银杏与三七制剂在治疗缺血性脑血管疾病中的异同  

Similarities and differences between Ginkgo biloba and Panax notoginseng in treatment of ischemic cerebrovascular disease

作　　者：吴旦 郑亚纯 丁楠 查慧军 闵会 姚建标 何厚洪 王如伟 WU Dan;ZHENG Ya-chun;DING Nan;ZHA Hui-jun;MIN Hui;YAO Jian-biao;HE Hou-hong;WANG Ru-wei(Zhejiang CONBA Pharmaceutical Co.,Ltd.,Hangzhou 310052,China;Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine Pharmaceutical Technology,Hangzhou 310052,China)

机构地区：[1]浙江康恩贝制药股份有限公司,浙江杭州310052 [2]浙江省中药制药技术重点实验室,浙江杭州310052

出　　处：《中国中药杂志》2020年第13期3063-3072,共10页China Journal of Chinese Materia Medica

基　　金：国家重点研发计划项目(2017YFD0601301)。

摘　　要：银杏与三七是常见的心脑血管治疗中药,在治疗缺血性脑血管疾病中发挥积极的作用,主要表现在抗氧化应激、神经保护、血管保护等作用。通过相关机制文献对比研究表明,在抗氧化应激过程中,银杏从自由基形成的初期至造成细胞炎症引起细胞凋亡的全过程均具有一定的保护作用,三七主要在抗炎、抗凋亡中起效;在谷氨酸引起的神经损害修复以及神经保护作用上,银杏与三七均能够促进神经元再生、修复受损轴突进而保护神经细胞。此外银杏叶还能缓解因谷氨酸引起的神经毒性;三七在修复血脑屏障与血管再生上有独特的作用。临床使用中银杏与三七主要作为辅助用药,配合溶栓相关治疗方案联用,起到缓解炎症、消除水肿、提高治愈率与改善预后的作用。慢性脑灌注不足的相关疾病中,银杏有独特疗效,银杏能够有效改善相关症状,提高认知与记忆力。此外,由于银杏能够影响体内多巴胺的分泌从而保护神经细胞,在抗抑郁相关疾病上有一定的疗效,但临床数据有限仍需要进一步研究。Ginkgo biloba and Panax notoginseng are both herb medicines for cerebrovascular disease,and play an active role in treating ischemic cerebrovascular disease(ICVD).Their mechanisms of action include antioxidant stress,nerve protection,vascular protection.According to the comparative study of literatures,G.biloba has a certain protective effect from the early stage of free radical formation throughout the whole process of causing cell inflammation and apoptosis in antioxidant stress;while P.notoginseng has mainly anti-inflammatory,anti-apoptosis effects.In the nerve protection and repair of nerve damage caused by glutamate,both could promote neurogenesis,repair damaged axons and protect nerve cells.In addition,G.biloba could also relieve neurotoxicity caused by glutamate damage,while P.notoginseng have a unique effect in repairing blood-brain barrier(BBB)and blood vessel regeneration.In clinic,they are used as auxiliary drugs in combination with thrombolytic therapy,and play curative effects in alleviating inflammation,eliminating edema,improving the cure rate and the prognosis.For cerebral diseases caused by chronic cerebral hypoperfusion,G.biloba could reduce inflammation and improve cognition.In addition,G.biloba could protect neurocyte by adjusting the secretion of dopamine in vivo,and has a certain effect on antidepressant diseases,which however needs further studies.

关 键 词：银杏 三七 急性缺血性脑卒中 慢性脑灌注不足 

分 类 号：R277.7[医药卫生—中医学]