Views: 2 Author: Wang Zhen, Huang Ke. Publish Time: 2022-12-22 Origin: Wang Zhen, Huang Ke. Research progress on the clinical application and mechanism of action of Poria [J]. Chinese Journal of Drug Abuse Prevention, 2022, 9 (28) 1175-1178.
Poria cocos mainly contains two kinds of compounds, polysaccharides and triterpenoids. Polysaccharides account for about 70%~90% of its dry weight, and have important functions such as anti-tumor, anti-inflammation, and immune regulation, mainly composed of β-(1 → 3) Glucan branched chain structure, carrying a small amount of β-(1 → 6) glucan branched chain and rhamnose, xylose, mannose, galactose, etc. The triterpenoids in Poria cocos have various effects such as diuresis, sedation, anti-tumor, hypoglycemia, and increase of myocardial contractility.
Mechanism and Application of Poria Cocos in Tumor Therapy
Pachynic acid is one of the important components of Poria cocos triterpenoids, which is considered to be the main component of Poria cocos exerting anti-tumor effect. Pachynic acid can activate polyadenosine diphosphate-ribose polymerase, inhibit the proliferation and induce apoptosis of human breast cancer MDA-MB-231 cells, down-regulate the expression of matrix metalloproteinase-9 (MMP-9), and inhibit the migration of breast cancer cells , Inhibit MAPK activation caused by interleukin, reduce prostaglandin, protein kinase AKT synthesis, activate anti-BCL2, induce mitochondria to initiate apoptosis and other processes, thereby exerting anti-cancer effects.
The anti-tumor effect of polysaccharide may be related to its molecular weight and chain structure. The triple helical conformation of β-(1 → 3)D-glucan and the hydrophilic group on the outer surface of the helix are the material basis for its effect.
Modern Chinese medicine mainly uses Poria compound prescriptions. Guizhi Fuling Pills can inhibit ovarian cancer microenvironment and tumor angiogenesis by regulating VEGFR signaling pathway, HIF-1 signaling pathway, and mTOR signaling pathway, and can also reduce estrogen in patients with uterine fibroids. The expression levels of hormones and progesterone can play a role in the treatment of ovarian cancer; the addition of Buyuan Decoction and Guizhi Fuling Pills to patients with advanced non-small cell lung cancer (NSCLC) receiving chemotherapy found that their immune function has been significantly improved, and adverse reactions have been observed. Guizhi Fuling Pills were added to chemotherapy for patients with primary brain tumors, the tumor volume shrunk more significantly, the short-term curative effect was better, and the average survival period was longer; patients with primary liver cancer were treated with Fuling Sini Decoction during interventional therapy , liver function, prothrombin time, and T cell subsets improved more significantly.
The Mechanism and Application of Poria Cocos in the Treatment of Gynecological Diseases
The application of Poria cocos in gynecological diseases is mainly in the form of Chinese patent medicine Guizhi Fuling pill (capsule), which comes from the prescription of Guizhi Fuling pill in Zhang Zhongjing's "Synopsis of the Golden Chamber". Composed of medicinal herbs, its active ingredient composition can inhibit the release of inflammatory factors such as TNF-α and interleukin-1β (IL-1β) and the synthesis of cytokines, coordinate complex inflammation-related networks, activate the body’s immune response, and reduce blood viscosity , Improve the pregnancy rate, widely used in the treatment of gynecological diseases.
Animal experiments have found that Guizhi Fuling Capsules can improve prostaglandins, superoxide dismutase, nitric oxide, etc. in the uterine tissue of rats with primary dysmenorrhea, and inhibit endometrial hyperplasia; it can accelerate chronic pelvic inflammatory disease in experimental rats. The clearance of circulating immune complexes (CIC) enhances the expression of RBC-C3bR receptors on the red blood cell membrane by red blood cells and improves the immune function of red blood cells. The mechanism of action is related to the regulation of lipid metabolism and amino acid metabolism.
In clinical application, Guizhi Fuling Pills can better relieve pain and improve hormone levels in the adjuvant treatment of patients with endometriosis (EMs); when combined with Gongliuxiao to treat patients with uterine fibroids, the volume of uterine fibroids, immune The indicators and sex hormone indicators were significantly improved; when combined with moxifloxacin in the treatment of chronic pelvic inflammatory disease, the overall effective rate can be improved and the inflammatory response can be reduced; when combined with Fuke Qianjin Capsules in the treatment of elderly ovarian cysts, the levels of NO, TNF-α, and E2 in patients were significantly reduced, and the levels of LH , FSH levels were significantly increased; infertility patients with tubal obstruction after taking Guizhu Fuling Capsules significantly increased the pregnancy rate and decreased serum TNF-α.
The Mechanism and Application of Poria Cocos in the Treatment of Edema
Edema is the name of a disease in traditional Chinese medicine, which refers to water retention in the body and overflowing of the skin. The main clinical manifestations of patients are head, face, eyelids, limbs, abdomen and back, including renal edema, cardiac edema, functional edema, endocrine edema, hepatic edema, etc.
Poria cocos plays an important role in the treatment of edema due to its ability to diuresis and expelling dampness. In clinical practice, it is mainly based on the addition and subtraction of classic prescriptions based on syndrome differentiation, and it is widely used in the treatment of edema.
Animal experiments have confirmed that Poria cocos can protect gastrointestinal mucosa by regulating serum EGF and small intestinal MUC2 content, reduce kidney AQP1 or AQP2 content and improve water metabolism disorders, and has a good effect on spleen deficiency model rats; at the same time, it can regulate AQP1 and ADHAQP2 related The role of the pathway can increase the body weight, 24 h urine volume, serum albumin of experimental rats, reduce total protein, and produce obvious diuretic and dampness effects; Poria cocos water extract can improve the glomerular Filtration rate can accelerate the excretion of metabolites such as serum creatinine (SCr) and blood urea nitrogen (BUN). In addition, administration of Poria cocos water-soluble polysaccharide solution can effectively prevent the formation of urinary stones in experimental rats. High urinary magnesium content, simulated oxidative stress, etc.
Clinical studies have shown that the water extract of Poria sclerotia can inhibit the cAMP/PKA pathway and TonEBP/Sgk1 signaling pathway, regulate the water balance of the kidney, and also exhibit anti-apoptotic activity on the kidney; , Poria cocos 100g had the best diuretic effect, and no poisoning occurred; Guizhi Fuling pills combined with Zhenwu decoction were added to the routine treatment of diabetic nephrotic edema with Western medicine, and the TCM syndrome scores were lower; When adding Jianpi Lishui Decoction to patients with cirrhosis, patients will benefit more in terms of 24-hour urine volume, waist circumference, liver function, and TCM syndrome scores, and their antiviral ability will be stronger; Modified Fuling Guizhi Baizhu Gancao Decoction has more advantages in improving clinical symptoms and liver function.
The Mechanism and Application of Poria Cocos in the Treatment of Other Diseases
With the continuous development of traditional Chinese medicine, the scope of clinical application of Poria cocos continues to expand.
Animal experiments have confirmed that Poria cocos triterpenoids can significantly reduce the liver damage process in mice and have liver protection effects; after rats are deprived of sleep, inflammatory indicators such as red blood cells, hemoglobin, white blood cells, and neutrophils increase, and all indicators after using Poria cocos After the intervention of Poria cocos, the learning, memory and insomnia of the rats were significantly improved.
Clinical research shows that Poria cocos polysaccharide has good antioxidant activity; Pachinko Fuling Zhizi Douchi Decoction can significantly improve the insomnia symptoms of patients; the addition of Fuling Guizhi Baizhu Decoction to conventional Western medicine treatment of coronary heart disease patients has a higher clinical total effective rate , blood lipid indexes and cardiac function indexes were significantly improved; the addition of Guizhi Fuling Capsules in the routine treatment of patients with alcoholic liver cirrhosis in the compensatory stage has a better effect.
