从补阳还五汤治疗脑卒中谈中药复方药理学新模式及发展方向  

Pharmacological Effects and Therapeutic Models of Chinese Herbal Medicine for Post-stroke: Using Buyang Huanwu Decoction for Neurogenesis and Brain Repair in Post-stroke as an Example

作　　者：沈剑刚[1] Jiangang Shen(School of Chinese Medicine,The University of Hong Kong,10 Sassoon Road,Hong Kong,Hong Kong SAR,China)

机构地区：[1]香港大学中医药学院

出　　处：《世界科学技术-中医药现代化》2018年第8期1430-1435,共6页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：香港研究资助局卓越研究计划(第七次)(AoE/P-705/16):以化学生物学方法探索分子医学;共同项目负责人:沈剑刚;国家自然科学基金面上项目(32270902):探讨活性氮介导的过度线粒体自噬在脑缺血再灌注损伤中的作用及抗氧化剂柚皮苷的干预效应;负责人:沈剑刚;RGC GRF grant香港研究资助局(17102915);负责人:沈剑刚~~

摘　　要：内源性神经干细胞是再生医学重要的治疗靶细胞,以促进干细胞生长和形成新生神经元,用于重建脑卒中及神经退行性疾病的神经功能和修复脑组织。在成年脑组织,内源性神经干细胞具有潜在的生长能力,缺血缺氧可以诱导神经干细胞或前体细胞增殖和分化,但是这种自发的脑修复机制并不能够有效重建功能性神经元,其原因是多方面的,既有新生神经干细胞生存能力的问题,又有微环境多种有害因子影响其生长及生存能力。因此,单靶点治疗策略在促进神经再生和脑修复方面收效甚微。中医药以其多成分和多靶点的治疗策略显示了极大的优势,历代医籍及当代临床为中医药治疗脑卒中及促进神经修复提供了大量研究素材。具有促进干细胞生长的中药单体、提取物及复方中药制剂多有补肾填精、活血化淤及化痰醒神之功效,与中医理论不谋而合。补阳还五汤是中医药治疗中风的代表方剂,本文以经典复方补阳还五汤为例,讨论中医药活性复方的药理学模式,根据补阳还五汤促进神经再生功能及其有效成分研究的最新进展,讨论补阳还五汤促进神经再生功能的作用机制。研究表明:补阳还五汤能调节神经再生过程中的多种信号通路和分子靶点,其作用机制是通过网络调节而达到促进脑修复和神经功能的作用,其复杂的活性成分与效应靶点相互关系值得深入探究。Neural stem/progenitor cells(NSCs) could be attractive therapeutic targets for promoting adult neurogenesis,brain plasticity and repair in stroke,raising great potentials for regeneration therapy.In adult ischemic brains,NSCs have limited capacities of growth,differentiation and generating new neurons for repairing the damaged central nerve system.However,the spontaneous brain repair seems to be insufficient to recover neurological deficits in most stroke cases.To overcome those problems,pharmacological manipulation targeting on endogenous neural stem cells is promoting strategy for regeneration therapy.Chinese herbal medicine has a long history for post-stroke treatment.Many Chinese herbal formulas revealed the potentials for promoting neurogenesis and improving the recovery of neurological functions in poststroke patients.We evaluated the effects of a classic Chinese herbal formula named Buyang Huanwu Decoction on promoting proliferation and differentiation of NSCs and its related molecular mechanisms.The formula could promote growth and differentiation of NSCs and improve the recovery of neurological functions in experimental stroke models in vivo and cultured NSCs in vitro.The mechanisms are related to regulating multiple microenvironment niche signal pathways.This article reviews the recent progress of this formula for neurogenesis and brain repair in post-stroke treatment.Recent progress indicates that Buyang Huanwu Decoction could regulate multiple signaling pathways and molecular targets to promote proliferation and differentiation of NPCs and microenvironment niche for brain repair and improving neurological functions.The therapeutic strategy of Chinese herbal medicine is a network regulation toward multiple targets.Traditional Chinese Medicine has unique advantages in promoting the growth of neural stem/progenitor cells and adult neurogenesis.Due to the complex interactions of herbal ingredients in network regulation,huge challenge remains to be resolved for further study.

关 键 词：补阳还五汤 脑卒中 中药复方药理学 神经干细胞 神经再生 

分 类 号：R289.5[医药卫生—方剂学]