基于活血化瘀理论的中药配伍防治脑缺血再灌注损伤炎症反应的作用机制

Mechanism of Chinese Medicine Based on the Theory of Promoting Blood Circulation and Removing Blood Stasis in Preventing and Treating Inflammatory Response of Cerebral Ischemia-reperfusion Injury

[目的]以丹红注射液为例,研究活血化瘀中药防治脑缺血再灌注损伤(cerebral ischemia-reperfusion injury,CIRI)炎症反应的作用机制。[方法]通过对以往研究文献的整理复习,从CIRI与炎症反应的相关性及瘀血证与炎症反应的相关性出发,重点分析以丹红注射液为代表的活血化瘀中药防治CIRI炎症反应的作用机制。[结果]炎症反应在CIRI的病理生理过程中起到重要作用,基于中医活血化瘀理论的瘀血证与炎症反应的关系密不可分。瘀血证的病理实质包括了多种致炎细胞因子造成组织器官水肿、血栓形成及相关炎症通路激活等一系列的病理变化,而活血化瘀疗法可以从不同方面通过不同途径调节CIRI过程中的炎症反应,如活血化瘀的代表药物丹红注射液能抑制CIRI中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)和IL-10的分泌,从而减轻炎症反应,有利于缓解脑组织损伤,防止病情进展,改善患者预后。[结论]对活血化瘀中药防治CIRI炎症反应的作用机制进行探讨,可以为临床防治CIRI的新药开发提供理论基础。

[Objective] To summarize the mechanism of Chinese medicine promoting blood circulation and removing blood stasis in preventing and treating inflammatory response of cerebral ischemia-reperfusion injury(CIRI), and taking Danhong injection as an example. [Methods] Based on the review of previous literature, the relationship between CIRI and inflammatory response and the correlation between blood stasis syndrome and inflammatory response were summarized, and the anti-inflammatory effect of promoting blood circulation and removing blood stasis Chinese medicine represented by Danhong injection was analyzed. [Results] Inflammatory response has a certain degree of influence on the pathophysiological process of CIRI. The relationship between blood stasis syndrome and inflammatory response based on TCM theory of promoting blood circulation and removing blood stasis is inseparable. The pathological essence of blood stasis syndrome includes a series of pathological changes such as edema, thrombosis and related inflammatory pathways activation caused by various inflammatory factors. Therapy of promoting blood circulation and removing blood stasis can regulate the inflammatory response in the CIRI process through different ways from different aspects. Danhong injection can inhibit the secretion of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and IL-10 in CIRI, thereby alleviating inflammation, relieving brain tissue injury, preventing disease progression and improving prognosis of patients. [Conclusion] To explore the mechanism of promoting blood circulation and removing blood stasis with Chinese medicine in preventing and treating inflammatory response of CIRI can provide a theoretical basis for the development of new drugs for CIRI.