中医药防治帕金森病的机制研究进展

Mechanism of Traditional Chinese Medicine in Prevention and Treatment of Parkinson's Disease:A Review

帕金森病(PD)是一种渐进性慢性神经退行性疾病,发病机制复杂,与氧化应激、神经炎症、线粒体功能障碍等多种致病因素密切相关。目前临床用于治疗PD的药物主要包括复方左旋多巴、多巴胺(DA)受体激动剂、单胺氧化酶B型抑制剂、儿茶酚氧位甲基转移酶抑制剂和抗胆碱能药等,缺少可以明确改善病理进展的疾病修饰疗法。在中医学的认知体系中,该病属本虚标实,总由肝肾阴损、气血不足,并与风、火、痰、瘀关系密切。大量临床实践表明,中医药对PD的防治,对运动症状和非运动症状的处理,以及对DA能神经元的神经保护,具有非常重要的临床价值,其潜在的机制包括并不限于抗氧化应激、抗神经炎症、调节线粒体功能障碍等。该文主要根据PD的发病机制进行分类总结,系统阐述中药单体提取物及复方在防治PD中的药理作用、分子机制,以及最新的临床研究进展,以期为PD的中药开发和临床用药提供参考。

Parkinson's disease(PD)is a progressive chronic neurodegenerative disorder with a complex pathogenesis involving oxidative stress,neuroinflammation,mitochondrial dysfunction,and other factors.Currently,the clinical treatment of PD mainly includes levodopa,dopamine receptor agonists,monoamine oxidase B inhibitors,catechol-O-methyltransferase inhibitors,and anticholinergic drugs,but there is a lack of disease-modif g therapies that can definitively improve disease progression.According to the understanding of traditional Chinese medicine(TCM),PD is characterized by asthenia in origin and sthenia in superficiality.It is primarily caused by liver-kidney Yin deficiency,Qi-blood insufficiency,and closely related to wind,fire,phlegm,and blood stasis.Numerous clinical practices have shown that TCM has significant clinical value in the prevention and treatment of PD,the management of motor and non-motor symptoms,and the neuroprotection of dopaminergic neurons.The underlying mechanisms of TCM include antioxidative stress,anti-neuroinflammation,and regulation of mitochondrial dysfunction.This article categorized and summarized the pathogenesis of PD,systematically elucidated the pharmacological actions and molecular mechanisms of TCM monomer extracts and compounds in the prevention and treatment of PD,and provided the latest clinical research progress,aiming to provide references for the development and clinical use of TCM for PD.