中药单体活性成分治疗缺血性脑卒中的研究进展

Research Progress on Traditional Chinese Medicine Monomer Active Ingredient in Treatment of Ischemic Stroke

缺血性脑卒中是由于脑供血不足,导致局部脑组织缺血缺氧坏死的神经功能缺损的疾病,目前多采用溶栓治疗,预后较差。近年来发现许多中药及其提取物在防治缺血性脑卒中方面表现出良好的治疗及预后作用,其相关的研究也日益受到重视。为明确中药在防治缺血性脑卒中的具体作用机制,特归纳了其有效成分在疾病研究及治疗中的关键环节。其中黄酮类、皂苷类、酚类、萜类、多糖类、生物碱类、醌类等中药单体成分,能够通过PI3K-Akt、AGE-RAGE、MAPK、缺氧诱导因子-1(Hypoxia inducible factor-1,HIF-1)、mTOR、ERK、SIRT1、NF-κB等多条信号通路发挥抗氧化应激、抗炎、抑制细胞凋亡、抗兴奋性毒性、抑制自由基、修复受损的血脑屏障功能、促进神经再生和血管再生等作用,在治疗缺血性脑卒中的研究中表现出了巨大的潜力。通过对近年来国内外关于中药单体成分防治缺血性脑卒中作用机制的系统整理,为深入研究疾病发病机制及挖掘更为丰富的中药活性成分提供思路,也为开辟新的缺血性脑卒中的治疗路径提供理论参考依据。

Ischemic stroke is a disease of neurological deficit caused by localized ischemic and hypoxic necrosis of brain tissue due to insufficient blood supply to the brain,and currently is mainly treated by thrombolysis with a poor prognosis.In recent years,many Chinese herbal medicines and their extracts have been found to show good therapeutic and prognostic effects in the prevention and treatment of ischemic stroke,and their related studies have received increasing attention.In order to clarify the specific mechanism of action of herbal medicines in the prevention and treatment of ischemic stroke,the key pathological aspects of their active ingredients in disease research are summarized.In particular,some flavonoids,saponins,phenols,terpenoids,polysaccharides,alkaloids,quinones and other monomeric components of traditional Chinese medicine are able to exert anti-oxidative stress,anti-inflammatory,inhibit apoptosis,anti-excitotoxicity,inhibit free radicals,repair damaged blood-brain barrier function,promote neural regeneration and vascular regeneration,and show great potential in the research of treatment of ischemic stroke through multiple signaling pathways such as phosphatidylinositol 3 kinase-protein kinase B(PI3K-Akt),advanced glycation endoproduct(AGE)-receptor for advanced glycation end(RAGE),mitogen-activated protein kinase(MAPK),hypoxia-inducible factor(HIF-1),mammalian target of rapamycin(mTOR),extracellular regulated protein kinases(ERK),silent mating type information regulation 2 homolog-1(SIRT1)and nuclear factor-kB(NF-κB).A systematic review of the mechanisms of protective effects of monomeric components of traditional Chinese medicine against ischemic stroke in recent years has been conducted at home and abroad.Our goals in this review aim to provide ideas for further research on specific mechanisms and explore more active components of traditional Chinese medicine or theoretical references for new therapeutic pathways of ischemic stroke in the future.