首页|基于"栓炎反应"探讨缺血性中风瘀热证的生物学实质及中医药防治研究现状

基于"栓炎反应"探讨缺血性中风瘀热证的生物学实质及中医药防治研究现状

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瘀热证是缺血性中风常见的证型之一,患者病变过程中易出现"瘀""热"交互之证,是疾病进展的重要表象,目前缺乏对其生物学实质的系统研究.血栓炎症(thromboinflammation)病理反应是新近提出的关于血栓形成与炎症反应相互关联的病理概念,是指在血管性血友病因子(von Willebrand factor,vWF)与激肽释放酶-激肽系统的介导下,血栓形成和炎症反应相互影响,T细胞及中性粒细胞活化进而加剧血栓形成,恶化缺血性中风病理进展,颇具中医瘀热证之瘀热相搏的特点.该文基于血栓炎症病理反应(简称栓炎反应)的相关研究进展,结合缺血性中风瘀热证临床证候特征及生物标志物,提出栓炎反应可能是缺血性中风瘀热证的生物学基础的观点;同时,系统梳理了活血化瘀及清热解毒功效的中药单体或复方应用现状及机制研究,发现其药理机制与栓炎反应相关生物标志物的调控密切相关,进一步反证了缺血性中风瘀热证的生物学基础是栓炎反应.该文旨在为以栓炎反应为靶标的缺血性中风中医药防治策略提供科学依据.
Biological essence of blood stasis-heat syndrome in ischemic stroke and current research status of traditional Chinese medicine prevention and treatment based on thromboinflammation reaction
Blood stasis-heat syndrome is one of the common syndromes of ischemic stroke,which is manifested as syndromes of blood stasis and heat during the pathological progression of patients with ischemic stroke,but there is a lack of systematic research on its biological essence.Thromboinflammation reaction is a newly proposed pathological mechanism highly associated with thrombosis and inflammatory reaction,and it refers to the fact that under the mediation of von Willebrand factor (vWF) and the kallikrein-kinin system,thrombosis and inflammatory reaction interact with each other.Activation of T cells and neutrophils further aggravates thrombosis and worsens the pathological progression of ischemic stroke.Therefore,thromboinflammation reaction has the characteristics of the interaction between blood stasis and heat in blood stasis-heat syndrome in traditional Chinese medicine (TCM).Based on the research progress related to thromboinflammation reaction and the clinical syndrome characteristics and biomarkers of blood stasis-heat syndrome in ischemic stroke,this paper put forward the view that thromboinflammation reaction may be the biological foundation of blood stasis-heat syndrome in ischemic stroke.Besides,this paper systematically organized the current applications and research on the mechanism of TCM monomers or compound formulas with the effects of promoting blood circulation to remove blood stasis and clearing heat and detoxifying.It is found that the pharmacological mechanisms are intimately linked to the regulation of biomarkers related to thromboinflammation reaction,verifying that the biological foundation of the blood stasis-heat syndrome in ischemic stroke is thromboinflammation reaction.This paper aims to provide a scientific basis for TCM prevention and treatment strategies for ischemic stroke targeting thromboinflammation reaction.

ischemic strokeblood stasis-heat syndromethromboinflammationbiological essencedrug targets

周静、梅志刚

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湖南中医药大学中西医结合学院中西医结合基础理论研究室,湖南长沙 410208

缺血性中风 瘀热证 血栓炎症 生物学实质 药物靶点

2024

中国中药杂志
中国药学会

中国中药杂志

CSTPCD北大核心
影响因子:1.718
ISSN:1001-5302
年,卷(期):2024.49(23)