If you're doing read-heavy access (looking up filenames, etc) you might benefit from memcached. You could store the "hottest" (most recently created, recently used, depending on your app) data in memory, then only query the DB (and possibly files) when the cache misses. Memory access is far, far faster than database or files.
If you need write-heavy access, a database is the way to go. If you're using MySQL, use InnoDB tables, or another engine that supports row-level locking. That will avoid people blocking while someone else writes (or worse, writing anyway).
But ultimately, it depends on the data.
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