黄芪治疗缺血性脑损伤的有效性

Effectiveness of astragulus for cerebral ischemic injury

目的:对近年来黄芪治疗缺血性脑损伤作以总结,以阐明其在治疗缺血性脑血管病中的有效作用。资料来源:检索数据库Medline1966-01/2005-05有关黄芪的药理作用及其治疗缺血性脑损伤的文章,检索词为“astragulus,cerebralischemiainjury”,限定文章语言种类为英文。同时检索中文医学期刊全文数据库1994-01/2004-12及万方数据库1998-01/2005-11有关黄芪的药理作用及其治疗缺血性脑损伤的文章,检索词为“黄芪,缺血性脑损伤”,限定文章语言种类为中文。资料选择:对资料进行初审,选取包括黄芪与缺血性脑损伤的动物实验和临床研究文章。质量评价主要考察资料的真实性,实施过程是否严密。关于重复实验的多篇文章,选取样本量较大的文章予以纳入。资料提炼:共检索到72篇中文和94篇英文,选取较新的或经典的探讨黄芪的药理作用及其治疗缺血性脑损伤的文章共25篇。排除重复性研究。资料综合:①黄芪具有清除自由基,降低血浆内皮素含量,防止脂质过氧化,改善脑功能的作用。②黄芪能降低兴奋性氨基酸的含量,抑制热休克蛋白70的表达,减轻缺血性脑损伤。③黄芪能提高脑缺血后Bcl-2的水平,拮抗P53和Caspase-3的表达,有效抑制脑缺血引起的神经元凋亡。④黄芪能降低血管通透性,改善脑缺血后血液流变状态,减轻脑缺血损伤。⑤黄芪能抑制脑缺血早期胶质细胞原纤维酸性蛋白过度表达,减轻海马区锥体细胞损伤,保护缺血后脑损伤。结论:黄芪能显著改善脑缺血患者的临床症状,降低致残率,且安全无副作用,有广阔的临床前景。

OBJECTIVE： To summarize the articles on the astragulus for cerebral ischemic injury in recent years to clarify its efficacy for ischemic cerebrovaseular disease. DATA SOURCES： Using the keywords ＂astragnlus, cerebral ischemia injury＂, we searched the Modline database for the relevant articles on pharmacological effect on astragnlus and the treatment 9f cerebral isehemic injury published from January 1966 to May 2005 in English. Meanwhile, using the same keywords we searched the China Journal Full-text Database from January 1994 to December 2004 tbr the relevant articles on pharmacological effects of astragulus and the treatment of cerebral ischemic injury and published between January 1998 and November 2005 in Wanfang Database in Chinese. STUDY SELECTION： All articles were selected firstly, the articles relevant to experiment animal research and clinical research of astragulus and cerebral ischemic injury were selected. The evaluation of quality mainly inspected the validity of data, and the procedure of putting in practice whether accuracy or not. Among those articles with repetitive experiment, the articles with large number of samples were selected. DATA EXTRACTION： A total of 72 articles in Chinese and 94 articles in English were found. The latest or classical articles about pharmacological effects of astragulus and in the treatment of cerebral isehemic injury were collected, totally 25 articles. The repetitive articles were excluded. DATA SYNTHESIS： （1）Astragulus had the role of eliminating free radical, decreasing serum endothelin, avoiding lipid peroxidation and improving cerebral function. （2）Astragnlus could reduce the content of excitatory amino acid, restrain the expression of heat shock protein 70 and alleviate the cerebral ischemic injury. （3）Astragulus could enhance the level of Bcl-2 after cerebral ischemia, antagonise the expression of P53 and Caspase-3, effectively inhibit neuronal apoptosis caused by cerebral ischemia. （4）Astragulus could reduce the permeability of blood vessel, improve the condition of hemorrheotogy after ischemia, and alleviate the cerebral isehemic injury. （5）Astragnlus could restrain the hypemomic expression of glial fibrillary acidic protein in the period of early cerebral ischemia, alleviate the trauma of stratum pyramidale hippocampi, and protect cerebral cerebral lesion after ischemia. CONCLUSION： Astragulus can significantly improve the clinical symptom of the patients with cerebral ischemia and reduce the diseability, Furthermore, astragulus is safe, has no side effect and has wide clinical future.