[1]张行行 赵麓 王斌.脑缺血再灌注损伤机制及中药防治研究文献分析[J].现代中医药,2022,1(02):006-16.[doi:10.13424/j.cnki.mtcm.2022.02.002]
　ZHANG Xingxing ZHAO Lu WANG Bin.Literature Analysis on Mechanism of Cerebral Ischemia-reperfusion Injury and Prevention and Treatment of Traditional Chinese Medicine[J].Modern Traditional Chinese Medicine,2022,1(02):006-16.[doi:10.13424/j.cnki.mtcm.2022.02.002]
点击复制

脑缺血再灌注损伤机制及中药防治研究文献分析
分享到：

《现代中医药》[ISSN:1006-6977/CN:61-1281/TN]

卷:
1
期数:
2022年02期
页码:
006-16
栏目:
述评
出版日期:
2022-04-16

文章信息/Info

Title:
Literature Analysis on Mechanism of Cerebral Ischemia-reperfusion Injury and Prevention and Treatment of Traditional Chinese Medicine
文章编号:
1672-0571(2022)02-0006-11
作者:
张行行1; 2 赵麓1 王斌1; 2
1.陕西中医药大学，陕西 咸阳 712046；
2.陕西省中医药管理局中药药效机制与物质基础重点研究室，陕西 咸阳 712046
Author(s):
ZHANG Xingxing1; 2 ZHAO Lu1 WANG Bin1; 2
1.Shaanxi University of Traditional Chinese Medicine,Shaanxi Xianyang 712046,China；
2.Key Research Office of Traditional Chinese Medicine Efficacy Mechanism and Material Basis，Shaanxi Administration of Traditional Chinese Medicine，Shaanxi Xianyang 712046,China
关键词:
关键词：缺血性脑血管疾病; 脑缺血再灌注损伤; 病理病机; 研究进展; 中药
Keywords:
Key words：Ischemic cerebrovascular disease; Cerebral ischemia reperfusion injury; Pathological pathogenesis; Research progress; Traditional Chinese medicine
分类号:
R259
DOI:
10.13424/j.cnki.mtcm.2022.02.002
文献标志码:
A
摘要:
摘 要：缺血性脑血管疾病是指大脑某一部位血流供应不足而引起的脑功能障碍，可伴有脑血栓等并发症，具有高发病率、高致死率、高致残率的特点而成为近年医药学者们研究的热点，临床上常采取在缺血早期使用溶栓药物，使血流恢复，降低致残率，但缺血脑组织恢复供血供氧后，可能引发更为严重的脑组织损伤，即脑缺血再灌注损伤，而其损伤机制复杂多样，主要包括炎性反应、神经细胞凋亡、兴奋性氨基酸中毒、自由基及脂质过氧化、NO的毒性反应、细胞内Ga+超载和线粒体功能障碍等，而近年来中医药在治疗脑缺血再灌注损伤上表现出良好的效果，但其物质基础和作用机制还得进一步研究。通过整合近几年有关脑缺血再灌注损伤病理病机及中药在治疗该疾病中的研究，以期为临床研发新药提供参考。
Abstract:
Abstract：Ischemic cerebrovascular disease is a kind of cerebral dysfunction caused by insufficient blood supply in a certain part of the brain，which can be accompanied by cerebral thrombosis and other characteristics.It has the characteristics of high incidence rate，high mortality rate and high disability rate.It has become a hot topic of medical researchers in recent years.However，after the blood and oxygen supply of ischemic brain tissue is restored，it may lead to more serious brain tissue injury，namely cerebral ischemia-reperfusion injury，and its injury mechanism is complex and diverse，mainly including inflammatory reaction，neuronal apoptosis，excitatory amino acid poisoning，free radical and lipid peroxidation，toxic reaction of no，intracellular Ga+ overload and mitochondrial dysfunction，In recent years，traditional Chinese medicine has shown good effects in the treatment of cerebral ischemia-reperfusion injury，but its material basis and mechanism need to be further studied.This paper systematically integrates the research on the pathogenesis of cerebral ischemia-reperfusion injury and the application of traditional Chinese medicine in the treatment of the disease in recent years，in order to provide reference for the clinical research and development of new drugs.

参考文献/References:

[1]刘磊,刘丽华,马玉奎.脑缺血再灌注损伤机制研究进展[J].药学研究,2016,35(9):542-544.
[2]王萍,张密霞,庄朋伟,等.脑缺血再灌注损伤的炎症反应机制研究进展[J].天津中医药大学学报,2014,33(5):317-320.
[3]陈玉敏,陈涛平,冯浩楼.脑缺血再灌注损伤机制与治疗现状[J].医学研究与教育,2012,29(6):47-54.
[4]Emsley HC,Hopkins SJ.Acute ischaemic stroke and infection:recent and emerging concepts[J].The Lancet Neurology,2008,7(4):341-353.
[5]McColl BW,Allan SM,Rothwell NJ.Systemic infection,inflammation and acute ischemic stroke[J].Neuroscience,2009,158(3):1049-1061.
[6]Buffo A,Rolando C,Ceruti S.Astrocytes in the damaged brain:Molecular and cellular insights into their reactive response and healing potential[J].Biochemical Pharmacology,2010,79(2):77-89.
[7]刘付宁,纪风涛,何惠燕,等.右美托咪定对大鼠脑缺血再灌注损伤后星形胶质细胞的影响[J].中国病理生理杂志,2012,28(10):1751-1755.
[8]Wasserman JK,Yang H,Schlichter LC.Glial responses,neuron death and lesion resolution after intracerebral hemorrhage in young vs.aged rats[J].European Journal of Neuroscience,2008,28(7):1316-1328.
[9]吕敬雷,王鹏,隋雪琴,等.缺血后处理对脑缺血再灌注大鼠TNF-α和IL-1β表达影响[J].齐鲁医学杂志,2012,27(4):319-322,325.
[10]Hoppe C,Klitz W,D-Harlingue K,et al.Confirmation of an association between the TNF(-308) promoter polymorphism and stroke risk in children with sickle cell Anemia[J].Stroke,2007,38(8):2241-2246.
[11]Benakis C,Vaslin A,Pasquali C,et al.Neuroprotection by inhibiting the c-Jun N-terminal kinase pathway after cerebral ischemia occurs independently of interleukin-6 and keratinocyte-derived chemokine (KC/CXCL1) secretion[J].Journal of Neuroinflammation,2012,9:613.
[12]Suzuki S,Tanaka K,Suzuki N.Ambivalent aspects of interleukin-6 in cerebral ischemia:inflammatory versus neurotrophic aspects[J].Journal of Cerebral Blood Flow and Metabolism,2009,29(3):464-479.
[13]Sun YM,Tian Y,Li X,et al.Effect of atorvastatin on expression of IL-10 and TNF-α mRNA in myocardial ischemia-reperfusion injury in rats[J].Biochemical and Biophysical Research Communications,2009,382(2):336-340.
[14]Ooboshi H,Ibayashi S,Shichita T,et al.Postischemic gene transfer of interleukin-10 protects against both focal and global brain ischemia[J].Circulation,2005,111(7):913-919.
[15]Ma YW,He M,Qiang L.Exercise therapy downregulates the overexpression of TLR4,TLR2,MyD88 and NF-κB after cerebral ischemia in rats[J].International Journal of Molecular Sciences,2013,14(2):3718-3733.
[16]Maddahi A,Edvinsson L.Cerebral ischemia induces microvascular pro-inflammatory cytokine expression via the MEK/ERK pathway[J].Journal of Neuroinflammation,2010,7:14.
[17]Justicia C,Gabriel C,Planas AM.Activation of the JAK/STAT pathway following transient focal cerebral ischemia:Signaling through Jak1 and Stat3 in astrocytes[J].Glia,2000,30(3):253-270.
[18]程道宾.脑缺血预处理对脑缺血再灌注损伤的保护作用及其机制[D].武汉:华中科技大学,2007:99.
[19]孙文阁,费志宏,周静.脑缺血再灌注损伤与基因表达调控研究进展[J].赤峰学院学报(自然科学版),2010,26(7):47-50．
[20］姜恩平.蒺藜皂苷对脑缺血再灌注损伤的保护作用及机制的研究[D].长春:吉林大学，2010:7-9．
[21]Rehni AK，Singh N.Role of phosphoinositide 3-kinase in ischemic postconditioning-induced attenuation of cerebral ischemia-evoked behavioral deficits in mice[J].Pharmacol Rep,2007 Mar-Apr,59(2):192-198.
[22]Tounai H,Hayakawa N,Kato H,et al.Immunohistochemical study on distribution of NF-κB and p53 in gerbil Hippocampus after transient cerebral ischemia:effect of pitavastatin[J].Metabolic Brain Disease,2007,22(1):89-104.
[23]Ahmad A,Khan MM,Raza SS,et al.Ocimum sanctum attenuates oxidative damage and neurological deficits following focal cerebral ischemia/reperfusion injury in rats[J].Neurological Sciences,2012,33(6):1239-1247.
[24]Valko M,Leibfritz D,Moncol J,et al.Free radicals and antioxidants in normal physiological functions and human disease[J].The International Journal of Biochemistry & Cell Biology,2007,39(1):44-84.
[25]梁辰,初海平,王福文.脑缺血再灌注损伤药物治疗的研究进展[J].中国药房,2016,27(4):538-541.
[26]Li J,Yu W,Li XT,et al.The effects of propofol on mitochondrial dysfunction following focal cerebral ischemia-reperfusion in rats[J].Neuropharmacology,2014,77:358-368.
[27]Vaibhav K,Shrivastava P,Khan A,et al.Azadirachta indica mitigates behavioral impairments,oxidative damage,histological alterations and apoptosis in focal cerebral ischemia-reperfusion model of rats[J].Neurological Sciences,2013,34(8):1321-1330.
[28]De Rougemont O,Dutkowski P,Clavien PA.Biological modulation of liver ischemia-reperfusion injury[J].Current Opinion in Organ Transplantation,2010,15(2):183-189.
[29]Tekin D,Dursun AD,Xi L.Hypoxia inducible factor 1 (HIF-1) and cardioprotection[J].Acta Pharmacologica Sinica,2010,31(9):1085-1094.
[30]王梅,王友群.缺血引发的脑损伤发病学机理[J].中国实用医药,2008,3(25):183-186.
[31]Diaz de Barboza G,Guizzardi S,Moine L,et al.Oxidative stress,antioxidants and intestinal calcium absorption[J].World Journal of Gastroenterology,2017,23(16):2841.
[32]冯喜莲,沈梅红.针刺防治脑缺血再灌注损伤的分子机制研究进展[J].中国老年学杂志,2015,35(17):5003-5005.
[33]赵秋振,薄爱华,贾勇圣.钙离子抑制剂对脑缺血再灌注损伤神经元凋亡相关基因表达的影响[J].陕西医学杂志,2009,38(4):409-411.
[34]Zhang C,Shen W,Zhang G.N-methy1-D-aspartate receptor and L-type voltage-gated Ca2+channelmantagonists suppress the release of cytochrome c and the expression of procaspase-3 in rat hippocampus after global brain ischemia[J].Neurosci Lett，2002，328(3)：265-268．
[35]刘启锋,刘明,刘玉河,等.脑缺血再灌注损伤机制研究进展[J].中华神经外科疾病研究杂志,2006,5(6):566-568.
[36]李威,于海龙,王亮珠，等.脑缺血再灌注损伤后线粒体功能障碍及中药制剂保护作用的研究进展[J].东南大学学报(医学版),2019,38(5):928-933.
[37]Eltzschig HK,Eckle T.Ischemia and reperfusion—from mechanism to translation[J].Nature Medicine,2011,17(11):1391-1401.
[38]屈生彪.鹰嘴豆素A对大鼠脑缺血再灌注损伤的保护机制初步研究[D].桂林:桂林医学院,2018.
[39]Zhang KZ,Kaufman RJ.The unfolded protein response:a stress signaling pathway critical for health and disease[J].Neurology,2006,66(2 Suppl 1):S102-S109.
[40]Wang Y,Ren QY,Zhang X,et al.Neuroprotective mechanisms of calycosin against focal cerebral ischemia and reperfusion injury in rats[J].Cellular Physiology and Biochemistry,2018,45(2):537-546.
[41]Huang LF,Chen CW,Zhang X,et al.Neuroprotective effect of curcumin against cerebral ischemia-reperfusion via mediating autophagy and inflammation[J].Journal of Molecular Neuroscience,2018,64(1):129-139.
[42]Khatri R,McKinney AM,Swenson B,et al.Blood-brain barrier,reperfusion injury,and hemorrhagic transformation in acute ischemic stroke[J].Neurology,2012,79(13 Suppl 1):S52-S57.
[43]Schwartz C,Hampton M,Andrews MT.Seasonal and regional differences in gene expression in the brain of a hibernating mammal[J].PLoS One,2013,8(3):e58427.

备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81473385）；陕西省自然科学基金项目(2018JM7111)；陕西中医药大学学科创新项目（2019-YL13）
更新日期/Last Update: 2022-04-08