foundation for the in-depth systematic research and development of topical preparations of Wuzhuyu(Euodiae Fructus).

, authors=Lili LIU1, 2, Zhanghong YAO1, 2, Tong LI3, Yan LIANG2, Lihua CHEN2, Yongmei GUAN2, Weifeng ZHU2, authorsList=Lili LIU, Zhanghong YAO, Tong LI, Yan LIANG, Lihua CHEN, Yongmei GUAN, Weifeng ZHU, authorCompany=null, correspAuthors=Weifeng ZHU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, 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=1322926133305541349, articleId=1322926126535934679, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=吴茱萸现代药理作用、剂型设计与临床外用研究进展, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=

吴茱萸为江西道地药材“三子一壳”之一,历史悠久,应用广泛。通过查阅历代本草著作梳理吴茱萸功效的历史沿革,在此基础上,以吴茱萸的现代研究为切入点,分别从现代药理作用、制剂设计、临床外用研究等方面进行文献分析。根据其研究现状,分析存在的问题。如吴茱萸现代药理作用研究聚焦于抗肿瘤、抗炎、保肝、抗阿尔茨海默病等,然目前的研究均以相应细胞模型作为研究对象,缺乏基于临床需求导向的真实世界研究;吴茱萸作为穴位贴敷之要药,常外用疗顽疾,可实现对多种神经系统疾病、心血管系统疾病和消化系统疾病的“内病外治”;但目前临床外用研究报道多而散,多集中于一些病例报道,缺乏深入的机制探索,且尚未形成规范的治疗体系,缺乏对吴茱萸外用人用经验的规范化收集整理;针对其所含主要药效成分如吴茱萸碱、吴茱萸次碱、柠檬苦素等水溶性差、溶出慢和生物利用度低等问题,通过合理制剂设计如纳米制剂、磷脂复合物和包合物等,改善其生物利用度,有望将其开发成有效治疗肿瘤及炎症疾病的候选药物,但研究局限于新制剂与原药之间的生物利用度变化及制剂的质量评价研究,缺乏对相关疾病治疗效果的评价,制约了其新药创制过程。将近年来吴茱萸现代药理作用、相关剂型设计与临床外用进行系统文献梳理,以期为吴茱萸的深入系统研究及外用制剂开发奠定基础。

, authors=刘丽丽1, 2, 尧章洪1, 2, 李童3, 梁炎2, 陈丽华2, 管咏梅2, 朱卫丰2, authorsList=刘丽丽, 尧章洪, 李童, 梁炎, 陈丽华, 管咏梅, 朱卫丰, authorCompany=null, correspAuthors=朱卫丰, authorNote=

刘丽丽(1985-),女,江西九江人,副教授,硕士研究生导师,博士,研究方向:中药经皮给药。

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朱卫丰(1969-),女,广东平远人,教授,博士研究生导师,博士,研究方向:中药新剂型与新技术。E-mail:。
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刘丽丽(1985-),女,江西九江人,副教授,硕士研究生导师,博士,研究方向:中药经皮给药。

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Asian J Pharm Sci,2019,14(3):265-274., articleTitle=Phyto-phospholipid complexes(phytosomes):A novel strategy to improve the bioavailability of active constituents, refAbstract=null), Reference(id=1322926175273747376, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926126535934679, doi=null, pmid=null, pmcid=null, year=2024, volume=59, issue=3, pageStart=532, pageEnd=542, url=null, language=null, rfNumber=[103], rfOrder=102, authorNames=夏哲炜, 孙驭航, 黄天乐, journalName=药学学报, refType=null, unstructuredReference=夏哲炜,孙驭航,黄天乐,等. 以天然产物吴茱萸碱为先导结构的抗肿瘤药物设计策略研究进展[J]. 药学学报,2024,59(3):532-542., articleTitle=以天然产物吴茱萸碱为先导结构的抗肿瘤药物设计策略研究进展, refAbstract=null)], funds=[Fund(id=1322926148853826362, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926126535934679, awardId=82360775, language=CN, fundingSource=国家自然科学基金项目(82360775), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322926134496723686, tenantId=1146029695717560320, 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注:图中圈越大代表出现频次越多。

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炎症类别化学成分作用机制参考文献
溃疡性结肠炎吴茱萸碱通过调节嗜酸乳杆菌,以增加结肠炎肠道中乙酸盐的产生,从而预防或治疗溃疡性结肠炎[34]
吴茱萸次碱通过调节CGRP的合成和释放干预溃疡性结肠炎[35]
柠檬苦素通过下调p-STAT3/miR-214水平来改善溃疡性结肠炎[36]
结肠炎吴茱萸碱通过诱导自噬体介导的炎症小体降解和抑制NF-κB途径抑制NLRP3炎症小体活化,协同作用于吴茱萸碱在结肠炎中的作用[37]
慢性结肠炎柠檬苦素通过抑制内质网应激(ER)的PERK-ATF4-CHOP途径和NF-κB信号传导来缓解葡聚糖硫酸盐钠(DSS)诱导的慢性结肠炎[38]
肺炎吴茱萸碱通过激活apelin途径减轻脂多糖诱导的肺部炎症和纤维化,达到抗炎作用[39]
神经炎症吴茱萸碱通过调节AKT/Nrf2/HO-1/NF-κB信号轴来抑制过度激活的小胶质细胞引起的神经炎症[40]
关节炎吴茱萸碱通过调节Treg和Th17细胞的异常分化,减少IL-17的产生并增加IL-10水平,抑制Stat3磷酸化并诱导Stat5磷酸化,达到抗关节炎的作用[41]
骨关节炎柠檬苦素通过Nrf2/HO-1/NF-κB信号通路对骨关节炎发挥保护作用[42]
肠炎柠檬苦素通过Nrf2/ARE途径改善肠道损伤和溃疡[43]
炎症吴茱萸碱通过抑制核因子激活的B细胞的κ-轻链增强(NF-κB)和丝裂原活化蛋白激酶(MAPK)途径抑制炎症[44]
吴茱萸次碱通过下调PI3K/AKT和MAPK介导的NF-κB信号通路,抑制Src/FAK通路以达到抗炎作用[45]
急性胰腺炎吴茱萸次碱通过抑制MAPK和NF-κB信号通路来改善急性胰腺炎;通过激活VR1上调内源性CGRP释放,改善胰腺组织的微循环,调节炎症因子的表达,以达到预防大鼠急性胰腺炎作用[46-47]
柠檬苦素通过抑制JAK2/STAT3信号通路改善两种小急性胰腺炎(AP)模型中的急性胰腺炎症状[48]
乳腺炎吴茱萸碱通过抑制AKT/NF-κB p65和MAPK信号通路,即通过抑制AKT、NF-κBp65、ERK1/2、p38和JNK的磷酸化来抑制炎症,从而改善脂多糖诱导的乳腺炎[49]
), ArticleFig(id=1322926147918496563, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926126535934679, language=CN, label=表1, caption=

吴茱萸抗炎作用机制

, figureFileSmall=null, figureFileBig=null, tableContent=
炎症类别化学成分作用机制参考文献
溃疡性结肠炎吴茱萸碱通过调节嗜酸乳杆菌,以增加结肠炎肠道中乙酸盐的产生,从而预防或治疗溃疡性结肠炎[34]
吴茱萸次碱通过调节CGRP的合成和释放干预溃疡性结肠炎[35]
柠檬苦素通过下调p-STAT3/miR-214水平来改善溃疡性结肠炎[36]
结肠炎吴茱萸碱通过诱导自噬体介导的炎症小体降解和抑制NF-κB途径抑制NLRP3炎症小体活化,协同作用于吴茱萸碱在结肠炎中的作用[37]
慢性结肠炎柠檬苦素通过抑制内质网应激(ER)的PERK-ATF4-CHOP途径和NF-κB信号传导来缓解葡聚糖硫酸盐钠(DSS)诱导的慢性结肠炎[38]
肺炎吴茱萸碱通过激活apelin途径减轻脂多糖诱导的肺部炎症和纤维化,达到抗炎作用[39]
神经炎症吴茱萸碱通过调节AKT/Nrf2/HO-1/NF-κB信号轴来抑制过度激活的小胶质细胞引起的神经炎症[40]
关节炎吴茱萸碱通过调节Treg和Th17细胞的异常分化,减少IL-17的产生并增加IL-10水平,抑制Stat3磷酸化并诱导Stat5磷酸化,达到抗关节炎的作用[41]
骨关节炎柠檬苦素通过Nrf2/HO-1/NF-κB信号通路对骨关节炎发挥保护作用[42]
肠炎柠檬苦素通过Nrf2/ARE途径改善肠道损伤和溃疡[43]
炎症吴茱萸碱通过抑制核因子激活的B细胞的κ-轻链增强(NF-κB)和丝裂原活化蛋白激酶(MAPK)途径抑制炎症[44]
吴茱萸次碱通过下调PI3K/AKT和MAPK介导的NF-κB信号通路,抑制Src/FAK通路以达到抗炎作用[45]
急性胰腺炎吴茱萸次碱通过抑制MAPK和NF-κB信号通路来改善急性胰腺炎;通过激活VR1上调内源性CGRP释放,改善胰腺组织的微循环,调节炎症因子的表达,以达到预防大鼠急性胰腺炎作用[46-47]
柠檬苦素通过抑制JAK2/STAT3信号通路改善两种小急性胰腺炎(AP)模型中的急性胰腺炎症状[48]
乳腺炎吴茱萸碱通过抑制AKT/NF-κB p65和MAPK信号通路,即通过抑制AKT、NF-κBp65、ERK1/2、p38和JNK的磷酸化来抑制炎症,从而改善脂多糖诱导的乳腺炎[49]
), ArticleFig(id=1322926147998188340, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926126535934679, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
药理作用相关成分作用机制参考文献
镇痛吴茱萸碱通过抑制炎症反应和维持线粒体抗氧化功能可改善紫杉醇诱导的神经性疼痛;通过调节nNOS和抑制AMPA受体GluA1的总蛋白表达及其在Ser831和Ser845处的磷酸化达到抑制偏头痛样疼痛作用[60-61]
抗增殖吴茱萸次碱通过与调节p81、Bax、Bcl-53以及半胱天冬酶-2和半胱天冬酶-9的相关表达诱导细胞的凋亡并抑制其生长,表现出抗增殖作用;通过降低细胞NO含量和NO合成酶活性,调节p81,Bax,Bcl-53等表达到抗增殖作用[62-63]
抗动脉粥样硬化吴茱萸碱通过抑制PI3K/AKT轴的活化来调节血管平滑肌细胞的增殖、迁移、炎症反应和氧化应激,从而抑制动脉粥样硬化的发生[64]
吴茱萸次碱通过优先上调ABCA1表达来保护ApoE小鼠免于动脉粥样硬化[65]
抗肥胖吴茱萸碱通过抑制脂肪细胞中的mTOR-S6K信号传导和IRS1丝氨酸磷酸化以改善葡萄糖耐量,预防肥胖或糖尿病状态相关的胰岛素抵抗作用[66]
降血糖吴茱萸次碱通过调节肝脏中的IRS-1/PI3K/AKT信号通路和骨骼肌中的AMPK/ACC2信号通路来改善大鼠的高脂血症和高血糖[67]
降血脂吴茱萸碱通过促进PPARγ-ABCG1信号通路降低小鼠的血脂[68]
), ArticleFig(id=1322926148094657333, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926126535934679, language=CN, label=表2, caption=

吴茱萸其他药理作用及其相关机制

, figureFileSmall=null, figureFileBig=null, tableContent=
药理作用相关成分作用机制参考文献
镇痛吴茱萸碱通过抑制炎症反应和维持线粒体抗氧化功能可改善紫杉醇诱导的神经性疼痛;通过调节nNOS和抑制AMPA受体GluA1的总蛋白表达及其在Ser831和Ser845处的磷酸化达到抑制偏头痛样疼痛作用[60-61]
抗增殖吴茱萸次碱通过与调节p81、Bax、Bcl-53以及半胱天冬酶-2和半胱天冬酶-9的相关表达诱导细胞的凋亡并抑制其生长,表现出抗增殖作用;通过降低细胞NO含量和NO合成酶活性,调节p81,Bax,Bcl-53等表达到抗增殖作用[62-63]
抗动脉粥样硬化吴茱萸碱通过抑制PI3K/AKT轴的活化来调节血管平滑肌细胞的增殖、迁移、炎症反应和氧化应激,从而抑制动脉粥样硬化的发生[64]
吴茱萸次碱通过优先上调ABCA1表达来保护ApoE小鼠免于动脉粥样硬化[65]
抗肥胖吴茱萸碱通过抑制脂肪细胞中的mTOR-S6K信号传导和IRS1丝氨酸磷酸化以改善葡萄糖耐量,预防肥胖或糖尿病状态相关的胰岛素抵抗作用[66]
降血糖吴茱萸次碱通过调节肝脏中的IRS-1/PI3K/AKT信号通路和骨骼肌中的AMPK/ACC2信号通路来改善大鼠的高脂血症和高血糖[67]
降血脂吴茱萸碱通过促进PPARγ-ABCG1信号通路降低小鼠的血脂[68]
), ArticleFig(id=1322926148337926966, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926126535934679, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
剂型相关成分制剂优点参考文献
脂质体柠檬苦素增加药物的稳定性及溶解度,使药物具有一定的缓释作用,且抑制肿瘤细胞增殖效果优于原料药[70]
纳米粒吴茱萸碱制剂理化性质较好,能有效改善保肝疗效,改善对小鼠急性肝损伤的保护作用;增强吴茱萸碱抗癌作用,增加细胞周期蛋白B1的表达,降低β-肌动蛋白的表达;提高生物利用度,且效果优于原料药[71-73]
纳米粒吴茱萸次碱制备成脂质立方液晶纳米粒,包封率高,疗效较原料药高[74]
吴茱萸碱衍固体脂质纳米粒增加缓释效应,同时增加[75]
生物两种衍生物在胃肠道的吸收,提高生物利用度
纳米乳吴茱萸碱吴茱萸碱油包水型复合纳米乳可增强吴茱萸碱在胃和各个肠段中的吸收,提高吴茱萸碱在大鼠体内的生物利用度[76]
吴茱萸碱较原料药更能促进药物的吸收,能明显提高吴茱萸碱的体外释放和大鼠口服生物利用度[77]
吴茱萸碱水包油型复合物纳米乳最大累积释放率约为原料药的2.61倍,口服生物利用度为7.35倍,可极大提高生物利用度[78]
吴茱萸碱吴茱萸碱负载油包水纳米乳液可增强原料药的理化性质和生物学特性,显著改善口服生物利用度,增加胃肠道的吸收[79]
吴茱萸碱吴茱萸碱-磷脂纳米复合物的新型油包水纳米乳液可显著增强吴茱萸碱的胃肠道吸收和口服生物利用度,增强疗效并减少不良反应[80]
纳米混悬剂吴茱萸次碱有效增加药物经皮渗透率[81]
柠檬苦素大量提高其溶解度和溶出度[82]
水凝胶吴茱萸碱制剂性能较优,24 h累积释放率达96.28%,与原料药比可显著增强体外经皮吸收[83]
吴茱萸碱将基于微乳液的水凝胶作为透皮共递送载体,可有效改善吴茱萸碱镇痛作用,提高溶解度,有效增强小鼠疼痛模型的镇痛效果,并改善透皮通透性[84]
磷脂复合物分散片吴茱萸碱制剂稳定性良好,能够有效提高体外累积释放率、体内胃黏膜累积渗透转运量、渗透速率、渗透通量及累积渗透量[85]
柠檬苦素可有效改善柠檬苦素口服吸收,其油制剂稳定性良好,相对生物利用度可增加5.98倍[86]
吴茱萸碱衍生物借助磷脂优势使两种药物更多聚集于内质网附近,诱导内质网应激发生,更好地增强药效[87]
吴茱萸碱可快速释药、迅速镇痛、增强药效,同时可通过提高溶解度和溶出速率增加在胃内滞留时间,提高吸收速度并增强吸收效果,提高生物利用度[88-89]
包合物吴茱萸碱吴茱萸碱制成吴茱萸碱羟丙基-β-环糊精包合物可使其具有更高的生物利用度[90]
吴茱萸次碱羟丙基-β-环糊精为载体制备吴茱萸次碱包合物,可以有效提高水溶性和生物利用度[91]
乳膏柠檬苦素乳膏色泽美,制剂工艺简单、质量可控,并可通过直接作用于痔疮部位让其更易发挥药效[92]
吴茱萸提取物可有效避免口服产生的便秘、咳嗽等系统不良反应[93-94]
贴剂吴茱萸可有效改善营养性肥胖小鼠脂质代谢及肠道菌群的影响,且效果较原药材优[95]
吴茱萸浸膏可有效提高药物透皮吸收率,且再加酸贴后吴茱萸浸膏具有更好体外透皮释放性能[96]
), ArticleFig(id=1322926148434395959, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926126535934679, language=CN, label=表3, caption=

吴茱萸及其成分相关制剂研究

, figureFileSmall=null, figureFileBig=null, tableContent=
剂型相关成分制剂优点参考文献
脂质体柠檬苦素增加药物的稳定性及溶解度,使药物具有一定的缓释作用,且抑制肿瘤细胞增殖效果优于原料药[70]
纳米粒吴茱萸碱制剂理化性质较好,能有效改善保肝疗效,改善对小鼠急性肝损伤的保护作用;增强吴茱萸碱抗癌作用,增加细胞周期蛋白B1的表达,降低β-肌动蛋白的表达;提高生物利用度,且效果优于原料药[71-73]
纳米粒吴茱萸次碱制备成脂质立方液晶纳米粒,包封率高,疗效较原料药高[74]
吴茱萸碱衍固体脂质纳米粒增加缓释效应,同时增加[75]
生物两种衍生物在胃肠道的吸收,提高生物利用度
纳米乳吴茱萸碱吴茱萸碱油包水型复合纳米乳可增强吴茱萸碱在胃和各个肠段中的吸收,提高吴茱萸碱在大鼠体内的生物利用度[76]
吴茱萸碱较原料药更能促进药物的吸收,能明显提高吴茱萸碱的体外释放和大鼠口服生物利用度[77]
吴茱萸碱水包油型复合物纳米乳最大累积释放率约为原料药的2.61倍,口服生物利用度为7.35倍,可极大提高生物利用度[78]
吴茱萸碱吴茱萸碱负载油包水纳米乳液可增强原料药的理化性质和生物学特性,显著改善口服生物利用度,增加胃肠道的吸收[79]
吴茱萸碱吴茱萸碱-磷脂纳米复合物的新型油包水纳米乳液可显著增强吴茱萸碱的胃肠道吸收和口服生物利用度,增强疗效并减少不良反应[80]
纳米混悬剂吴茱萸次碱有效增加药物经皮渗透率[81]
柠檬苦素大量提高其溶解度和溶出度[82]
水凝胶吴茱萸碱制剂性能较优,24 h累积释放率达96.28%,与原料药比可显著增强体外经皮吸收[83]
吴茱萸碱将基于微乳液的水凝胶作为透皮共递送载体,可有效改善吴茱萸碱镇痛作用,提高溶解度,有效增强小鼠疼痛模型的镇痛效果,并改善透皮通透性[84]
磷脂复合物分散片吴茱萸碱制剂稳定性良好,能够有效提高体外累积释放率、体内胃黏膜累积渗透转运量、渗透速率、渗透通量及累积渗透量[85]
柠檬苦素可有效改善柠檬苦素口服吸收,其油制剂稳定性良好,相对生物利用度可增加5.98倍[86]
吴茱萸碱衍生物借助磷脂优势使两种药物更多聚集于内质网附近,诱导内质网应激发生,更好地增强药效[87]
吴茱萸碱可快速释药、迅速镇痛、增强药效,同时可通过提高溶解度和溶出速率增加在胃内滞留时间,提高吸收速度并增强吸收效果,提高生物利用度[88-89]
包合物吴茱萸碱吴茱萸碱制成吴茱萸碱羟丙基-β-环糊精包合物可使其具有更高的生物利用度[90]
吴茱萸次碱羟丙基-β-环糊精为载体制备吴茱萸次碱包合物,可以有效提高水溶性和生物利用度[91]
乳膏柠檬苦素乳膏色泽美,制剂工艺简单、质量可控,并可通过直接作用于痔疮部位让其更易发挥药效[92]
吴茱萸提取物可有效避免口服产生的便秘、咳嗽等系统不良反应[93-94]
贴剂吴茱萸可有效改善营养性肥胖小鼠脂质代谢及肠道菌群的影响,且效果较原药材优[95]
吴茱萸浸膏可有效提高药物透皮吸收率,且再加酸贴后吴茱萸浸膏具有更好体外透皮释放性能[96]
), ArticleFig(id=1322926148568613688, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926126535934679, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
序号关键词频次序号关键词频次
1吴茱萸1219临床观察10
2穴位贴敷4310护理10
3涌泉穴3111穴位敷贴9
4胃肠功能1912尿潴留9
5失眠1513耳穴压豆9
6腹胀1314化疗8
7便秘1215高血压8
8神阙穴1216穴位按摩8
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吴茱萸临床外用关键词-出现频次一览表

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序号关键词频次序号关键词频次
1吴茱萸1219临床观察10
2穴位贴敷4310护理10
3涌泉穴3111穴位敷贴9
4胃肠功能1912尿潴留9
5失眠1513耳穴压豆9
6腹胀1314化疗8
7便秘1215高血压8
8神阙穴1216穴位按摩8
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吴茱萸现代药理作用、剂型设计与临床外用研究进展
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刘丽丽 1, 2 , 尧章洪 1, 2 , 李童 3 , 梁炎 2 , 陈丽华 2 , 管咏梅 2 , 朱卫丰 2
中华中医药学刊 | 国家项目点击 2025,43(6): 52-60
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中华中医药学刊 |国家项目点击 2025 , 43 (6) : 52 -60
吴茱萸现代药理作用、剂型设计与临床外用研究进展
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刘丽丽(1985-),女,江西九江人,副教授,硕士研究生导师,博士,研究方向:中药经皮给药。

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刘丽丽(1985-),女,江西九江人,副教授,硕士研究生导师,博士,研究方向:中药经皮给药。

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刘丽丽1, 2, 尧章洪1, 2, 李童3, 梁炎2, 陈丽华2, 管咏梅2, 朱卫丰2
作者信息
  • 1.江西中医药大学药学院,江西 南昌 330004
  • 2.江西中医药大学,现代中药制剂教育部重点实验室,江西 南昌 330004
  • 3.江西中医药大学,江西 南昌 330004
通讯作者:
朱卫丰(1969-),女,广东平远人,教授,博士研究生导师,博士,研究方向:中药新剂型与新技术。E-mail:。
作者简介:

刘丽丽(1985-),女,江西九江人,副教授,硕士研究生导师,博士,研究方向:中药经皮给药。

Research Progress in Modern Pharmacological Action,Formulation Design and Clinical Application of Wuzhuyu(Euodiae Fructus)
Lili LIU1, 2, Zhanghong YAO1, 2, Tong LI3, Yan LIANG2, Lihua CHEN2, Yongmei GUAN2, Weifeng ZHU2
Affiliations
  • 1.School of Pharmacy,Jiangxi University of Chinese Medicine,Nanchang 330004,Jiangxi,China
  • 2.Jiangxi University of Chinese Medicine,Key Laboratory of Modern Preparation of Traditional Chinese Medicine,Ministry of Education,Nanchang 330004,Jiangxi,China
  • 3.Jiangxi University of Traditional Chinese Medicine,Nanchang 330004,Jiangxi,China
出版时间: 2025-06-10 doi: 10.13193/j.issn.1673-7717.2025.06.009
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吴茱萸为江西道地药材“三子一壳”之一,历史悠久,应用广泛。通过查阅历代本草著作梳理吴茱萸功效的历史沿革,在此基础上,以吴茱萸的现代研究为切入点,分别从现代药理作用、制剂设计、临床外用研究等方面进行文献分析。根据其研究现状,分析存在的问题。如吴茱萸现代药理作用研究聚焦于抗肿瘤、抗炎、保肝、抗阿尔茨海默病等,然目前的研究均以相应细胞模型作为研究对象,缺乏基于临床需求导向的真实世界研究;吴茱萸作为穴位贴敷之要药,常外用疗顽疾,可实现对多种神经系统疾病、心血管系统疾病和消化系统疾病的“内病外治”;但目前临床外用研究报道多而散,多集中于一些病例报道,缺乏深入的机制探索,且尚未形成规范的治疗体系,缺乏对吴茱萸外用人用经验的规范化收集整理;针对其所含主要药效成分如吴茱萸碱、吴茱萸次碱、柠檬苦素等水溶性差、溶出慢和生物利用度低等问题,通过合理制剂设计如纳米制剂、磷脂复合物和包合物等,改善其生物利用度,有望将其开发成有效治疗肿瘤及炎症疾病的候选药物,但研究局限于新制剂与原药之间的生物利用度变化及制剂的质量评价研究,缺乏对相关疾病治疗效果的评价,制约了其新药创制过程。将近年来吴茱萸现代药理作用、相关剂型设计与临床外用进行系统文献梳理,以期为吴茱萸的深入系统研究及外用制剂开发奠定基础。

吴茱萸  /  现代药理作用  /  制剂设计  /  临床外用  /  研究进展

Wuzhuyu(Euodiae Fructus)is one of the“three seeds and one shell”of Jiangxi's authentic medicinal materials,with a long history and wide application.The author reviewed the historical evolution of the efficacy of Wuzhuyu(Euodiae Fructus)by consulting the works of materia medica.On this basis,taking the modern research of Wuzhuyu(Euodiae Fructus)as the starting point,the literature analysis has been carried out from the aspects of modern pharmacological effects,preparation design and clinical external research.According to the current status of its research,the existing problems were analyzed.For example,the research on the modern pharmacological effects of Wuzhuyu(Euodiae Fructus)focuses on anti-tumor,anti-inflammatory,hepatoprotective,anti-Alzheimer's disease,etc.,but now the research focuses on the corresponding cell model as the research object,and there is a lack of real-world research based on clinical needs.As an important medicine for acupuncture point application,Wuzhuyu(Euodiae Fructus)is often used externally to treat stubborn diseases,and can realize the“internal and external treatment”of a variety of nervous system diseases,cardiovascular system diseases and digestive system diseases.However,at present,there are many scattered clinical external use research reports,mostly focusing on some case reports,lacking in-depth mechanism exploration,and has not yet formed a standardized treatment system,and lacks a standardized collection and sorting of the experience of external use of Wuzhuyu(Euodiae Fructus).In view of the problems of poor solubility,slow dissolution and low bioavailability of the main pharmacodynamic components such as evodiamine,rutaecarpine and limonin,it is expected to be devel-oped into a candidate drug for the effective treatment of tumors and inflammatory diseases through rational formulation design,such as nano-preparations,phospholipid complexes and inclusion complexes,but the research is limited to the bioavailability changes between the new preparation and the original drug and the quality evaluation of the preparation,and the lack of evaluation of the treatment effect of related diseases restricts the process of new drug creation.In this paper,the modern pharmacological effects,related dosage form design and clinical external use of Wuzhuyu(Euodiae Fructus)were systematically reviewed in recent years,in order to lay a foundation for the in-depth systematic research and development of topical preparations of Wuzhuyu(Euodiae Fructus).

Wuzhuyu(Euodiae Fructus)  /  modern pharmacological action  /  design of drug preparation  /  external clinical use  /  research progress
刘丽丽, 尧章洪, 李童, 梁炎, 陈丽华, 管咏梅, 朱卫丰. 吴茱萸现代药理作用、剂型设计与临床外用研究进展. 中华中医药学刊, 2025 , 43 (6) : 52 -60 . DOI: 10.13193/j.issn.1673-7717.2025.06.009
Lili LIU, Zhanghong YAO, Tong LI, Yan LIANG, Lihua CHEN, Yongmei GUAN, Weifeng ZHU. Research Progress in Modern Pharmacological Action,Formulation Design and Clinical Application of Wuzhuyu(Euodiae Fructus)[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (6) : 52 -60 . DOI: 10.13193/j.issn.1673-7717.2025.06.009
中药吴茱萸历史悠久,应用广泛,早在秦汉时期已被发现并用于疾病的治疗,其最早记载于《神农本草经》[1]中,列为中品,主温中下气,止痛,且在历代本草中均有记载。汉代首次提出吴茱萸温中散寒、降逆止痛之功用;魏晋唐时期着重于其温中降逆、止泻定痛之效,并于《名医别录》中首次提出祛痰消积功用;宋金元时期在原有的温中、止痛功效基础上突出逐瘀消癖之效;明清时期研究趋于成熟发展,强调开郁化滞、散寒降逆、助阳止泻的效用;这表明其功效始终围绕着温中、散寒与止痛,常用于脾胃虚寒与胃腹脘痛的治疗。
现代研究表明吴茱萸中化学成分类型丰富,包括生物碱、苦味素、挥发油、黄酮等成分[2]。目前研究发现[3],吴茱萸共含有222种化合物,主要为生物碱类106个、萜类46个、黄酮类22个、挥发油类14个、苯丙素类19个、蒽醌类及甾醇类各3个、其他类9个。生物碱和苦味素为其主要药效成分,目前研究聚焦于吴茱萸碱、吴茱萸次碱,柠檬苦素,具有抗肿瘤、抗炎、保肝、抗阿尔茨海默病、抗肥胖和降血糖血脂等作用。吴茱萸临床应用广泛,疗效确切,通常以热敷或穴位贴敷等方式用于治疗失眠、头痛、高血压病和各种胃肠道疾病。本文从吴茱萸相关药理作用、吴茱萸及其成分剂型设计、临床外用等方面对其进行综述,为吴茱萸的深入系统研究及外用制剂开发提供参考。
吴茱萸为传统经典中药,药用价值高,文献记载吴茱萸有温中散寒,助阳止泻功效,可用于治疗多种疾病。现代药理学研究表明,吴茱萸提取物中吴茱萸碱、吴茱萸次碱,柠檬苦素等化学成分有抗肿瘤、抗炎、保肝、抗阿尔茨海默病、降血糖等作用,吴茱萸常见化学成分结构图见图1。
肺癌是世界上发病率及病死率最高的恶性肿瘤,但当前治疗手段存在不良反应、肿瘤耐药等问题,亟需寻找新的药物和疗法。JIANG等[4]研究发现吴茱萸碱以浓度依赖性升高CD+8 T细胞和下调MUC1-C/PD-L1轴中PD-L1和MUC1-C的表达增加H1650和H1975等非小细胞肺癌(NSCLC)细胞的细胞凋亡达到抗肺癌作用;LI等[5]研究发现吴茱萸碱可显著减轻肺癌荷瘤小鼠的肿瘤重量并延迟肿瘤生长,减少增殖标志物(Ki-67),并通过上调肺癌组织中TRAF2、ASK1、JNK、p-JNK、裂解半胱天冬酶12(Caspase-12)、裂解半胱天冬酶9(Caspase-9)、裂解半胱天冬酶3(Caspase-3)、Bax的蛋白表达和下调Bcl-2的表达以诱导肺癌细胞凋亡;李彦明等[6]发现柠檬苦素可通过抑制VEGF/VEGFR2诱导的MEK1/2、ERK1/2磷酸化以抑制肺癌人类肺泡基底上皮(A549)细胞增殖和血管生成,诱导肺癌A549细胞凋亡。说明吴茱萸中活性成分主要以诱导细胞凋亡达到抗肺癌作用,具有成为肺癌治疗药物的潜力。
作为全球高发性消化系统恶性肿瘤,胃癌(GC)和结直肠癌(CRC)存在较难在前期发现和临床预后差等问题,目前较为常规的治疗方法较难达到治疗效果。LIU等[7]研究发现吴茱萸碱可使剂量依赖性显著降低BGC-823细胞的细胞活力,并通过TRPV1/Ca2+途径诱导ROS依赖性细胞毒性,从多个方面达到抑制胃癌增长作用;YANG等[8]研究表明,吴茱萸碱以浓度依赖性显著抑制AGS和BGC-823等GC细胞增殖和凋亡,并通过促进PTEN的相对mRNA和蛋白表达,降低EGF/PI3K通路中EGF、EGFR、PI3K、AKT、p-AKT和mTOR等蛋白的表达达到抑制GC细胞的定向迁移和侵袭;熊伟等[9]发现柠檬苦素通过提高免疫功能和诱导凋亡以抑制MFC胃癌荷瘤模型小鼠肿瘤组织的生长,说明其在临床中治疗胃癌具有潜在价值。
KIM等[10]发现吴茱萸碱可靶向作用于HT29、SW480和HCT15等结直肠癌细胞系细胞中可块状癌细胞(BCC)和癌症干细胞(CSCs),诱导细胞凋亡,并通过抑制控制CSC的关键信号通路中WNT和NOTCH信号传导达到抗结肠癌作用;ZHOU等[11]研究表明吴茱萸碱可在0.375~116.0μmol·L-1和24~72 h内显著抑制HT-29细胞和HCT-116细胞等人结直肠癌细胞系细胞的增殖,并通过增加NAD+/NADH的速率,激活Sirt9来降低乙酰-NF-κB p65以下调MMP-1来抑制结直肠癌细胞的迁移和侵袭;ZHAO等[12]发现吴茱萸碱可在24~72 h以时间依赖性降低HCT-116细胞的细胞活力,抑制细胞增殖并让HCT-116细胞周期停滞,并通过下调PGI、MMP3和p-STAT3等使JAK3/STAT2通路失活以诱导S期细胞周期停滞和细胞凋亡,从而抑制HCT-116细胞生长;CHAN等[13]研究发现Rut可显著减小生成异种移植肿瘤的BALB/c裸鼠的肿瘤大小,并以浓度依赖性显著降低HCT-116和SW480等结肠癌细胞系细胞的细胞活力并抑制细胞增殖、迁移和侵袭,同时通过上调cleaved-Caspase3的表达和下调Bcl-2的表达以抑制NF-κB/STAT3信号传导,促进HCT-116和SW480等结直肠癌细胞的凋亡;ISHAK等[14]研究表明LM 可通过增强CD+8、CD+4 和CD+19改善适应性免疫应答和上调Nrf2与SOD2 mRNA表达减轻氧化应激等方式抑制小鼠的结直肠癌增长,使其趋向于正常水平。因此,吴茱萸中吴茱萸碱、吴茱萸次碱和柠檬苦素等活性成分在结直肠癌治疗中均能发挥极大作用,有望成为抗结直肠癌的药物。
肝细胞癌(HCC)是一种具有强侵袭性的恶性肿瘤,而Evo和LM均具有潜在的治疗作用。HU等[15]研究表明吴茱萸碱能够在60 h内浓度依赖性地抑制HepG2和Hepa1-6等HCC细胞系细胞的增殖,显著减小Hepa1-6荷肝小鼠肿瘤大小,并通过激活WWOX依赖性途径诱导抗肝癌活性;LE SHI等[16]发现吴茱萸碱可通过抑制细胞侵袭和迁移并阻断血管生成等方式显著降低BALB/c裸鼠异种移植模型及HepG2、SMMC-7721、H22等HCC细胞系细胞中血管的生成,达到抗肝癌作用;TANG等[17]发现柠檬苦素通过升高PI3K、MTORC2、p-PDK1、p-AKT和MAPKAP1,降低p-PTEN等水平激活PI3K/AKT信号传导,以此减弱HCC细胞的干性,达到促进肿瘤细胞进入细胞周期减弱分化能力,并可增加一定的化学耐药性,从而达到抗肝癌作用。因此,在未来肝癌治疗中,有望将吴茱萸碱和柠檬苦素作为靶向药物用以抑制肝癌细胞的增殖分化或抑制其活性达到较好治疗效果。
乳腺癌(BC)是临床上常见的妇科恶性肿瘤,发病率与病死率较高。吴茱萸碱可选择性地激活MCF7和MDAMB 231等乳腺癌细胞系细胞的癌症干细胞样细胞(CSLC)中p53和p21,并减少G1/S中主要分子Rb失活,即通过p53-p21-Rb途径选择性靶向乳腺癌细胞,减少乳腺癌的复发性并降低其耐药性以达到抗乳腺癌作用[18];DU等[19]研究发现吴茱萸碱在15~60μmol内以及剂量依赖性对MDAMB-231细胞表现出抗细胞增殖、迁移和侵袭的能力,表明吴茱萸碱可通过抑制MMP-9、uPA和uPAR的水平抑制肿瘤细胞增殖,通过下调细胞周期蛋白D1的表达和上调CDK6和p27的表达诱导G0/G1期阻滞,通过上调Bax/Bcl-2比值诱导细胞凋亡,从而表现出抗肿瘤活性;XIONG YI等[20]研究发现吴茱萸次碱通过上调MDA-MB-149细胞中的miR-3-231p显著抑制BC细胞增殖并促进细胞周期停滞,通过逆转BC细胞中RU介导的miR-149-3p/S100A4轴以促进细胞凋亡、诱导细胞自噬和抑制血管生成,达到预防BC的恶性行为作用;CHEN JING等[21]通过体内外实验发现柠檬苦素能有效抑制VEGF诱导的血管生成,其可能通过直接靶向VEGFR2、抑制ATP与其结合口袋的结合以及拮抗VEGFR2介导的STAT3信号级联来发挥抗血管生成作用,从而抑制人乳腺癌细胞的血管生成和转移,发挥抗乳腺癌作用。
前列腺癌(CRPC)是临床上常见的恶性肿瘤,是男性死亡的主要原因,卵巢癌是妇科恶性肿瘤导致死亡的主要原因。LEI等[22]发现吴茱萸碱通过诱导DU145细胞的细胞毒性抑制细胞增殖,调节Cdc145c/CDK25/细胞周期蛋白B1信号通路阻滞G2/M 细胞周期,上调Bax/Bcl-2比值以诱导线粒体凋亡从而诱导细胞凋亡,并通过调节PI3K/AKT/NF-κB信号通路抑制前列腺癌增殖和迁移;HWANG等[23]研究发现吴茱萸碱可显著抑制细胞生长和细胞增殖,阻滞细胞周期并诱导PC-3和DU145细胞凋亡,其可能是通过消除c-Met/Src/STAT3信号轴的激活,从而发挥抑制肿瘤细胞存活、增殖作用。LIN等[24]研究发现吴茱萸次碱通过调控同种异体TRAMP-C1前列腺癌小鼠体内Th1极化免疫平衡,显著减小其肿瘤体积和重量,抑制前列腺癌细胞生长。
MAO等[25]表明吴茱萸碱可呈剂量依赖性诱导细胞凋亡来降低SKOV-3、A2780、A2780CP和ES-2等人卵巢癌细胞系细胞的细胞活力,诱导G2/M 期阻滞和细胞凋亡,促进miR-152-3p水平,抑制NEAT225、CDK625和CDK25的表达,即通过NEAT1-miR-152-3p-CDK19轴抑制卵巢癌;柠檬苦素通过激活p53诱导卵巢癌细胞凋亡,逆转卵巢癌细胞对顺铂的耐药性,能够显著降低SKOV-3、A2780和RMUG-S等卵巢癌细胞系细胞的细胞活力,诱导其凋亡[26]。
鼻咽癌(NPC)和口腔舌鳞状细胞癌(OTSCC)是常见的恶性肿瘤,由于其生长部位限制,难以用手术治疗,因此化疗和放疗成为主要的治疗方法。PENG等[27]研究表明吴茱萸碱可显著降低鼻咽癌细胞中MMP-2的mRNA和蛋白水平及其活性抑制鼻咽癌细胞的迁移和侵袭;GAO等[28]研究发现柠檬苦素显著且特异性地降低NPC细胞的侧群(SP)细胞的细胞活力、细胞干性、细胞迁移能力及其放射敏感性,达到抗肿瘤作用。
REN等[29]发现吴茱萸碱可以显著降低HSC-1细胞中HMGB2/RAGE、MMP4和VEGF的表达,同时显著降低转染裸鼠的肿瘤体积和重量,说明其通过抑制HMBG1/RAGE轴减少细胞增殖、侵袭和血管生成以抑制口腔鳞状细胞癌的增殖和侵袭;YANG等[30]研究发现柠檬苦素通过促进YAP的核质易位,降低YAP蛋白表达,降低YAP转录调节活性,从而抑制OTSCC细胞的增殖、迁移和侵袭能力以抑制OTSCC。说明吴茱萸中吴茱萸碱和柠檬苦素等均可通过抑制细胞增殖和侵袭达到抗NPC和OTSCC作用,有望成为癌症化疗药物,作为代替手术治疗癌症的另一治疗方式。
KIM等[31]研究发现用不同剂量的吴茱萸碱处理TPC-5和SW10细胞等甲状腺癌细胞48 h后细胞活力降低,细胞毒性以剂量依赖性增强,同时TPC-5和SW10细胞生长得到抑制,且增加p21和p53水平、降低MMP-2和MMP-9水平可抑制甲状腺癌细胞生长和迁移;ZHONG HONG等[32]研究表明吴茱萸碱在1~10μmol内可剂量依赖性地降低SW1990和PANC-1等人胰腺癌(PC)细胞系的细胞活力,抑制PC细胞生长,同时通过抑制PI3K/AKT和MAPK/ERK信号通路中AKT、ERK1/2和p38等表达诱导PC细胞凋亡,并通过抑制STAT3的磷酸化来抑制PC细胞生长;CHIDAMBARA M K N等[33]通过Caspase-3的裂解、线粒体膜电位的降低和pAKT、p53、VEGF及Caspase等细胞凋亡相关蛋白的表达下降发现柠檬苦素可诱导细胞凋亡,显著抑制人胰腺(Panc-28)细胞的增殖。
综上所述,吴茱萸中生物碱类与苦味素类成分具有较为广泛的肿瘤抑制作用,可有效抑制肺癌、胃癌、结直肠癌、肝癌、乳腺癌等多种癌细胞的生长,其主要通过诱导细胞毒性T淋巴(CD+8 T)细胞数量增长、诱导肿瘤细胞的细胞毒性以抑制肿瘤细胞增殖、迁移和侵袭、诱导肿瘤细胞凋亡、阻碍细胞生长周期,或通过逆转肿瘤的多药耐药等方式发挥作用,具体作用机制见插页Ⅻ图2。
现代药理学研究表明,吴茱萸中部分化学成分能够有效缓解或抑制炎症因子对机体的损伤与机体抗损伤反应的斗争过程达到抑制炎症作用,如吴茱萸碱、吴茱萸次碱及柠檬苦素均可通过抑制NF-κB途径抑制相关炎症因子的表达达到抗炎作用,其中吴茱萸碱还可通过调节肠道中相关菌群达到预防或治疗溃疡性结肠炎作用[34],柠檬苦素可通过Nrf2/ARE途径改善肠道损伤和溃疡[35],具有较广泛的抗炎作用,具体作用机制见表1、插页Ⅻ图3。
肝脏对人体代谢有着极其重要的作用,研究发现吴茱萸生物碱和柠檬苦素能够有效抑制肝损伤和肝纤维化,减轻肝毒性。吴茱萸碱通过下调TGF-β1、p-Smad 2/3和α-SMA的相对表达以抑制肝纤维化[50];柠檬苦素通过抑制Smad2/3依赖性基因转录同时上调Smad7以抑制肝纤维化[51];吴茱萸次碱能够通过抗氧化酶的活化介导以抑制对乙酰氨基酚诱导的急性肝损伤[52];柠檬苦素还能够通过下调脂肪肝中成脂转录因子FASN和SREBP1的水平,下调巨噬细胞分泌的促炎因子IL-6、IL-1β和TNF-α的相对表达水平,上调肝脏中NRF2/HO-1信号通路来逆转谷胱甘肽的还原和活性氧的积累,达到保护脂肪肝的作用[53],并通过激活Nrf2抗氧化途径和上调Sirt1抑制NF-κB炎症反应来减轻对乙酰氨基酚诱导的肝毒性[54],通过NLRP3/gasdermin D信号通路来改善脂多糖诱导的肝毒性[55]。
阿尔茨海默病(Alzheimer's disease,AD)是一种不可逆的神经退行性疾病,也是目前临床上的高发病之一,其最常见的是以老年人为主的不可逆的、退行性改变的、发生于中枢神经系统的疾病,临床上常表现在记忆、语言、行为和认知功能发生障碍[56]。国内外研究发现,吴茱萸所含生物碱类和苦味素类成分能够治疗阿尔茨海默病。
吴茱萸碱可以通过多种方式缓解AD的病理症状,首先可通过独特的含氮碱基更容易地与AChE的一个特定位点结合,使其去磷酸化并降低其活性,确保ACh能够维持记忆功能;其次可通过激活Nrf2/ARE途径降低MDA含量,抑制氧化应激的不良反应;最后,还可以通过减少神经炎症(TNF-α、IL-1β和IL-6水平)以此保护神经系统并达到抗AD作用[57]。研究发现,吴茱萸碱[58]和吴茱萸次碱[59]通过抑制GSK-3β活性降低tau的磷酸化及聚集的神经毒性,具有神经保护作用,说明其具有抗阿尔茨海默病的潜力。
吴茱萸中所含成分还具有镇痛、抗增殖、抗动脉粥样硬化、抗肥胖、降血糖和降血脂等作用,LIN等[60-61]研究发现吴茱萸碱通过维持线粒体抗氧化功能来改善紫杉醇诱导的神经性疼痛(CINP),调节nNOS,抑制AMPA受体GluA1的总蛋白表达及其在Ser831和Ser845处的磷酸化,抑制血清NO水平,降低PAG中c-Fos和nNOS的mRNA/蛋白表达以达到镇痛作用。LI等[62]研究发现吴茱萸次碱在一定范围内能够抑制AngⅡ诱导的VSMC增殖,吴茱萸次碱拮抗AngⅡ诱导的细胞一氧化氮(NO)含量和NO合成酶(NOS)活性降低,说明吴茱萸次碱对AngⅡ诱导的大鼠VSMC增殖有效;WANG L Y等[63]研究发现吴茱萸次碱显著抑制CE81T/VGH细胞生长,促进细胞G2/M期停滞,并诱导细胞凋亡,达到抗增殖作用。具体药理作用及其作用机制见表2。
吴茱萸药效成分在肿瘤、炎症和肝损伤等模型中均表现出显著活性,表明其具有广阔的应用前景,由于其活性物质口服生物利用度较差,采用制剂技术改善其生物利用度有望将其开发成有效治疗肿瘤及炎症疾病的候选药物。
中药制剂可以根据中药成分、性味归经和功效的差异进行合理剂型设计,由于吴茱萸味苦辛,故既可引药下行又可散中焦之寒。吴茱萸有小毒,也可通过制剂手段改善或者缓解吴茱萸的毒性;另一方面,鉴于吴茱萸碱、吴茱萸次碱和柠檬苦素等水溶性差、溶出慢和生物利用度低等问题,通过合理的制剂设计如纳米制剂、水凝胶、磷脂复合物、分散片、包合物等,改善溶解性并提高生物利用度[69],相关剂型研究见表3。
以上研究表明,纳米制剂、水凝胶制剂、磷脂复合物、分散片、包合物、乳膏、贴剂等均可增加吴茱萸生物碱和柠檬苦素等难溶性成分的溶解度和稳定性,增加其在体内外的吸收并提高生物利用度。同时,脂质体制剂还能通过稳定化合物、克服细胞和组织摄取的障碍以及增加药物在体内靶位点的生物分布,同时最大限度地减少全身毒性,提高治疗效果[97];纳米乳制剂能够赋予其缓释和靶向作用,并且有纳米乳粒径小而且均匀,黏度小等优点[98];纳米混悬剂可通过超粉碎或者控制析晶条件将吴茱萸和难溶性成分吴茱萸碱制成粒径较小的高度分散粒子群,形成稳定的纳米胶态分散体,以提高溶解度和溶出速率[99];水凝胶则可用于实现疾病引发的原位组装和水凝胶程序降解和随后的药物释放[100];制成磷脂复合物可在不改变原型药物化学结构的前提下,使其存在状态(晶型)、溶解度、油水分配系数等参数发生较大变化,同时由于其高度的生物相容性和膜渗透性,可以有效改善吴茱萸碱靶向性差的情况[101],有效促进其在胃内的吸收,提高口服吸收生物利用度[102];分散片可使绝大部分吴茱萸碱以微晶形式分散在载体中,有效增加其溶解度和溶解速率,提高生物利用度和功效[88];包合物能够通过形成的特殊络合物以增加吴茱萸中亲脂性物质的溶解性及稳定性,从而提高生物利用度;传统剂型乳膏剂和贴剂则能够有效避免口服产生的便秘、咳嗽等系统不良反应,同时提高吴茱萸提取物的透皮吸收,并使其更快地作用于病变部位。
吴茱萸性热,味辛、苦,味辛则升,上治厥阴头痛,味苦则降,引药下行。在临床上吴茱萸常被制成外用制剂,如贴剂、乳膏剂等。作为穴位贴敷之常用药,吴茱萸调醋穴位贴敷涌泉穴可以引热下行治疗脾胃虚寒,又可升清降浊而达到治疗肝阳头痛的目的,而且吴茱萸在加热后更容易发挥其大热之性,将其有效成分进一步活化,并利用温热之力使药性更容易从脐腹部体表透入经络、血脉之中,从而达到温经通络、行气活血、散寒止痛之效。
近年来,吴茱萸穴位贴敷临床应用广泛,通过查阅中国知网数据库(CNKI)中吴茱萸临床外用相关文献,检索年限为2012年12月31日—2022年12月31日,得到相关文献820篇,根据纳入排除标准筛选文献并进行查重,符合要求的文献共232篇,利用CiteSpace 6.2.4.0软件进行关键词的共现分析,结果见表4、插页ⅩⅢ图4、插页ⅩⅢ图5。
由以上检索结果可知,关键词“吴茱萸”出现的频次最高,为121次,其次便为“穴位贴敷/敷贴”,出现了52次;研究热点在2013年—2016年为外敷、混合痔及高血压,2016年—2018年为热敷和穴位按摩,2018年—2022年为术后功能障碍、疗效观察和失眠。
吴茱萸临床外用领域研究整体分布较为分散,暂未形成核心研究团队,尚未形成规范的治疗体系。但研究发现吴茱萸在外用方面主要以穴位贴敷的方式治疗恶心呕吐、腹泻、便秘、胃肠功能障碍等消化系统疾病。吴茱萸在临床外用常用于治疗神经系统疾病、心血管系统疾病、消化系统疾病及其他疾病,能够有效治疗失眠、头痛、眩晕、高血压病、腹泻、便秘、恶心呕吐、术后胃肠道功能障碍等疾病。
吴茱萸化学成分种类繁多,药理作用较为广泛,其药效及质控成分吴茱萸碱、吴茱萸次碱和柠檬苦素均能通过调控或介导肿瘤细胞相关代谢途径以诱导癌细胞的凋亡,并通过多路径调节炎症通路达到抗炎作用,呈现广谱抗肿瘤及抗炎活性,但目前研究大部分均以体外细胞模型作为研究对象,缺乏临床试验数据,体内外相关性研究极少,建议今后加强在体研究,着重加强基于吴茱萸临床需求导向的真实世界研究,阐明其抗肿瘤及抗炎的作用靶点及作用机制,为其新药创制过程奠定基础。
在制剂设计方面,鉴于吴茱萸碱、吴茱萸次碱及柠檬苦素水溶性较差、生物利用度低、体内抗肿瘤活性不佳等问题,一方面通过将其设计成纳米粒、磷脂复合物等以提高溶解度及生物利用度,但研究均限于以制剂与原药之间的生物利用度变化与制剂的质量评价研究,缺少新制剂对疾病治疗效果的研究,限制了其新药创制进程。另一方面,以吴茱萸碱、吴茱萸次碱等为先导结构开展药物设计,通过骨架修饰策略、分子杂交策略、骨架跃迁策略以及改善其理化性质和材料包载策略对吴茱萸碱进行改造和优化,可大幅提升了抗肿瘤活性,目前基于肿瘤微环境开发具有肿瘤靶向性的吴茱萸碱衍生物成为研究热点[103]。
吴茱萸常作为穴位贴敷之要药,常通过穴位贴敷治疗多种疾病,但目前的研究多集中于相关的病例报道,缺乏深入的机制探索,且尚未形成规范的治疗体系,缺乏对吴茱萸外用人用经验的规范化收集整理。且穴位贴敷多集中于传统剂型,用醋调或姜汁调敷,建议在新型经皮给药技术的指导下,结合新剂型、新方法及新技术,推进其穴位贴敷的临床应用现代化。
综上所述,吴茱萸现代药理研究对相关疾病的致病机理与治病机制研究较为深入,但未能将现代药理研究、制剂设计与具体临床应用有机结合,建议未来可聚焦于吴茱萸及其成分的抗癌及抗炎作用,开发新型给药系统,深入研究其释药机制及药效等,以期为吴茱萸及其成分的新药开发奠定基础。
  • 国家自然科学基金项目(82360775)
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2025年第43卷第6期
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doi: 10.13193/j.issn.1673-7717.2025.06.009
  • 首发时间:2026-10-30
  • 出版时间:2025-06-10
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国家自然科学基金项目(82360775)
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    1.江西中医药大学药学院,江西 南昌 330004
    2.江西中医药大学,现代中药制剂教育部重点实验室,江西 南昌 330004
    3.江西中医药大学,江西 南昌 330004

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朱卫丰(1969-),女,广东平远人,教授,博士研究生导师,博士,研究方向:中药新剂型与新技术。E-mail:。
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
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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