中医药干预铁死亡防治脑缺血再灌注损伤研究进展  

Research Progress on the Prevention and Treatment of Cerebral Ischemia-Reperfusion Injury by Targeting Ferroptosis with Traditional Chinese Medicine

作　　者：袁先江 王琴琴 喻梦婷 杨康杰 钱海兵 YUAN Xianjiang;WANG Qinqin;YU Mengting;YANG Kangjie;QIAN Haibing(Guizhou University of Traditional Chinese Medicine,Guiyang,Guizhou,China,550025;Guizhou Province Research Center for Consistency of Quality and Efficacy of Authentic Chinese Medicinal Materials,Guiyang,Guizhou,China,550025;Guizhou Provincial Key Laboratory of Pharmacology and Efficacy of Traditional Chinese Medicine(Ethnic Medicine),Guiyang,Guizhou,China,550025)

机构地区：[1]贵州中医药大学,贵州贵阳550025 [2]贵州省道地药材性效用一致性研究中心,贵州贵阳550025 [3]贵州省高等学校中药(民族药)药性与效应研究重点实验室,贵州贵阳550025

出　　处：《河南中医》2025年第4期623-632,共10页Henan Traditional Chinese Medicine

基　　金：贵州省高等学校中药(民族药)药性与效应研究重点实验室项目{黔教技[2023]018号};贵州省科技厅重大专项项目{黔科合支撑[2022]重点023}。

摘　　要：脑卒中是导致人类死亡的重要原因之一,具有极高的发病率、死亡率和致残率,且并发症多,预后不良。脑缺血再灌注损伤(cerebral ischemia reperfusion injury,CIRI)作为缺血性脑卒中的后续治疗引起的脑组织损伤,严重威胁着人类的身心健康。铁死亡作为一种新型细胞程序性死亡方式,是由于氧化还原系统失衡引起大量脂质过氧化物堆积而造成的。大量研究表明,中药及其单体成分、中药复方、电针刺激等通过调节铁稳态、抑制脂质过氧化物的生成和增强机体抗氧化能力等机制抑制铁死亡的发生,进而改善CIRI。尽管中医药在干预铁死亡防治CIRI上取得了不错的进展,但仍然存在一些问题:(1)目前的研究多集中在中药单体上,对单味中药或者复方的研究较少;(2)通过抗氧化应激调节铁死亡改善CIRI的信号通路的具体上下游尚不明确;(3)目前的研究仍然停留在动物或细胞模型上,缺乏大量的临床研究来验证;(4)研究缺乏对铁死亡模型的直接干预研究,都是针对疾病中已经出现的铁死亡现象来进行干预等。在将来的研究中,需要利用中医药的多靶点和综合性的治疗特点探讨铁死亡中的一些新机制和新靶点,为临床防治CIRI提供新的理论依据。Stroke is one of the leading causes of death in humans,with a high incidence,mortality,and disability rate,as well as many complications and poor prognosis.Cerebral ischemia reperfusion injury(CIRI),as the brain tissue damage caused by subsequent treatment of ischemic stroke,seriously threatens human health and well-being.Ferroptosis,a novel form of programmed cell death,is caused by an imbalance in the redox system leading to the accumulation of large amounts of lipid peroxides.Numerous studies have shown that Chinese medicinals and their monomer components,Chinese medicinal compound formulas,and electroacupuncture stimulation can inhibit ferroptosis by regulating iron homeostasis,inhibiting the generation of lipid peroxides,and enhancing the antioxidant capacity of the body,thereby improving CIRI.Although TCM has made considerable progress in preventing and treating CIRI by targeting ferroptosis,there are still some problems as follows:(1)Current research mainly focuses on Chinese medicinal monomers,with fewer studies on single medicinals or compound formulas;(2)The specific upstream and downstream signaling pathways of ferroptosis regulation through antioxidant stress to improve CIRI are not yet clear;(3)Current research is still limited to animal or cell models,lacking large-scale clinical studies for verification;(4)There is a lack of direct intervention studies on ferroptosis models in research,and all interventions are targeted at the existing ferroptosis phenomenon in diseases.In future research,it is necessary to utilize the multi-target and comprehensive treatment characteristics of TCM to explore new mechanisms and targets in ferroptosis,providing new theoretical basis for the clinical prevention and treatment of CIRI.

关 键 词：脑缺血再灌注损伤 铁死亡 铁代谢 脂质过氧化 

分 类 号：R277.5[医药卫生—中医学]