中医提供治疗帕金森症新方法

原作者：
来源Chinese medicine offers new Parkinson\'s treatments - health - 17 June 2011 - New Scientist
译者dlq

A hooked herb, root extract and a dash of bark – it may sound like a witches' brew, but these compounds could provide treatments for diseases that have so far foiled western doctors, such as Parkinson's and irritable bowel syndrome.

      钩状香草，取根与少量茎枝，这听起来像女巫在酿制些什么奇怪的东西，但是这些成分能治疗至今困扰西方医学界的疑难杂症，比如帕金森症和肠易激综合征。

中医，译者选自网络

For over 2000 years Chinese doctors have treated "the shakes" – now known as Parkinson's disease – with gou teng, a herb with hook-like branches.

       两千多年以来中国医生就是这样治疗“这种打摆子”的（现在被称为帕金森症），其用药就是钩藤，茎间有刺，形若钓钩。（注：这里引用的是《唐本草》的描述，原文是”钩藤，出梁州。叶细长，茎间有刺，形若钓钩者。“《本草纲目经》则载：” 钩藤，《神农本草经》不载所出州土。苏恭云出梁州，今兴元府亦有之。叶细茎长，节间有刺若钓钩。三月采。葛洪治小儿方多用之。又《广济》及《崔氏方》疗小儿惊癎诸汤钦，皆用吊藤皮。《纲目》： 钩藤，状如葡萄藤而有钩，紫色。古方多用皮，后世多用钩，取其力锐尔。“）

Early this year, 115 people with Parkinson's were given a combination of traditional Chinese medical herbs, including gou teng, or a placebo for 13 weeks. At the end of the study, volunteers who had taken the herbs slept better and had more fluent speech than those taking the placebo.

       今年年初，115名帕金森氏症患者食用传统中药（其中包括钩藤）和安慰剂，连续13周。研究结果表明，用中草药治疗的患者睡眠更好，比用安慰剂的患者能够更流利地表达。

Gou teng appears to stabilise symptoms, says Li Min, a traditional Chinese doctor at Hong Kong Baptist University. Now, Li and her colleagues have figured out how it might work.

       香港浸会大学的中医李敏表示，钩藤似乎能稳定病情。现在李敏和她的同事正在研究这一机理。

Preserving dopamine

多巴胺

Parkinson's symptoms, such as muscle tremors, slowness of movement and rigidity, are caused by the progressive destruction of brain cells that produce dopamine. Previous work has suggested that an abundance of a protein called alpha-synuclein may be to blame. Current treatments aim to boost levels of dopamine, which only partly alleviates symptoms and does not affect the protein clusters.

       帕金森症的症状诸如肌肉颤抖，移动缓慢僵硬，这都是由于产生多巴胺的脑细胞遭受破坏。目前的研究表明，帕金森症和一种叫做共核蛋白（ alpha-synuclein）的蛋白质过度积累有关。现在的治疗目的都在于增加多巴胺水平，这只能部分缓解症状，却不能对这种蛋白质起作用。

It is thought that clumps of alpha-synuclein accumulate because brain cells cannot remove them through autophagy – a type of programmed cell death. Mice without the genes needed for autophagy quickly develop Parkinson's-like symptoms.

        研究者认为，共核蛋白的大量积累是因为脑细胞不能通过自吞噬（一种细胞的程序性死亡）消除它们。缺少这一基因的老鼠由于不能自吞噬很快也呈现出与帕金森症类似的症状。

According to Li, autophagy is the only known process that gets rid of abnormal proteins within cells. "Enhancing this pathway may be key to treating Parkinson's," she says.

       李敏表示，自吞噬是清除细胞内异常蛋白质的唯一途径。“增强这一途径可能是治疗帕金森症的关键。”她如是说。

Li's team screened gou teng for its active compounds and tested which of these compounds increase the rate of autophagy and remove alpha-synuclein. To do this, the team added the compounds to human nerve cells and fruit flies that had been genetically modified to develop alpha-synuclein clusters.

       李敏的团队通过刷选钩藤的有效成分，测试到底是哪种成分能提高自吞噬的速率，起到清除共核蛋白的效用。为了达到这一目的，研究者将钩藤组分注入人类神经细胞，以及通过基因工程能产生共核蛋白的果蝇中。

Rapamycin connection

雷帕霉素

One of the compounds, an alkaloid called isorhy, induced autophagy for alpha-synuclein at a similar rate to a drug called rapamycin. Rapamycin is normally used to suppress the immune system in transplant patients, but has recently been touted as a promising candidate for Parkinson's treatment because it prevents nerve cell death in flies with a Parkinson's-like disease. However, because rapamycin depresses the immune system, it would have serious side effects for people with Parkinson's. Gou teng, meanwhile, has been taken for centuries with no apparent side effects.

       其中一种组分是一种名为异钩藤碱（isorhy）的生物碱，其诱导共核蛋白自吞噬的速率和一种名为雷帕霉素（rapamycin）的药物相似。雷帕霉素通常用来抑制移植患者免疫系统的排除反应，但是最近被视为治疗帕金森症的希望之星，因为它阻止了有帕金森症类似症状的果蝇神经细胞的死亡。即便如此，因为雷帕霉素抑制了免疫系统，它对帕金森症患者有负面作用。而已经被运用了数个世纪的钩藤没有明显的副作用。

Further testing found that isorhy activates autophagy through a different pathway to rapamycin, which may explain why it does not affect the immune system in the same way. Li, who recently presented her results at the Keystone Symposia on Molecular and Cellular Biology in Whistler, British Columbia, Canada, will begin trials of Isorhy in rodents later this year.

       进一步的研究表明异钩藤碱活化自吞噬的途径和雷帕霉素截然不同，同时这也解释了为什么它对免疫系统没有副作用。李敏最近在分子和细胞生物学重点会议（加拿大，不列颠哥伦比亚，威斯勒）上公布了这一研究结果，同时她将在今年晚些时候研究异钩藤碱对啮齿类动物的影响。

Herbs for the gut

Meanwhile, Zhaoxiang Bian, also at Hong Kong Baptist University, is developing a drug called JCM-16021 for irritable bowel syndrome (IBS) using seven herbal plants and based on a Chinese formulation called tong xie yao fang, used to treat IBS since the 1300s.

         同时香港浸会大学的卞兆祥发明了一种名为 JCM-16021的药物来治疗肠道易激综合症（IBS），使用了数种草本植物。这一药物是基于从十四世纪以来就用于治疗IBS的中药药方：痛泻要方。（注：此配方出《丹溪心法》卷三方。组成：炒白术三两，炒芍药二两，炒陈皮一两半，防风一两。上剉，分八帖。水煎或丸服。其实IBS可以简单理解为便秘加腹泻的威力加强版。）

IBS affects up to 20 per cent of people, causing abdominal pain, constipation and diarrhoea. "They feel really rotten, and it's sufficiently severe for people to take time off work," says John Furness at the University of Melbourne, Australia. Stress management can help symptoms, but there is no effective medicine to treat it.

       IBS影响了20%的人群，引起腹痛，便秘和腹泻。“他们感觉都要虚脱了，导致他们需要休息一段时间而不能工作”澳大利亚墨尔本大学的John Furness 坦承。抗压力治疗能缓解症状，但是至今没有特效药。

In 2007, Bian gave 80 people with IBS either JCM-16021 with Holopon – a drug that interrupts nerve impulses in the parasympathetic nervous system responsible for digestion – or Holopon alone. After eight weeks, 52 per cent of those given JCM-16021 with Holopon reported reduced IBS symptoms, compared with 32 per cent of those given Holopon alone.

        2007年，卞兆祥给80名IBS患者服用含有Holopon的JCM-16021或者只服用Holopon，Holopon（溴甲东莨菪碱）是一种能打断消化副交感神经系统神经冲动的药物。八周之后，52%服用含有Holopon的JCM-16021的患者表示他们IBS症状减轻了，而相较之下在只服用Holopon的患者中这个比例只有32%。

IBS is partly caused by high levels of serotonin in the gut. Last year, Bian found that giving JCM-16021 to rats with IBS-like symptoms broke down serotonin in their bowel faster than normal, reducing their discomfort.

       IBS可能是由于肠胃里高水平的血清素（serotonin）导致的。去年，卞兆祥给有IBS类似症状的白鼠注射了JCM-16021，结果发现能够比平常更快的降低肠胃里的血清素含量，减少它们的不适。

His team has since isolated several active compounds in JCM-16021 that block serotonin's activity in the rat gut, including magnolol, a herb taken from the bark of Magnoliae officinalis.

       他的研究团队已经分离出 JCM-16021中数种活化成分，正是它们降低了白鼠肠胃中血清素的活性，其中就有厚朴酚（magnolol），是从木兰科植物厚朴中提取的。（注：《本草汇言》载：厚朴，宽中化滞，平胃气之药也。厚朴 Cortex magnoliae officinalis，缩写CMO，厚朴酚是其主要化学成分之一）

厚朴，译者选自网络

Root of relief

草根奇效

This month, Keiko Lee at Juntendo University in Tokyo, Japan, found that paeoniflorin, a root extract used in JCM-16021, acts as an analgesic in rats, inhibiting adrenaline receptors in the spine.

       本月，日本东京顺天堂大学的Keiko Lee 发现芍药苷（paeoniflorin），一种JCM-16021里用到的芍药根的成分，对白鼠起到了止痛剂的作用，抑制了颈椎感应产生肾上腺素的能力。

Bian is now combining the active extracts of JCM-16021 to develop a new drug that attacks IBS from different angles. Unlike conventional approaches, which target only one aspect of the disease, he believes the combination drug will be more effective.

       卞兆祥结合JCM-16021中的活化成分研制出来一种从不同角度治疗IBS的新药。与传统方法只能治疗病症的某一方面不同，他坚信这种复方药将更有效。

"I think it is a very rational way to go," says Furness, but warns that combination drugs usually take longer to gain approval because of the greater-than-usual possibility of unexpected side effects. But because these compounds have a long history of being safe for human consumption, it is hoped they will be approved faster, says Li.

       “我认为这个方向是很合理的”， Furness如是说，但同时警告说复方药获批通常需要更长的时间，因为可能会有比常规药更大的副作用。但是因为这些成分长期来就被人们服用，很安全，所以尽快获批还是有希望的，李敏表示。

"In the past the pharmaceutical industry didn't put much effort into traditional Chinese medicine," says Jing Kang, a biochemist at Harvard Medical School in Boston. "In the past few years this has been changing. More people are paying attention."

       “过去制药业没有在中医药方面下太多功夫”，波士顿哈弗医学院生物化学家Jing Kang说，“过去几年已经改变不少了。越来越多的人开始关注了？”

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