基于脑肠轴理论概述中医药防治缺血性中风的研究

A study on the prevention and treatment of ischemic stroke in TCM based on brain-gut axis theory

缺血性中风是指多种原因引起脑部血液供应障碍导致脑组织不可逆的损伤,近年来其患病率持续上升,严重危害人类的健康和生活质量。近年来研究发现缺血性中风的发生发展与脑肠轴的异常变化相关,脑肠轴在脑系疾病的防治研究中的作用逐步受到重视。文章通过对脑肠轴通路中各个调控环节的研究现状、脑肠轴理论与中医理论二者之契合点以及中医药对缺血性中风防治的临床实验研究进行论述。当前中医药对脑缺血防治已取得很好的疗效,目前研究发现中药组方、中药单体、中药有效成分份和针灸治疗能有效调控脑肠轴通路,介导脑肠肽和下丘脑-垂体-肾上腺轴(HPA)的调节,有效维持肠道微生物群的生态平衡和保护脑肠屏障,从而对缺血性中风后的神经缺损、胃肠功能障碍具有良好的保护作用,并能减轻脑梗死体积、改善脑功能。中医认为脾胃失调,酝酿痰瘀,痰瘀互结而气血运行不畅是中风的病机,从藏象学说、经络走行、经方等多个角度均认为脑和胃肠之间存在相关通路,中风发生时改善胃肠脏腑气机升降以达醒神通窍之效,这也遵循上病下治的治则,符合脑肠轴理论。脑肠轴理论和中医理论二者结合为将来脑缺血的治疗方案研究提供有效的方向和理论参考。现将研究现况综述如下。

Ischemic stroke refers to the irreversible damage to the brain tissue caused by blood supply disturbance in the brain due to various reasons.In recent years,its prevalence has continued to rise,seriously endangering human health and quality of life of the patient.Now,studies have found that the occurrence and development of ischemic stroke is related to the abnormal changes of the brain-gut axis,and the role of the brain-gut axis in the prevention and treatment of brain diseases has gradually been paid attention to.At present,TCM has gained a good curative effect on the prevention and treatment of cerebral ischemia.Studies have found that TCM prescriptions,TCM monomers,TCM medicine active ingredients and acupuncture can effectively regulate the brain-gut axis pathway,mediate brain-gut peptide and the regulation of the hypothalamic-pituitary-adrenal axis,effectively maintain the ecological balance of intestinal microflora and protect the brain-gut barrier,so as to gain a good protective effect on nerve defects and gastrointestinal dysfunction after ischemic stroke,reduce the volume of cerebral infarction,and improve brain function.The combination of brain-gut axis theory and TCM theory provides an effective direction and theoretical reference for future research on the treatment of cerebral ischemia.The current research status is summarized as follows.