中药调控mTOR信号通路治疗缺血性脑卒中的研究进展  

Traditional Chinese Medicine Treats Ischemic Stroke by Regulating mTOR Signaling Pathway:A Review

作　　者：马玉刚 王兴臣[2] 王学斌[2] 李雅慧[2] MA Yugang;WANG Xingchen;WANG Xuebin;LI Yahui(Shandong University of Traditional Chinese Medicine(TCM),Jinan 250014,China;The Second Afiliated Hospital of Shandong University of TCM,Jinan 250001,China)

机构地区：[1]山东中医药大学,济南250014 [2]山东中医药大学第二附属医院,济南250001

出　　处：《中国实验方剂学杂志》2024年第11期265-272,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：全国名老中医专家传承工作室建设项目[国中医药人教函(2022)75号];山东省自然科学基金项目(ZR2020MH156)。

摘　　要：缺血性脑卒中(IS)是临床上较为常见的一类严重的脑血管疾病。针对其缺血损伤发生机制,通过静脉溶栓以恢复血流仍是临床上最主要最有效的治疗手段,但因静脉溶栓存在增加出血风险、治疗窗口狭窄、禁忌证多等弊端,使其在临床的应用受到限制。在未达到完全有效复流的同时,对缺血脑组织进行有效保护事关IS预后。研究发现,改善IS导致的脑损伤存在诸多通道机制,哺乳动物雷帕霉素靶蛋白(mTOR)信号通路就是其中之一。中医在治疗IS,尤其在改善缓解患者症状和提高生活质量方面,具有丰富的干预手段和独特优势。在IS发病后,中医药尽早介入其治疗、康复和预防复发的全过程可以充分发挥中西医协同治疗优势,保证患者获益最大化,对IS后的神经功能和运动功能恢复具有重要临床意义。诸多研究表明,中药干预手段通过调控激活mTOR信号通路,以干预和调节细胞自噬、抑制神经细胞凋亡、抑制氧化应激和炎症反应等方式有效减轻IS导致的脑损伤,对实现脑保护、改善IS预后具有积极作用,为IS的防治提供了新的治疗策略和思路。该文基于此,对mTOR信号通路在IS发病中的作用机制及近年来中药调控mTOR信号通路治疗IS的研究进展进行综述,以期为IS的中医药治疗提供新的治疗思路和系统的科学参考。Ischemic stroke(IS)is a serious cerebrovascular disease common in clinical practice.Targeting the pathogenesis of IS,intravenous thrombolysis for restoring blood flow is still the most effective therapy.However,intravenous thrombolysis has shortcomings such as increased bleeding risk,narrow therapeutic window,and contraindications,which limited its clinical application.Protection of the ischemic brain tissue before full recovery of blood flow is associated with the prognosis of IS.Studies have identified multiple pathways in the alleviation of the brain injury caused by IS,such as the mammalian target of rapamycin(mTOR)signaling pathway.Traditional Chinese medicine(TCM)has abundant therapies and unique advantages in the treatment of IS,especially in alleviating symptoms and improving the quality of life of patients.After the onset of IS,TCM can be integrated with Western medicine to play a role in the whole process of treatment,rehabilitation,and recurrence prevention as soon as possible,thus maximizing patient benefits.TCM has clinical significance for the recovery of neurological and motor functions after IS.Studies have shown that TCM can reduce the cerebral injury caused by IS by regulating and activating the mTOR signaling pathway,thereby regulating autophagy,inhibiting apoptosis of nerve cells,and reducing oxidative stress and inflammation.TCM exerts a positive effect for achieving cerebral protection and improving the prognosis of IS and provides new ideas for the prevention and treatment of IS.This article introduces the role of the mTOR signaling pathway in the pathogenesis of IS and reviews the research progress in the TCM regulation of this pathway in the treatment of IS,aiming to provide new therapeutic ideas and systematic scientific reference for the treatment of IS with TCM.

关 键 词：缺血性脑卒中 哺乳动物雷帕霉素靶蛋白(mTOR) 信号通路 自噬 中医药 研究进展 

分 类 号：R2-0[医药卫生—中医学] R22R242R287R651.1