经典名方开心散治疗阿尔茨海默病的机制研究进展

Research progress on mechanism of classic famous prescription Kaixin Powder in treatment of Alzheimer’s disease

阿尔茨海默病(Alzheimer’s disease,AD)是一种以进行性认知功能障碍和记忆损害为特征的神经退行性疾病,临床主要表现为记忆力减退、语言障碍、情感和行为异常等。开心散源于《备急千金要方》,已有研究证实开心散中的远志皂苷、人参皂苷、茯苓三萜类和多糖类化合物、α-细辛醚及β-细辛醚等成分,可通过调节丝裂原活化蛋白激酶/核因子-κB、磷脂酰肌磷脂酰肌醇3-激酶/蛋白激酶B/糖原合成酶激酶-3β和Kelch样ECH关联蛋白1/核因子E2相关因子2/锰超氧化物歧化酶等炎症相关信号通路及抗氧化应激、抑制tau蛋白过度磷酸化、抑制神经细胞凋亡和调节胆碱能系统等机制治疗AD,在临床防治AD方面前景广阔。通过对开心散治疗AD的药效基础及治疗AD相关作用机制进行综述,为开心散的新药研发和临床应用奠定基础。

Alzheimer’s disease(AD)is a neurodegenerative disease characterized by progressive cognitive dysfunction and memory impairment.The main clinical manifestations are memory loss,language impairment,emotional and behavioral abnormalities.Kaixin Powder(开心散,KXP)is derived from Valuable Prescriptions for Emergency.Studies have confirmed that KSP contains polygala saponins,ginsenosides,poria triterpenoids and polysaccharides,α-andβ-asarone,etc.,can regulate inflammation-related signaling pathways such as mitogen-activated protein kinases/nuclear factor-κB,phosphatidylinositol 3-kinase/protein kinase B/glycogen synthasekinase-3βand Kelch-like ECH-associated protein 1/nuclear factor E2 related factor 2/manganese superoxide dismutase,as well as anti-oxidative stress,inhibit tau protein hyperphosphorylation,inhibit neuronal apoptosis,and modulate the cholinergic system.KSP has great potential in the clinical prevention and treatment of AD.This article reviews the pathogenesis of AD,the pharmacodynamic material basis of KSP in the treatment of AD and the related mechanism,laying the foundation for the new drug research and clinical application of the classic famous prescription KSP.