中医药治疗中风神经保护和促进神经再生的疗效与机制研究进展（英文）

Clinical Efficacy and Therapeutic Mechanisms of Traditional Chinese Medicine for Neuroprotection and Neurogenesis in Stroke Treatment

中风是主要的致残性的疾病,目前缺乏有效的治疗性药物。由于中风涉及多靶点多条信号通路紊乱,发展新药以恢复多靶点多条信号通路极具挑战性。中医药的复方中药治疗模式以多种成分针对多条信号通路的治疗具有独特优势。研究表明,许多中医组方具有促进神经保护和神经再生的潜力,惟缺乏设计完善的临床试验观察其疗效以其复杂的药物成分,其作用机制不易阐明。本文介绍了治疗中风的常用中医经典方剂,并选择安宫牛黄丸和补阳还五汤为代表方,介绍有关安宫牛黄丸和补阳还五汤神经保护和神经再生作用的最新研究进展。科学证据和临床试验皆表明,安宫牛黄丸是有效的治疗中风的神经保护组方,常规短期治疗安全可靠,可作为急性中风的辅助治疗。补阳还五汤是治疗中风后遗症的代表性中药复方,研究显示,补阳还五汤具有神经保护和促进神经再生作用,能改善中风后神经功能,其机制可能是与该方各种成分同步调节不同分子靶标有关。总之,中医药可能是治疗中风的重要治疗手段,其神经保护和促进神经再生的临床疗效和分子机制有待进一步研究。

Stroke is the leading cause of human disability with limited effective drugs availability. The disruption of multiple signaling pathways in stroke makes developing new drugs be difficult. Traditional Chinese medicine(TCM) has its unique advantage in targeting multiple signaling pathways with multiple components. Many TCM formulas have the potential for neuroprotection and neurogenesis, but well-designed clinical trials are insufficient and underlying mechanisms unclear. Herein, we introduce the commonly used TCM formulas for stroke treatment and selectively introduce two classic formulas, An Gong Niu Huang(AGNH) pill and Bu Yang Huan Wu Decoction(BYHWD) for neuroprotection and neurogenesis, respectively. Current scientific evidence and clinical trials indicate AGNH pill could be an effective neuroprotective formula as adjunct therapy with relative safety. On the other hand, as a representative TCM formula for post stroke disability, BYHWD could improve the neurological outcome with its neuroprotective and neurogenic effects. The underlying mechanisms could be attributed to the modulation of multiple molecular targets with its multiple components. In conclusion, TCM formulas could be potential adjunct therapies for stroke treatment. The clinical efficacies and molecular mechanisms of promoting neuroprotection and neurogenesis remain to be further studies.