进入21世纪以来,国内外慢病高发的态势并没有得到有效控制,对医学和药学领域提出了新的挑战,无论是化学药、生物药还是中药的研发与评价,都面临着如何显著提升药效、降低其毒副作用即增敏促效的极其迫切的现实需求。随着精准医疗和大数据时代的到来,为新药研发、老药新用等提出了新的机遇与挑战。然而,由于目前不断认识到由人体共生微生物群体所构成的人体微生态系统尤其是肠道微生态系统在人体健康与疾病方面越来越重要的作用,甚至与部分疾病如肥胖和糖尿病具有一定程度的因果关系,因此,对于目前药物研发甚至当前医学理论体系的一些核心思路提出了新的思考,只有从根本上对这些核心问题进行正确分析,才有可能让新药研发在新的时期以创新的方式走出传统路线,为真正有效实现慢病防控事业做出新的贡献。本文结合国内外人体微生态尤其是肠道微生态领域的研究进展,系统分析当前新药研发存在的问题,提出如何分别从人体、人体微生态和人体与人体微生态平衡这3个角度综合出发,破解当前慢病高发时期新药研发所面临和困扰的难题,期望能够促进新药研发以及慢病防控事业又好又快地发展,为我国人民身心健康服务。
Since entering the 21(st) century,the trend of high incidence of chronic diseases in the international community has not been effectively controlled and the pharmaceutical and medical fields are put forward new challenges. Both the development and evaluation of chemical drugs,biological drugs or traditional Chinese medicine are facing with how to significantly improve the efficacy and reduce the side effect of the drugs. With the coming of the accurate medical treatment as well as the big data era,new opportunities and challenges are needed either in the development of new drugs or new use of old drugs. However,as known that the human body consists of the symbiotic microbial groups of human microecological system especially the gut microecology system is more and more important in human health and disease,and even part diseases such as obesity and diabetes have a certain degree of causality with the gut microflora,so we need to reanalyze the core ideas about drug development or even the current medical theory system. Therefore,it is possible to step out of the old way of current drug development in the new period,to make new contributions on the real effective implementation of prevention and control of chronic diseases. According to international human body microecological especially the research progress of gut microecological field,systematic analysis of the problems existing in the current research and development of new drugs,will not only focus on the human body itself,but also the human microecology as well as the balance between human and microecological,which will promote rapid development of research and development of new drugs and prevention and control of chronic disease in order to improve the physical and mental health services in our country.