黄连解毒汤源自葛洪《肘后备急方》，以黄连、黄芩、黄柏、栀子配伍，针对“火毒壅滞三焦”核心病机，立苦寒直折、分消湿热、攻补兼施之法，融清火、解毒、调畅气机于一体。药理研究揭示其通过多靶点、多通路发挥对炎症、氧化、细胞死亡、自噬、免疫、代谢、屏障保护等方面的系统调节作用，尤其在脑卒中、非酒精性脂肪性肝炎、溃疡性结肠炎等湿热蕴结、血热壅盛、热毒炽盛证候中展现“异病同治”优势。首次系统整合了黄连解毒汤的方证内涵、现代药理作用机制与基于中医证候分型的临床应用证据链，构建了“病机-机制-证候”的整合框架。然而，当前研究仍面临复方动态效应解析不足、成分协同机制模糊、基础与临床转化脱节等问题。未来研究亟需整合多组学与人工智能构建动态网络模型，开发中医证候导向的生物模型，并利用类器官等先进技术验证其跨器官调节效应，以最终建立“病机解析-机制验证-临床转化”的闭环研究体系，为精准应用提供科学支撑。

>Huanglian Jiedu Decoction (HJD), originating from Ge Hong’s Handbook of Prescriptions for Emergency (Zhou Hou Bei Ji Fang), combines Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Chinense Cortex) and Zhizi (Gardeniae Fructus). It targets the core pathogenesis of “fire toxin stagnation in the triple energizer” and employs strategies of purging intense heat directly, eliminating damp-heat through multiple pathways, and harmonizing attack with reinforcement. This formula integrates clearing fire, detoxifying, and regulating qi movement into a unified therapeutic approach. Pharmacological studies have revealed that HJD exerts systematic regulatory effects on inflammation, oxidative stress, cell death, autophagy, immunity, metabolism, and barrier protection via multi-target and multi-pathway mechanisms. It demonstrates the principle of “same treatment for different diseases” particularly in conditions such as stroke, non-alcoholic steatohepatitis, and ulcerative colitis, which are characterized by damp-heat accumulation, blood heat exuberance, and excessive heat-toxin according to traditional Chinese medicine (TCM) pattern differentiation. This review is the first to systematically integrate the formula-pathogenesis correlation of HJD, its modern pharmacological mechanisms, and clinical application evidence based on TCM syndrome subtypes, thereby establishing a holistic framework linking “pathogenesis-mechanism-syndrome”. However, current research still faces challenges, including insufficient analysis of the dynamic effects of the compound formula, unclear synergistic mechanisms among its constituents, and a disconnect between basic research and clinical translation. Future studies should focus on integrating multi-omics and artificial intelligence to construct dynamic network models, developing TCM syndrome-oriented biological models, and utilizing advanced technologies such as organoids to validate its cross-organ regulatory effects. These efforts will ultimately help establish a closed-loop research system from “pathogenesis exploration-mechanistic verification-clinical translation”, providing scientific support for the precise application of HJD.

R285

四大慢病重大专项(2024ZD0530700)