益气化痰类中药复方对阿尔茨海默病神经保护作用的研究进展

Neuroprotective Effect of Chinese Medicinal Compounds Effective in Supplementing Qi and Resolving Phlegm on Alzheimer's Disease:A Review

阿尔茨海默病(AD)是一种老年人常见的慢性退行性神经性疾病,主要表现为认知、记忆和行为等方面的损害。当前该病病因和发病机制尚未完全明确,用于缓解疾病进展的相关药物研究仍处于临床试验中。中医认为老年人脏腑功能低下,正气亏虚,痰浊蒙窍是AD发生的核心病机,气虚痰阻贯穿AD的整个病理过程,治疗上强调益气化痰的重要作用。近年来,以开心散为代表的益气化痰类中药复方被广泛用于AD的临床和基础研究,发现其不仅可以改善AD的认知功能,还具有减少β淀粉样蛋白(Aβ)沉积、抑制tau蛋白过度磷酸化、改善神经递质活性、调节神经元突触可塑性、抗氧化应激损伤、抑制中枢炎性反应、抑制神经细胞凋亡等重要的神经保护作用。基于此,该文从益气化痰治疗AD的视角出发,对益气化痰治疗AD的理论基础及益气化痰类中药复方抗AD的作用机制研究进行了综述和分析,以期为中医药防治AD的临床应用提供理论支持和科学依据。

Alzheimer's disease(AD)is a common chronic degenerative neurological disease in the elderly and is mainly manifested by the impairment of cognition,memory,and behaviors.At present,the etiology and pathogenesis of this disease have not been fully unraveled,and the research on related drugs for alleviating the disease progression is still in clinical trials.Traditional Chinese medicine(TCM)believes that the elderly have reduced visceral function.Deficiency of vital Qi and turbid phlegm obscuring orifices are the core pathogenesis of AD.Qi deficiency and phlegm obstruction run through the whole pathological process of AD,and the important role of therapeutic principles of supplementing Qi and resolving phlegm is emphasized in treatment.In recent years,the Chinese medicinal compounds effective in supplementing Qi and resolving phlegm represented by Kaixin Powder have been widely used in the clinical and basic research of AD.As reported,in addition to the improvement of the cognitive function of AD,it can also reduceβamyloid(Aβ)deposition,inhibit tau hyperphosphorylation,improve neurotransmitter activity,regulate neuronal synaptic plasticity,resist oxidant stress injury,and inhibit the central inflammatory response and neuronal apoptosis.Therefore,this article reviewed and analyzed the theoretical basis of the treatment of AD by supplementing Qi and resolving phlegm and the mechanism of Chinese medicinal compounds effective in supplementing qi and resolving phlegm against AD to provide theoretical support and a scientific basis for the clinical application of TCM in the prevention and treatment of AD.