补阳还五汤治疗缺血性中风疗效机制研究进展

Research progress on the mechanism of Buyang Huanwu decoction in the treatment of ischemic stroke

补阳还五汤是治疗缺血性中风病的名方效方,可据辨证应用于中风病各期病程中。鉴于目前中风病急性期的研究文献质量不高,不推荐急性期常规运用。补阳还五汤疗效机制复杂,既涉及抗炎、抗栓、改善血液流变性、保护血脑屏障、降同型半胱氨酸、促血管新生等血管相关机制,也涉及抗自由基损伤、抗兴奋性氨基酸毒性、调控热休克蛋白、改善红细胞膜ATP酶活性、纠正离子代谢紊乱、提高脑组织能量代谢、促神经发生、抗神经细胞凋亡等脑组织保护机制。然而目前研究多局限于某一机制或某几种机制,尚不能阐明补阳还五汤复方的多靶点综合效应特点,基于临床的方证代谢组学的提出有望开启补阳还五汤复方疗效机制研究的新篇章。

Buyang Huanwu decoction is a famous and effective prescription for the treatment of ischemic stroke and can be used in different clinical phases of stroke based on the syndrome. In view of the low quality of the literature on the acute phase of stroke, it is not recommended for routine use in the acute phase. The mechanism of Buyang Huanwu decoction is complex, not only involving anti-inflammatory, anti-thrombosis, improve blood theology, protect the blood-brain barrier, reduce homocysteine and promote angiogenesis,but also involving anti-free radical damage, anti-excitatory amino acid toxicity, regulation of heat shock protein, improvement of erythrocyte membrane ATPase activity, correction of ion metabolism disorders, improve brain tissue energy metabolism, promote neurogenesis and anti-neural cell apoptosis. However, current research is limited to one or several mechanisms. It is still unable to clarify the multi target and comprehensive effect characteristics of Buyang Huanwu decoction. The clinical study on the metabolome of formula and syndrome is expected to open a new chapter of Buyang Huanwu decoction.