溃疡性结肠炎（UC）是一种病因复杂且易复发的慢性非特异性炎症性疾病，其在我国乃至全球的发病率和死亡率呈显著上升趋势。目前西医临床治疗方式虽然能在一定程度上缓解病情进展，但存在激素依赖、不良反应多、耐药以及生活质量下降等问题，无法完全满足临床需要，因此寻找新的治疗药物迫在眉睫。中医药作为一种历史悠久且不断发展的医学体系，在与现代医学的碰撞中焕发出新的活力，更以其多组分、多靶点、多通路等优势在抗UC上发挥独特作用。中药皂苷类活性成分因其广泛的治疗作用成为当前学者研究和开发的重点。UC的发病机制复杂，尚未完全阐明，但其与炎症、氧化应激、免疫异常及肠道菌群失调等因素密切相关。大量研究表明白头翁皂苷、人参皂苷、仙茅苷、薯蓣皂苷等中药皂苷类活性成分可通过核因子κB（NF-κB）、磷脂酰肌醇3-激酶/蛋白激酶B（PI3K/Akt）、半乳糖凝集素-3/核苷酸结合寡聚化结构域样受体蛋白3/白细胞介素-1β（Gal-3/NLRP3/IL-1β）等信号通路，调节UC炎症微环境、抗氧化应激、调节肠道菌群、调控免疫微环境及调控相关细胞自噬、凋亡、焦亡等发挥抗UC的活性作用。基于这些研究成果，总结近年来中药皂苷类成分治疗UC的作用机制，旨在为UC的药物治疗研究和临床新药开发提供新的思路。同时，也为进一步深入探索UC的防治机制提供理论参考和借鉴。

Ulcerative colitis (UC) is a complex, recurrent chronic non-specific inflammatory disease with unclear etiology. Its incidence and mortality rates are showing a significant upward trend both in China and globally. While western medical treatments can alleviate disease progression to some extent, they are accompanied by issues such as hormonal dependence, adverse reactions, drug resistance, and decreased quality of life, failing to fully meet clinical needs. Therefore, the search for new therapeutic drugs is urgent. Traditional Chinese medicine (TCM), as a time-honored and continuously evolving medical system, has rejuvenated its vitality through interactions with modern medicine. It particularly excels in treating UC due to its multifaceted approach involving multiple components, targets, and pathways. TCM saponin components, known for their broad therapeutic effects, have become a focal point for researchers and developers. The pathogenesis of UC is complex and not yet fully understood, but it is closely related to inflammation, oxidative stress, immune abnormalities, and dysbiosis of the gut microbiota. Numerous studies have demonstrated that TCM saponin components, such as anemoside, ginsenosides, curculigoside, and dioscin, can exert anti-UC activities through various mechanisms. These include regulating inflammatory microenvironments, antioxidative stress, modulating gut microbiota, controlling immune microenvironments, inducing autophagy, apoptosis, and pyroptosis via signaling pathways such as NF-κB, PI3K/Akt, Gal-3/NLRP3/IL-1β, etc. This review summarizes the recent understanding of the mechanisms of action of TCM saponin components in the treatment of UC. It aims to provide new insights for drug treatment research and the development of novel clinical medications for UC. Additionally, it offers theoretical references and inspirations for further in-depth exploration of prevention and treatment mechanisms of UC.

R285.5

河南省高等学校重点科研项目计划（20A360011）；河南省中医药科学研究专项课题（2022ZY2027）；河南省中医药科学研究专项课题（2023ZY2103）