清热解毒药治疗缺血性脑白质病变的研究进展  

Research Progress of Antipyretic and Antidote Drugs in Treatment of White Matter Ischemic Lesions

作　　者：杨凤梅 蔡芸蔓 黄世敬[2] 杨雄 YANG Fengmei;CAI Yunman;HUANG Shijing;YANG Xiong(Medical School of Yunnan University of Economics and Management,Kunming 650000,China;Department of Geriatrics,Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Department of Surgery,the Third Affiliated Hospital of Kunming Medical University,Kunming 650000,China)

机构地区：[1]云南经济管理学院医学院,昆明650000 [2]中国中医科学院广安门医院老年病科,北京100053 [3]昆明医科大学第三附属医院外科,昆明650000

出　　处：《医学综述》2024年第11期1349-1353,共5页Medical Recapitulate

基　　金：国家自然科学基金(82374283);中国中医科学院科技创新工程重大攻关项目(CI2021A01313)。

摘　　要：近年来缺血性脑白质病变(WMIL)的检出率不断提高,热毒的形成与演变贯穿WMIL的发病过程,内生热毒损伤脑络在WMIL病理机制中占重要地位。针对WMIL“虚、热、毒、瘀”的病机,清热解毒药通过抑制炎症过程干扰缺血级联反应、清除痰瘀热毒等有害物质的产生,从而发挥解毒祛邪的作用。临床常用的清热解毒药(如牛黄、大黄、黄芩、黄连)在WMIL治疗中疗效明确,可显著改善患者脑缺血状态,延缓或阻止WMIL等神经退行性疾病的发展,为有效治疗脑白质病提供新思路。In recent years,with the continuous improvement of the detection rate of white matter ischemic lesions(WMIL),the formation and evolution of heat toxicity runs through the pathogenesis of WMIL,and the injury of cerebral collaterals caused by endogenous heat toxicity plays an important role in the pathological mechanism of WMIL.Aiming at the pathogenesis of"deficiency,heat,toxicity and stasis"in WMIL,antipyretic and antidote drugs interfere with ischemic cascade reaction and eliminate the production of harmful substances such as phlegm,stasis,heat and toxity by inhibiting the inflammatory process,so as to play the role of detoxification and exorcism.In the treatment of WMIL,the heat-clearing antidote(such as bezoar,rhubarb,scutellaria,rhizome,etc.)commonly used in clinics has a clear effect,which can significantly improve the cerebral ischemia state,delay or prevent the development of neurodegenerative diseases such as ischemic leukoencephalopathy of the patients,and provide a new idea for the effective treatment of leukoencephalopathy.

关 键 词：缺血性脑白质病变 清热解毒药 缺血性脑卒中 毒损脑络 

分 类 号：R749[医药卫生—神经病学与精神病学]