小续命汤对缺血性脑卒中作用机制研究进展

缺血性脑卒中(ischemic stroke,IS)是人口老龄化问题严重以来,医疗卫生界面临的发病率最高的神经系统性疾病。小续命汤治疗脑卒中疗效确切,有调控线粒体自噬、调节血脑屏障、保护和修复神经元、抗炎症因子、抗氧化应激、减轻脑水肿及预防脑血管病作用,且临床上用途广泛。临床不应拘泥于“内风”学说,应重新从现代科学和中医基础理论的角度更深入地挖掘小续命汤治疗缺血性中风的疗效,寻找不同信号通路以及生物信息对细胞的作用,为进一步揭示小续命汤治疗缺血性脑卒中的效应机制提供更科学、准确的证据。

小续命汤在治疗大面积脑梗死后脑水肿的临床作用

目的考察小续命汤结合常规治疗大面积脑梗死后脑水肿的临床效果。方法随机选取2018年1月—2020年1月医院收治的大面积脑梗死后脑水肿患者90例,患者被随机分为实验组和对照组,每组45例。对照组接受常规治疗,实验组接受常规治疗+小续命汤治疗,连续治疗14 d。治疗后,采用ELISA法测定血清S-100β、神经元特异性烯醇化酶(NSE)、髓鞘碱性蛋白(MBP)水平,NIHSS评估患者神经功能缺损程度,采用BORN-BE无创脑水肿动态监护仪监测各组脑水肿变化情况(脑水肿扰动吸收),颅脑CT观测梗死灶周围低密度容量。结果实验组明显改善率和总有效率显著高于对照组(χ^(2)=4.727,P<0.05;χ^(2)=8.459,P<0.01);实验组第7天和第14天梗死灶周围低密度容积大小显著低于对照组(t=3.134,P<0.01;t=7.067,P<0.01),实验组第7天和第14天脑颅内压显著低于对照组(t=5.576,P<0.01;t=3.971,P<0.01);治疗后,实验组S-100β、NSE、MBP和NIHSS显著低于对照组(t=8.050,P<0.01;t=10.463,P<0.01;t=5.700,P<0.01;t=8.341,P<0.01)。结论小续命汤结合常规治疗可缓解大面积脑梗死后脑水肿程度,保护神经功能,值得临床推广使用。

小续命汤历史沿革、有效成分组、药理作用及临床应用研究进展

小续命汤是《千金要方》中治疗中风的代表方,具有保护神经血管单元、保护神经细胞、抗阿尔茨海默病、降血脂、抗凝血、保护线粒体功能、改善急性肺损伤等作用,临床上用于治疗中风及其后遗症、面神经炎、类风湿性关节炎、格林-巴利综合征、儿童过敏性鼻炎-哮喘综合征等疾病,具有较好疗效。该文对小续命汤历史沿革、有效成分组、药理作用和临床应用的研究进展进行综述。

小续命汤为基本方加减治疗颈椎病68例

目的:观察补益气血、活血通痹治疗神经根型颈椎病的疗效。方法:采用小续命汤为基本方加减(桂枝、党参、防风、防己、羌活、白芍、葛根、制附子、川芎、麻黄、细辛等)随证加减治疗本病68例。结果:显效率76.5%。结论:本方法对本病有补益气血,活血通痹的功效。

从刘完素论治中风探讨风药对中风的作用

刘完素为金元四大家之首,首开“内风”学说之先河,其对中风的论治具有划时代的意义。“玄府”理论与“阳气怫郁”学说为刘完素两大主要学术思想,一者言气机通行之道路遍布周身,一者言气机闭塞不通则病邪丛生,两者分别从生理、病理角度强调了气机宣通的重要意义。刘完素论治中风的方剂主要有大秦艽汤、小续命汤、三化汤等,方中皆有大量风药的应用,临床每取良效。文章旨在以刘完素玄府理论及阳气怫郁学说为立足点,深入探讨风药对中风的作用。

古代经典名方小续命汤的处方关键信息考证

《古代经典名方目录(第一批)》中小续命汤出自唐·孙思邈所著《备急千金要方》。本文对小续命汤中各药材的基原、炮制方法以及度量衡和煎煮服用等相关信息进行系统的考证,初步确认小续命汤处方的关键信息,为经典名方小续命汤的开发提供依据。经考证,麻黄为麻黄科植物草麻黄Ephedra sinica Stapf的干燥草质茎;防己为防己科植物粉防己Stephania tetrandra S.Moore的干燥根;人参为五加科人参Panax ginseng C.A.Mey.的干燥根和根茎;黄芩为唇形科植物黄芩Scutellaria baicalensis Georgi的干燥根;桂心为樟科植物肉桂Cinnamomum cassia Presl.的干燥树皮;甘草为豆科植物甘草Glycyrrhiza uralensis Fisch.的干燥根及根茎;芍药为毛茛科植物芍药Paeonia lactiflora Pall.的干燥根;芎为伞形科植物川芎Ligusticum chuanxiong Hort.的干燥根茎;杏仁为蔷薇科植物山杏Prunus armeniaca L.var.ansu Maxim.的干燥成熟种子;附子为毛茛科植物乌头Aconitumcarmichaelii Debx.的子根;防风为伞形科植物防风Saposhnikovia divaricate(Turcz.)Schischk.的干燥根;生姜为姜科植物姜Zingiber officinale Rosc.的新鲜根茎。甘草的炮制方法为“炒甘草”;苦杏仁的炮制方法为“燀苦杏仁”;附子的炮制方法为“炒附片”或“炮附片”,其余各药材建议生用。经考证,唐代一两约为今13.80 g。煎煮方法为:以上12味药材加水2400 mL,先煮麻黄“三沸”并去沫,再加剩余药材,煮取600 mL,分三次温服。

Xiao-Xu-Ming decoction extract alleviates LPS-induced neuroinflammation associated with down-regulating TLR4/MyD88 signaling pathway in vitro and in vivo

In the present study, we aimed to investigate the effects of Xiao-Xu-Ming decoction extract(XXM) on lipopolysaccaride(LPS)-induced neuroinflammation in vitro and in vivo. In vitro, the microglia BV2 cells were treated with 200 ng/mL LPS for 24 h to induce inflammatory responses. In vivo, mice were treated with 5 mg/kg LPS to induce inflammatory responses. The NO level was determined by Griess Reagents. The levels of IL-1β, IL-6, TNF-α and MCP-1 were determined by ELISA. The expressions of Iba-1, TLR4 and MyD88 at the protein levels were determined by Western blotting analysis. The mRNA levels of TLR4 and MyD88 were determined by real-time PCR. In vitro, XXM significantly reduced the levels of various pro-inflammatory factors, including NO, IL-1β, IL-6 and TNF-α, induced by LPS in the supernatant of BV2 cells and suppressed expressions of inflammatory proteins TLR4 and MyD88 induced by LPS in BV2 cells. In vivo, XXM significantly inhibited microglia activation, attenuated LPS-induced inflammatory factors and chemokine production, such as IL-1β, IL-6, TNF-α and MCP-1, and inhibited the expressions of inflammatory proteins including TLR4 and MyD88, in the cortex of LPS-induced mice. Our findings suggested that XXM could attenuate LPS-induced neuroinflammation via down-regulating TLR4/MyD88 signaling pathway.

Xiao-Xu-Ming decoction extract ameliorates brain injury in rats with thrombotic focal ischemic stroke and understanding possible therapeutic targets using proteomics

Ischemic stroke seriously threatens human health and quality of life.Xiao-Xu-Ming(XXM)decoction has been a classical prescription for stroke therapy.In our previous studies,we have found that XXM exerts neuroprotective effects,improves brain injury,and attenuates neuroinflammation in cerebral ischemia rats.In this study,we investigated the effects and possible mechanism of XXM on thrombotic focal cerebral ischemia.After treatment with XXM,the neurological function and motor abilities were improved,and cerebral infarction volume was significantly decreased compared with rats of thrombotic focal cerebral ischemia.Besides,the results of BBB integrity detected by EB leakage and tight junction(TJ)protein expression showed that XXM could maintain BBB integrity and improve the expressions of TJ proteins,including claudin-1,occluding,and ZO-1,in the ischemic ipsilateral cortex disrupted by thrombotic cerebral ischemia.Furthermore,proteomic techniques were used to identify the differentially expressed proteins(DEPs)in the ischemic cerebral cortex,and the results showed that 132 DEPs regulated by XXM were detected in the ischemic cerebral cortex.Bioinformatic analysis showed that these regulated proteins by XXM were mainly involved in complement and coagulation cascade,and lysosome,etc.Furthermore,there was an interaction among DEPs,including Lgals3,Ctsz,Capg,C1qa,S100a4,Grn,Hspb1,Aif1,and Anxa1,etc.In conclusion,XXM ameliorated brain injury of thrombotic focal ischemic stroke,and Lgals3,Ctsz,Capg,C1qa,S100a4,Grn,Hspb1,Aif1,and Anxa1 could help provide possible therapeutic targets of XXM for ischemic stroke and offer research direction for further research.

Network pharmacological analysis of Xiao-Xu-Ming decoction against ischemic stroke and verification of its mechanism of anti-inflammation and neurovascular protection in vivo

Stroke is a major cause of severe disability and death.Xiao-Xu-Ming decoction(XXMD)is an effective prescription for stroke and its sequelae,while its effective ingredients and mechanism are still unclear.In the present study,we aimed to explore the effective ingredients and mechanism of XXMD in treating cerebral ischemia using network pharmacology.The main chemical components and targets of 12 herbs of XXMD were obtained by the TCMSP database and analysis platform database.The active components in XXMD were screened according to oral utilization and drug-like properties.Then,the cerebral ischemia targets were obtained through GeneCards,OMIM,TTD,Diligent and Drugbank databases.We analyzed the pathophysiological processes and pathways involved in the treatment of cerebral ischemia with XXMD by using the Metascape data analysis platform.Results showed thatβ-sitosterol,kaempferol,quercetin,stigmasterol,wogonin,and catechins might be the potential core active ingredients of XXMD in the treatment of cerebral ischemia.The therapeutic effect of XXMD on stroke was mainly exerted through regulating neuroinflammatory response and neurovascular protection.Furthermore,the anti-neuroinflammation and neurovascular protection of XXMD were further confirmed using cerebral ischemia rats.Collectively,our findings revealed that the mechanism of XXMD on the treatment of cerebral ischemia was related to anti-neuroinflammation and neurovascular protection.