水蛭治疗脑卒中的作用机制研究进展  

Mechanism of Hirudo in Treatment of Stroke:A Review

作　　者：徐寒莹 张冬梅[2] 卢靖[2] 崔雅斌[2] 吴雷 陈助明 金子淇 吕志国[2] 徐鹏[2] 张艺缤 兰天野[2] 王健[2] XU Hanying;ZHANG Dongmei;LU Jing;CUI Yabin;WU Lei;CHEN Zhuming;JIN Ziqi;LYU Zhiguo;XU Peng;ZHANG Yibin;LAN Tianye;WANG Jian(Changchun University of Chinese Medicine,Changchun 130117,China;The Affiliated Hospital to Changchun University of Chinese Medicine,Changchun 130021,China)

机构地区：[1]长春中医药大学,长春130117 [2]长春中医药大学附属医院,长春130021

出　　处：《中国实验方剂学杂志》2023年第18期209-217,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(8207152160);国家重点研发计划项目(2019YFC1709902);国家中医药管理局项目(2019XZZX-NB005);吉林省科技发展计划项目(20210303004SF);吉林省自然科学基金项目(20200201542JC)。

摘　　要：脑卒中是最常见的脑血管疾病之一,包括出血性和缺血性2种类型。从现代医学角度,脑卒中是由于脑血管损伤或栓塞引发的血液循环障碍;从中医学角度分析该病病机主要是由于气血逆乱,上犯于脑,从而导致血溢脉外或脑络痹阻。“瘀”是贯穿于脑卒中全程的病理因素,活血化瘀法也是长久以来脑卒中的核心治法。水蛭作为传统的虫类药物,具有较好的破血化瘀之效。现代药理学研究证实,水蛭中含有的抗凝组分在缺血性卒中血栓溶解、出血性卒中后血肿吸收等方面有巨大优势。水蛭及其相关制剂已被证实可通过抗凝、抗栓、保护血管内皮等途径发挥抗脑卒中作用,并广泛应用于该病治疗。该文将基于水蛭的主要活性成分及其具备的化瘀特性探讨其治疗脑卒中的理论基础及研究现状,总结水蛭相关的常用复方、制剂的研究现状,旨在为水蛭参与脑卒中的治疗提供参考。Stroke is one of the most common cerebrovascular diseases,including hemorrhagic stroke and ischemic stroke.From a modern medical perspective,stroke is caused by cerebrovascular damage or embolism leading to impaired blood circulation.From the traditional Chinese medicine(TCM)perspective,the pathogenesis of this disease is mainly due to the disorder of Qi and blood,which ascend to the brain,causing either blood extravasation or blockage of brain collaterals.Stasis is a pathological factor that runs throughout the entire course of stroke,and the method of promoting blood circulation and resolving stasis has been a core treatment for stroke for a long time.Hirudo,as a traditional insect drug,has shown good effects in promoting blood circulation and resolving stasis.Modern pharmacological research has confirmed that Hirudo contains anticoagulant components,which provide significant advantages in dissolving thrombi in ischemic stroke and facilitating hematoma absorption in hemorrhagic stroke.Hirudo and its related preparations have been proven to exert an anti-stroke effect through anticoagulation,anti-thrombosis,and protection of vascular endothelium.As a result,they have been widely used in the treatment of stroke.This article explored the theoretical basis and research status of using Hirudo for treating stroke based on its main active components and hemostatic properties and summarized the current research status of commonly used Hirudo-based formulations and preparations,aiming to provide references for the involvement of Hirudo in stroke treatment.

关 键 词：水蛭 脑卒中 缺血性卒中 出血性卒中 水蛭素 

分 类 号：R2-0[医药卫生—中医学] R33[文化科学—情报学] G353.11R743.2