基于“鼻-脑”通路的中药防治脑缺血损伤的研究进展

Research progress on traditional Chinese medicine in preventing and treating cerebral ischemia injury based on "nose-brain" pathway

由于中枢神经系统疾病发病率不断增加,特别是脑中风发病率以及死亡率不断增加,脑靶向给药日益受到重视。鼻腔给药作为脑靶向给药的途径之一,可有效地使药物绕过血脑屏障,靶向递送到脑部,为中枢神经系统疾病的治疗提供了新的思路,是一种极有发展前景的给药途径。中药经鼻给药治疗脑病已经成为近年来中药研究的热点。缺血性脑中风是危害人类健康的重要疾病之一,通过鼻腔给药治疗中风已有几千年的历史,现代医学研究证明,鼻腔与大脑间存在着微妙的联系,鼻腔复杂而巧妙的结构为药物经鼻入脑提供了可能。药物经鼻腔给药应用于以缺血性脑中风为代表的中枢神经系统疾病具有明显的优势。鼻腔给药具有非侵入、低感染、吸收迅速、脑靶向性等特点。笔者将从解剖学和生理学方面阐述鼻腔给药脑靶向的理论基础,对药物经鼻入脑的转运通路,"鼻-脑"通路的体外、体内实验研究基础,中药鼻腔给药防治脑缺血的临床应用等方面进行综述。为更好地研究药物经"鼻-脑"通路防治脑缺血损伤提供参考,并为"鼻-脑"通路研究的深入奠定基础。

Due to the increasing incidence of central nervous system diseases,especially the increasing incidence and mortality of stroke,brain-targeted drug delivery has attached more and more attention. Nasal administration,as one of the ways of brain-targeted administration,can effectively make the drug delivered to the brain in a targeted way after by passing the blood-brain barrier,providing a new idea for the treatment of central nervous system diseases. Therefore,it is a promising administration way. In recent years,the treatment of encephalopathy by nasal administration of traditional Chinese medicine has become a hot topic in the research of traditional Chinese medicine. Ischemic stroke is one of the most important diseases endangering human health. Nasal administration has a history of thousands of years in treatment of stroke. Modern medical research has proved that there is a subtle connection between the nasal cavity and the brain,and the complex and ingenious structure of the nasal cavity provides the possibility for drugs delivery to the brain through the nose. Drug administration through nasal cavity has obvious advantages in treatment of central nervous system diseases represented by ischemic stroke. Nasal administration is characterized by non-invasion,low infection,rapid absorption and brain targeting. The author will expound the theoretical basis of brain targeting of nasal administration from the aspects of anatomy and physiology,and summarize the transport pathway of drugs through the nose into the brain,the in vitro and in vivo experimental research basis of the " nose-brain"pathway,and the clinical nasal administration of traditional Chinese medicine to prevent cerebral ischemia. It provides a reference for better research of drugs to prevent and treat cerebral ischemia injury through the " nose-brain"pathway and lays a foundation for further research of the " nose-brain" pathway.