石菖蒲-川芎药对改善血管性痴呆机制研究进展

Research Progress of Shichangpu(Acori Tatarinowii Rhizoma)-Chuanxiong(Chuanxiong Rhizoma)Medicine Pair on the Improvement of Vascular Dementia

血管性痴呆(vascular dementia,VD)是由于各种脑血管损害引起的一种智能和认知障碍综合征。与胆碱能系统障碍、突触改变、氧化应激、炎性反应机制和兴奋性神经毒性密切相关。中医属“痴呆”“呆病”“善忘”等范畴,基本病机为髓减脑消,神机失用。石菖蒲-川芎药对主要含苯丙素类、萜类等挥发油成分和苯酞及其二聚体、生物碱、有机酸酚、多糖以及脑苷脂和神经酰胺等类化合物。具有开窍醒神、活血行气之功效。多项研究表明,石菖蒲-川芎药对及其有效组分可通过调节与VD相关的多个信号转导通路改善VD,延缓其进展。文章基于VD本虚标实的病机,以脏腑虚损、气血不足为本,痰、瘀、热毒为标,从改善学习记忆、抗炎、抗凝、抗氧化、保护血管内皮方面探讨石菖蒲-川芎药对及其有效组分在改善VD中的研究进展,并进一步总结、分析、阐述其作用机制,得出石菖蒲-川芎药对及其有效组分主要通过调控神经型一氧化氮合酶(nNOS)、一氧化氮(NO)、神经生长相关蛋白43(GAP-43)、Wnt7a蛋白、自噬基因Beclin-1、核转录因子-κB(NF-κB)、胞内磷脂酰肌醇激酶(PI3K)、脑内皮素(ET)、神经肽Y(NPY)、凝血酶、抗凝血酶Ⅲ、凝血因子Ⅹa、血栓调节蛋白、谷胱甘肽过氧化物酶(GSH-Px)、乙酰胆碱脂酶(AChE)、乙酰胆碱(Ach)等途径,调控脑组织蛋白质的表达及自噬紊乱,抑制血栓形成、免疫炎症及氧化应激,保护血管内皮,进而改善VD,以期为石菖蒲-川芎药对在VD中的研究提供借鉴,挖掘其在临床中的应用价值,为临床治疗VD提供科学的指导和依据。

Vascular dementia(VD)refers to a syndrome of intellectual and cognitive impairment caused by various cerebrovascular damage.It is closely related to cholinergic system disorders,synaptic changes,oxidative stress,inflammatory response mechanisms,and excitatory neurotoxicity.Traditional Chinese medicine belongs to the categories of“dementia”“idiocy”“forgetfulness”and so on,and the basic pathogenesis is myeloid reduction,brain elimination,and the use of the divine machine.Shichangpu(Acori Tatarinowii Rhizoma)-Chuanxiong(Chuanxiong Rhizoma)drug mainly contains volatile oil components such as phenylpropanoids and terpenes,and phthalide and its dimers,alkaloids,organic acid phenols,polysaccharides,cerebrosides and ceramides.It has the effect of enlightening the mind and activating the blood and Qi.Several studies have shown that the Shichangpu(Acori Tatarinowii Rhizoma)-Chuanxiong(Chuanxiong Rhizoma)drug pair and its effective components can improve VD and delay its progression by modulating multiple signal transduction pathways associated with VD.Based on the etiology and pathogenesis of VD,based on internal organ deficiency,lack of Qi and blood,phlegm,stasis and heat toxicity,this paper discusses the research progress of Shichangpu(Acori Tatarinowii Rhizoma)-Chuanxiong(Chuanxiong Rhizoma)drug pair and its effective components in improving VD from the aspects of improving cognitive impairment,anti-inflammatory,anticoagulant,antioxidant and vascular endothelium,and further summarizes,analyzes and elaborates its mechanism of action.It was concluded that Shichangpu(Acori Tatarinowii Rhizoma)-Chuanxiong(Chuanxiong Rhizoma)and its effective components mainly regulated the signals of neuronal nitric oxide synthase(nNOS)/nitric oxide(NO),nerve growth-related protein 43(GAP-43),Wnt7a protein,autophagy gene Beclin-1,nuclear transcription factor-κB(NF-κB),intracellular phosphatidylinositol kinase(PI3K),brain endothelin(ET)and neuropeptide Y(neuropeptide Y),and other pathways regulate the expression of brain tissue proteins,autophagy disorders,inhibit thrombosis,immune inflammation and oxidative stress,and then improve VD,in order to provide reference for its research in VD,and further exert its application value in clinical practice,and provide scientific guidance and basis for clinical treatment.