“标本兼治”的生物学原理
The biological principle of "Biao Ben Jian Zhi"
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摘要: 现代药理学研究历经百年进步, 从“伪介质”理论, 到配体-受体学说, 再发展至更广泛的靶点理论, 不断地为临床治疗贡献了重要的科学认识和临床药物。由于过往的成功经验, 西方药理学研究重视分子机制, 越来越强调单靶点和精准治疗; 虽然局部机制相对清楚, 但临床效果还远不够理想, 药物治疗的科学疆域里依然充满探索。近年来, 我国的新药研究显示出如下特点, 一方面紧跟国际前沿; 另一方面注重中国原创, 在寻找新药的同时, 探索对药物多靶点理论的认识, 其中, “标本兼治”的理念因其化学基础与生物学原理的进展, 逐渐显示出系统论的轮廓及新的生命力, 可能有助于未来的药物发现、药物设计和临床治疗。本文以小檗碱、二甲双胍和阿兹夫定为例, 以“药效云”的概念阐述“标本兼治”的药物作用模式, 以期为今后的新药研发探索新的前沿。Abstract: Along with the progress of pharmaceutical science in the past century, the theme of pharmacology has gone through pseudo agent scheme, to ligand-receptor model, and then to the theory of targeted therapy today. Due to the success of drug R&D, current drug research keeps its focus mainly on drugs with single target and precise treatment, in which the molecular mechanism is relatively clear but the therapeutic efficacy is often limited. Thus, there is a big space for exploration in the field of pharmacology. In the past 30 years, several novel chemical drugs, originated from traditional Chinese medicine, have been identified and then used in clinic, provoking a strong interest to explore new theory for pharmacology, of which the term of "Biao Ben Jian Zhi" (treating diseases by directing symptoms and root causes) has demonstrated a promising nature. We consider this concept useful for future drug discovery, drug design and clinical therapy. In this review, example drugs such as berberine, metformin and azvudine, are discussed, and "drug Cloud" (dCloud) model is introduced to elaborate the mechanism of treating diseases by directing symptoms and root causes of diseases.
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