星蒌承气汤治疗中风痰热腑实证的研究进展  

Research Progress of Xinglou Chengqi Decoction in Treatment of Stroke with Heat-phlegm and Sthenic-Fu Syndrome

作　　者：王爽[1,2] 吴丹 张敬博 秦月雯 王萍 WANG Shuang;WU Dan;ZHANG Jing-bo;QIN Yue-wen;WANG Ping(Heilongjiang University of Chinese Medicine,Harbin 150040,China;Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]黑龙江中医药大学,哈尔滨150040 [2]中国中医科学院中药研究所,北京100700

出　　处：《中国实验方剂学杂志》2021年第10期213-221,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(81774201)。

摘　　要：中风是由于脑血管的阻塞或爆裂造成脑血流中断的一类破坏性脑血管事件,容易造成患者身体残疾和多重功能损伤。我国中风患者的死亡率占世界首位,如何有效地治疗中风是目前亟待解决的卫生健康问题之一。王永炎院士在临床中观察到60%中风患者兼有痰热腑实证,表现为大便郁结、口臭咽干等,经临床实践后创立星蒌承气汤,对证治疗具有痰热腑实证的中风患者。星蒌承气汤为化痰通腑类方药的代表方剂之一,由大黄、芒硝、瓜蒌、胆南星按5∶5∶15∶3比例组成。目前星蒌承气汤的研究多集中在临床观察及药理作用机制的初步探索,其药效物质基础研究相对薄弱。笔者拟对星蒌承气汤的组方药味化学成分、药理作用及其作用机制进行梳理,以期为后期该复方的化学成分鉴定、药物靶标预测、药效物质基础筛选等提供依据;此外,拟通过对星蒌承气汤及其加减方治疗脑中风的案例分析,总结其临床应用规律,旨在为该复方的临床应用提供参考。Stroke is a destructive cerebrovascular event caused by the interruption of cerebral blood flow caused by the blockage or rupture of cerebral vessels,which is easy to cause physical disability and multiple functional injuries. The mortality rate of stroke patients in China occupies the first place in the world. How to effectively treat stroke is one of the urgent health problems to be solved. In the clinic,academician WANG Yongyan observed that 60% of stroke patients with heat-phlegm and sthenic-Fu syndrome. Most of the patients with heat-phlegm and sthenic-Fu syndrome are characterized by stagnation of stool,bad breath and dry pharynx,and so on,After clinical practice,Xinglou Chengqi decoction(XLCQD)was established to treat stroke patients with heat-phlegm and sthenic-Fu syndrome. XLCQD is one of the representative prescriptions for removing phlegm to relax bowels,which is composed of Rhei Radix et Rhizoma,Natrii Sulfas,Trichosanthis Fructus and Arisaema Cum Bile by the ratio of 5∶5∶15∶3. At present,the research on XLCQD is mainly focused on clinical observation and pharmacological mechanism,while the basic research of its pharmacodynamic substance is relatively weak. This paper intends to sort out the chemical composition and pharmacological mechanism of XLCQD,in order to provide the basis for the chemical component identification,drug target prediction and material basis screening of this compound in the later stage. In addition,through the case analysis of XLCQD and modified XLCQD in the treatment of stroke,its rules of clinical application were summarized,in order to provide reference for the clinical application of this compound.

关 键 词：星蒌承气汤 物质基础 药理作用 临床应用 中风 大承气汤 痰热腑实证 

分 类 号：R22[医药卫生—中医基础理论] R857.3[医药卫生—中医学]