通窍活血汤治疗血管性认知障碍和痴呆的研究进展

Research Progress of Tongqiao Huoxue Decoction(通窍活血汤)in Treatment of Vascular Cognitive Impairment and Dementia:A Review

随着社会老龄化的加重,血管性认知障碍和痴呆(vascular cognitive impairment and dementia,VCID)的发病率日益升高,挖掘与研究可以阻止疾病进展的有效干预方剂具有重要的社会意义。中医“瘀血理论”对健忘、精神异常等认知减退症状有丰富、明确的论述。通窍活血汤出自清代王清任《医林改错》,具有活血化瘀、通窍活络之功效,其原书所载治疗症目十三条,主要治疗头目、官窍等因血瘀引起的病证。通窍活血汤因其临床疗效确切、组方精妙,在当代临床中应用十分广泛。临床及基础研究表明,通窍活血汤可以通过调节炎症、自噬、凋亡、氧化应激等途径改善β淀粉样蛋白的沉积和Tau蛋白过度磷酸化引起的神经退行性改变发挥治疗血管性认知障碍和痴呆。通过查阅文献,综述近年来通窍活血汤及其加减化裁方治疗血管性认知障碍和痴呆上的临床应用及基础研究进展,为其更广泛地研究提供支持。

With the aggravation of aging society,the incidence of vascular cognitive impairment and dementia is increasing day by day.It is of great social significance to explore and research effective intervention prescriptions that can prevent its progress.The theory of blood stasis in traditional Chinese medicine has a rich and clear discussion on the symptoms of cognitive decline such as forgetfulness and mental abnormality.Tongqiao Huoxue Decoction(通窍活血汤)was made by WANG Qingren in the Qing Dynasty(1644-1912).It has the effect of promoting blood circulation and removing blood stasis,promoting body circulation and activating orifices and collaterals.The original book contains 13 items for the treatment of diseases,mainly targeting at the head,orifices and other places caused by blood stasis.Tongqiao Huoxue Decoction is widely used in contemporary clinical practice because of its exact clinical effect and exquisite formulation.Clinical and basic studies have shown that Tongqiao Huoxue Decoction can treat vascular cognitive impairment and dementia by regulating inflammation,autophagy,apoptosis,oxidative stress and other pathways to ameliorate neurodegeneration caused by amyloid beta deposition and Tau protein hyperphosphorylation.This paper reviewed the clinical application and basic research progress of Tongqiao Huoxue Decoction and its addition and reduction prescription in the treatment of vascular cognitive impairment and dementia in recent years by reviewing the literature,so as to provide support for more extensive research.