中风后胶质瘢痕形成及中医药干预作用机制研究进展  

Advance in mechanisms of glial scarring after stroke and intervention of traditional Chinese medicine

作　　者：刘吉勇[1] 廖君[2] 方锐[3] 葛金文[3] 梅志刚 LIU Ji-yong;LIAO Jun;FANG Rui;GE Jin-wen;MEI Zhi-gang(Hunan Provincial Key Laboratory of Traditional Chinese Medicine Diagnostics,Hunan University of Chinese Medicine,Changsha 410208,China;Medical School,Hunan University of Chinese Medicine,Changsha 410208,China;Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases,Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学中医诊断学湖南省重点实验室,湖南长沙410208 [2]湖南中医药大学医学院,湖南长沙410208 [3]湖南中医药大学中西医结合心脑疾病防治湖南省重点实验室,湖南长沙410208

出　　处：《中国中药杂志》2021年第23期6139-6148,共10页China Journal of Chinese Materia Medica

基　　金：国家自然科学基金项目(81774033,82174167);湖南省教育厅项目(19C1413);湖南中医药大学校级科研基金项目(2019XJJJ009);湖南中医药大学中医学一流学科开放基金项目(2018ZYX30);湖南省大学生创新创业训练计划项目(2582)。

摘　　要：中风损伤过程中,星形胶质细胞被多种内源性调控因子激活为反应性星形胶质细胞,继而进行大量增殖、分化、迁移,并且在小胶质细胞、神经元-胶质抗原2(neuron-glial antigen 2,NG2)胶质细胞与细胞外基质的共同参与下形成胶质瘢痕。胶质瘢痕在中风损伤不同阶段作用迥异,损伤中后期,其分泌的硫酸软骨素蛋白聚糖和硫酸软骨素是阻碍神经轴突再生和神经功能恢复的主要因素。靶向调控胶质瘢痕是中风后神经功能恢复的重要路径。中医药临床应用被证实对中风康复具有较好疗效,究其机制,可能与其具有促进血液复供,抗炎、抗氧化应激,抑制细胞增殖分化,良性干预胶质瘢痕有关。该文综述了中风后胶质瘢痕形成病理过程和信号调节机制,以及中医药对胶质瘢痕的干预作用研究进展,试图从胶质瘢痕的视角,为中风康复治疗的中医药创新药物研发提供理论参考和循证依据。When ischemia or hemorrhagic stroke occurs,astrocytes are activated by a variety of endogenous regulatory factors to become reactive astrocytes.Subsequently,reactive astrocytes proliferate,differentiate,and migrate around the lesion to form glial scar with the participation of microglia,neuron-glial antigen 2(NG2)glial cells,and extracellular matrix.The role of glial scars at different stages of stroke injury is different.At the middle and late stages of the injury,the secreted chondroitin sulfate proteoglycan and chondroitin sulfate are the main blockers of axon regeneration and nerve function recovery.Targeted regulation of glial scars is an important pathway for neurological rehabilitation after stroke.Chinese medicine has been verified to be effective in stroke rehabilitation in clinical practice,possibly because it has the functions of promoting blood resupply,anti-inflammation,anti-oxidative stress,inhibiting cell proliferation and differentiation,and benign intervention in glial scars.This study reviewed the pathological process and signaling mechanisms of glial scarring after stroke,as well as the intervention of traditional Chinese medicine upon glial scar,aiming to provide theoretical reference and research evidence for developing Chinese medicine against stroke in view of targeting glial scarring.

关 键 词：中风 胶质瘢痕 星形胶质细胞 小胶质细胞 NG2胶质细胞 中医药 

分 类 号：R255.2[医药卫生—中医内科学]