葛根素治疗血管性痴呆的作用机制研究进展  

Research progress in mechanism of puerarin in treating vascular dementia

作　　者：齐大河 马桦 陈媛媛 王可欣 丁萌萌 郝云龙 郭烨 孔令博[1] QI Da-he;MA Hua;CHEN Yuan-yuan;WANG Ke-xin;DING Meng-meng;HAO Yun-long;GUO Ye;KONG Ling-bo(Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine,Beijing 100700,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]南京中医药大学附属医院,江苏南京210029

出　　处：《中国中药杂志》2023年第22期5993-6002,共10页China Journal of Chinese Materia Medica

基　　金：国家重点研发计划项目(2018YFC1705001);2022年度科技创新项目(DZMKJCX-2022-006)。

摘　　要：血管性痴呆(vascular dementia)是由于急慢性脑组织灌注不足导致的一种认知障碍疾病。目前临床治疗主要以改善脑缺血、提高认知功能和控制精神行为为主。近些年来中药活性成分在治疗血管性痴呆的基础及临床研究方面取得一定的成果,其中主要包括银杏叶提取物、葛根素、淫羊藿苷、丹参酮、人参皂苷等。作用机制方面大都以抗炎、抗凋亡、抗氧化及神经保护等作用为主,但葛根素在改善胆碱能神经障碍及增加突触可塑性方面具有一定的优势。化学成分方面葛根素、银杏黄酮、淫羊藿苷均属于黄酮类化合物,而丹参酮属于二萜类化合物。葛根性辛,既能引清阳上养脑窍,又具风药升、散、动、窜之特征,入络则血脉通利,气血畅行,入玄府则通玄开智,脑神得通,符合血管性痴呆中医病机特点。因此,该文通过汇总葛根主要成分葛根素治疗血管性痴呆的作用机制,发现葛根素的作用途径包括改善胆碱能神经系统障碍、抑制兴奋性毒性作用、抗炎、抑制细胞凋亡、抑制氧化应激损伤、增加突触可塑性、促进神经保护因子表达、增加脑循环代谢、抑制Aβ损伤等,其作用通路包括激活核因子E2相关因子2(nuclear factor erythroid 2-related factor 2,Nrf2)/抗氧化反应元件(antioxidant response element,ARE)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、细胞外调节蛋白激酶(extracellular regulated protein kinases,ERK)、磷脂酰肌醇-3-激酶(phosphatidylinositol-3-kinase,PI3K)/蛋白激酶B(protein kinase B,Akt)、Janus激酶2(Janus-activating kinase 2,JAK2)/信号转导和转录激活因子3(signal transducer and activator of transcription 3,STAT3)、腺苷酸活化蛋白激酶(AMP-activated protein kinase,AMPK)及抑制肿瘤坏死因子α(tumor necrosis factor α,TNF-α)、瞬时受体电位M2(transient receptor potential melastatin 2,TRPM2)/N-甲基-D-天门冬氨酸受体(N-methyl-D-aspartVascular dementia(VD) is a condition of cognitive impairment due to acute and chronic cerebral hypoperfusion.The available therapies for VD mainly focus on mitigating cerebral ischemia,improving cognitive function,and controlling mental behavior.Achievements have been made in the basic and clinical research on the treatment of VD with traditional Chinese medicine(TCM) active components,including Ginkgo leaf extract,puerarin,epimedium,tanshinone,and ginsenoside.Most of these components have anti-inflammatory,anti-apoptotic,anti-oxidant,and neuroprotective effects,and puerarin demonstrates excellent performance in mitigating cholinergic nervous system disorders and improving synaptic plasticity.Puerarin,ginkgetin,and epimedium are all flavonoids,while tanshinone is a diterpenoid.Puerariae Lobatae Radix,pungent in nature,can induce clear Yang to reach the cerebral orifices and has the wind medicine functions of ascending,dispersing,moving,and scurrying.Puerariae Lobatae Radix entering collaterals will dredge blood vessels to promote blood flow,and that entering the sweat pore will open the mind,which is in line with the TCM pathogenesis characteristics of VD.This study reviews the progress in the mechanism of puerarin,the main active component of Puerariae Lobatae Radix,in treating VD.Puerarin can ameliorate cholinergic nervous system disorders,reduce excitotoxicity,anti-inflammation,inhibit apoptosis,alleviate oxidative stress injury,enhance synaptic plasticity,up-regulate neuroprotective factor expression,promote cerebral circulation metabolism,and mitigate Aβ injury.The pathways of action include activating nuclear factor erythroid 2-related factor 2(Nrf2)/antioxidant response element(ARE),vascular endothelial growth factor(VEGF),extracellular regulated protein kinases(ERK),phosphatidylinositol-3-kinase(PI3K)/protein kinase B(Akt),Janus-activating kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3),AMP-activated protein kinase(AMPK),as well as inhibiting the tumor necrosis factor α(TNF-α),

关 键 词：葛根素 血管性痴呆 作用机制 研究进展 

分 类 号：R285[医药卫生—中药学]