中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (3): 419-425.doi: 10.12307/2023.971

• 生物材料综述 biomaterial review • 上一篇    下一篇

中医药联合医用水凝胶治疗疾病的策略及意义

毕玉杰1,2,马笃军1,2,彭力平1,周紫琼1,赵  静1,朱厚均1,钟秋辉1,杨玉鑫1   

  1. 1广州中医药大学第四临床医学院,广东省深圳市  518033;2广州中医药大学,广东省广州市  510006
  • 收稿日期:2022-12-07 接受日期:2023-01-16 出版日期:2024-01-28 发布日期:2023-07-10
  • 通讯作者: 马笃军,硕士,副主任医师,硕士生导师,广州中医药大学第四临床医学院,广东省深圳市 518033;广州中医药大学,广东省广州市 510006
  • 作者简介:毕玉杰,男,1997年生,汉族,广州中医药大学在读硕士,主要从事中医药治疗骨关节疾病研究。
  • 基金资助:
    国家自然科学基金项目(81804124),项目负责人:马笃军;深圳市三名工程团队院内项目(SMGC20220704),项目负责人:马笃军

Strategy and significance of Chinese medicine combined with medical hydrogel for disease treatment

Bi Yujie1, 2, Ma Dujun1, 2, Peng Liping1, Zhou Ziqiong1, Zhao Jing1, Zhu Houjun1, Zhong Qiuhui1, Yang Yuxin1   

  1. 1The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, Guangdong Province, China; 2Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
  • Received:2022-12-07 Accepted:2023-01-16 Online:2024-01-28 Published:2023-07-10
  • Contact: Ma Dujun, Master, Associate chief physician, Master’s supervisor, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, Guangdong Province, China; Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
  • About author:Bi Yujie, Master candidate, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, Guangdong Province, China; Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
  • Supported by:
    National Natural Science Foundation of China, No. 81804124 (to MDJ); Shenzhen Sanming Engineering Team Hospital Project, No. SMGC20220704 (to MDJ)

摘要:


文题释义:

药物载体:将药物与生物材料结合形成载体-药物复合体,可保护药物避免过快分解,实现药物持续释放、定向释放和定量释放。
骨髓间充质干细胞:也称为骨髓基质成纤维细胞,是一类起源于中胚层的成体干细胞,具有自我更新及多向分化潜能,可在药物、所处环境的影响下进行增殖分化,可分化为血管、韧带和骨骼组织等。


背景:医用水凝胶是具有三维结构网络的新型功能高分子材料,具有出色的生物相容性,目前已在组织工程领域、药物载体领域有广泛研究,但基于组织工程探究医用水凝胶与中医药结合治疗疾病的研究还处于初期探索阶段。因此,通过对医用水凝胶机制作用的剖析,整合医用水凝胶与中医药在研究中联合应用的文章,进而更好地为科研工作者提供思路,对中医药与医用水凝胶联合应用具有重要意义。

目的:基于组织工程研究探讨中医药联合医用水凝胶治疗疾病的策略及意义。
方法:利用PubMed和中国知网数据库,检索有关中医药联合医用水凝胶在组织工程中应用的文献,检索时间为2010年1月至 2022年11月,英文检索词为“hydrogel,traditional Chinese medicine,drug carrier,tissue engineering”,中文检索词为“医用水凝胶、中医药、药物载体、组织工程”。根据纳入与排除标准对所有文章进行初筛后,最终纳入61篇文章进行综述。

结果与结论:①中医药联合医用水凝胶的应用虽然在关节内、组织器官内、软组织伤口和组织工程等方面有所涉及,但除了中医药结合水凝胶敷料在临床应用治疗软组织损伤外,其他方面尚处于基础实验阶段。②中医药联合医用水凝胶的发展有着巨大潜力和发展前景,但对于性能要求较高的凝胶在制造方面存在一定难度,理化性质精确掌握难度较大。③目前综合来看可注射水凝胶凭借着简便易用的特点,其在与中医药联合使用可延伸范围较广,可用于关节、器官和组织工程相关疾病的治疗;智能水凝胶有较高的灵敏度和可逆转化性也可满足特殊环境下的使用;将两者结合的中医药使用过程中还需要明确中药成分的作用机制。④中医药联合医用水凝胶治疗疾病的策略应着手于中医药对器官、组织、细胞的治疗作用联合适当种类的医用水凝胶进行匹配,可弥补传统中医给药方式和频繁给药的不足,在组织工程方面可以用水凝胶负载中药干预后的干细胞,或者同时负载中药和干细胞用于相关疾病的治疗。⑤在中医药联合医用水凝胶应用的未来研究中,还需要考虑:应当确保医用水凝胶生物性能可以量化,以不同材料不同制造工艺把握水凝胶特性,制造出所需要的符合应用条件的医用水凝胶;在中医药方面需要对已知中药单体、中药复方提取物的治疗效果和应用机制全面了解剖析,在更明了的机制下实现中医药与医用水凝胶更多更完美的结合;借助医学科技创新能力的不断提高,医用水凝胶可以创新性地结合中医药其他传统治疗方法比如针灸、推拿和拔罐等方式进行多角度运用。

https://orcid.org/0000-0003-4388-3416(毕玉杰);https://orcid.org/0000-0002-8050-2849(马笃军)

中国组织工程研究杂志出版内容重点:生物材料;骨生物材料口腔生物材料纳米材料缓释材料材料相容性组织工程

关键词: 医用水凝胶, 中医药, 研究策略, 药物载体, 组织工程, 骨髓间充质干细胞, 联合应用, 原位注射

Abstract: BACKGROUND: Medical hydrogels are new functional polymer materials with three-dimensional structural networks and excellent biocompatibility, which have been widely studied in the field of tissue engineering and drug carriers, but the research on the combination of medical hydrogels and Chinese medicine for the treatment of diseases based on tissue engineering is still in the early exploration stage. Therefore, through the analysis of the mechanism of the role of medical hydrogels, the integration of medical hydrogels and Chinese medicine in the research of the joint application of the article, can better provide ideas for scientific researchers, and the joint application of Chinese medicine and medical hydrogels is of great significance.
OBJECTIVE: To explore the strategy and significance of Chinese medicine combined with medical hydrogel for disease treatment based on tissue engineering research. 
METHODS: PubMed and CNKI were used to retrieve articles about the application of Chinese medicine combined with medical hydrogel in tissue engineering from January 2010 to November 2022, with the Chinese and English search terms “hydrogel, traditional Chinese medicine, drug carrier, tissue engineering”. After the initial screening of all articles according to the inclusion and exclusion criteria, the 61 articles with high relevance were retained for review. 
RESULTS AND CONCLUSION: (1) Although the application of Chinese medicine combined with medical hydrogel is involved in intra-articular, intra-tissue organ, soft tissue wounds, tissue engineering, etc., except for the clinical application of Chinese medicine combined with hydrogel dressing for soft tissue injury, other aspects are still in the experimental stage. (2) The development of Chinese medicine combined with medical hydrogel has great potential and development prospects, but there is a certain difficulty in the manufacture of the gel with high-performance requirements, and it is difficult to master the physical and chemical properties precisely. (3) At present, the comprehensive view of injectable hydrogel with the characteristics of easy to use, its joint use of Chinese medicine can be extended to a wider range, can be used for joint, organ, tissue engineering-related disease treatment. Smart hydrogel has high sensitivity and reversible transformation can also meet the use of the special environment. During the combined use of Chinese medicine, it also needs to understand the mechanism of action of Chinese medicine components. (4) The strategy of combining Chinese medicine with medical hydrogels for disease treatment should start with matching the therapeutic effects of Chinese medicine on organs, tissues and cells combined with appropriate types of medical hydrogels to make up for the shortcomings of traditional Chinese medicine delivery methods and frequent drug delivery. In tissue engineering, hydrogels can be loaded with stem cells after Chinese medicine intervention, or with both Chinese medicine and stem cells for disease treatment. (5) In future research of combined Chinese medicine and medical hydrogel application, we also need to consider: we should ensure that the biological properties of medical hydrogel can be quantified, and grasp the characteristics of hydrogel with different manufacturing processes of different materials to produce the required medical hydrogel that meets the application conditions. In Chinese medicine, we need to comprehensively understand and analyze the therapeutic effects and application mechanisms of known Chinese medicine monomer and Chinese medicine compound extracts, so as to achieve a more perfect combination between Chinese medicine and medical hydrogel under a more clear mechanism. With the continuous improvement of medical science and technology innovation, the medical hydrogel can be innovatively combined with other traditional treatment methods of Chinese medicine, such as acupuncture, massage, cupping and so on, to be used from multiple angles. 

Key words: medical hydrogel, Chinese medicine, research strategy, drug carrier, tissue engineering, bone marrow mesenchymal stem cell, combined application, in-situ injection

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