基于“病理-方证”探讨康益胶囊治疗缺血性脑卒中的机制  

Mechanism of Kangyi capsule in the treatment of ischaemic stroke based on“pathology-prescription syndrome”

作　　者：张奎明 崔应麟[2] 葛鸾蝶 侯露阳 马瑞红 ZHANG Kui-ming;CUI Ying-lin;GE Luan-die;HOU Lu-yang;MA Rui-hong(The Second Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou,Henan 450002,China;不详)

机构地区：[1]河南中医药大学第二临床医学院,河南郑州450002 [2]河南省中医院脑病科,河南郑州450002

出　　处：《中华全科医学》2022年第2期307-310,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(81573911);河南省中医药科学研究专项课题(2019ZY2003,2017ZY1020,212102311123)。

摘　　要：缺血性脑卒中又称脑梗死,是一种起病急骤、多环境危险因素诱发的异质性神经疾病,并伴随神经功能缺损症状。近年来,抗栓塞药物的更新、介入治疗的完善虽极大改善缺血性脑卒中的治疗效果、提升患者的生活质量,但溶栓窗口期的限制及介入疗法的特定性,严重制约其受益面积,而该病5年复发率及死亡率依旧居高不下。中医药简便廉验、理法方药相统一,具有多成分、多环节、多靶点、整体治疗的特点,对缺血性脑卒中的临床治疗,效果显著。因此,从病理角度探明缺血性脑卒中分子生物机制、理论流派角度挖掘脑缺血疾病共性,结合方证药理的现代研究,是探索该病的有效途径。康益胶囊是河南省中医院专家在前人基础上,根据缺血性中风病因病机特点,筛选有效药物而组成的院内制剂,具有益气活血、化瘀通络的功效,对于病理复杂的缺血性脑卒中具有独特的治疗优势。现代药理学研究证明康益胶囊可改善缺血缺氧性脑血管疾病神经损伤,方内药物能改善缺血神经细胞能量代谢、清除氧自由基、抑制炎症级联反应、缓解细胞内钙超载、阻断细胞凋亡进程、保护受损血脑屏障,亦能降低血脂、抑制血小板聚集,促进血栓溶解而发挥抗栓塞作用。笔者总结缺血性脑卒中现代病理生理机制、中医理论认识及康益胶囊方证研究,为康益胶囊的理论研究及临床应用提供依据。Ischaemic stroke,also known as cerebral infarction,is a heterogeneous neurological disease induced by sudden onset and multi-environmental risk factors and is accompanied by symptoms of neurological impairment.In recent years,the renewal of antiembolic drugs and the improvement in interventional therapy have greatly enhanced the therapeutic effect of ischaemic stroke and improved the quality of life of patients.However,the limitation of the thrombolytic window period and the specificity of interventional therapy seriously restrict its benefits.Moreover,the 5-year recurrence rate and mortality rate of the disease remain high.With the characteristics of multi-component,multi-link,multi-target,and overall treatment,traditional Chinese medicine is simple and low cost.It is effective in the clinical treatment of ischaemic stroke.Therefore,from the perspective of pathology to explore the molecular biological mechanism of ischaemic stroke,theoretical studies on the commonness of cerebral ischaemic disease,combined with modern research on prescription and syndrome pharmacology,are effective ways to explore the disease.Kangyi capsule is a hospital preparation formulated by experts in the Henan Hospital of Traditional Chinese Medicine on the basis of predecessors and according to the aetiology and pathogenesis of ischaemic stroke.It has the effect of replenishing qi and activating blood circulation,removing blood stasis,and dredging collaterals.It has unique advantages in the treatment of ischaemic stroke with complex pathology.Modern pharmacological studies have proven that Kangyi capsule can improve the nerve injury of ischaemic and hypoxic cerebrovascular diseases.Drugs in the prescription can improve the energy metabolism of ischaemic nerve cells,eliminate oxygen free radicals,inhibit inflammatory cascade reaction,relieve intracellular calcium overload,block the process of apoptosis,protect the damaged blood-brain barrier,reduce blood lipids,inhibit platelet aggregation,promote thrombolysis,and play an anti-embolism ro

关 键 词：缺血性脑卒中 机制 中医认识 方证 药理 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R242[医药卫生—临床医学]