[1]陈 晓,马 彬,戴 璇,等.星蒌承气汤治疗急性脑梗死机制研究进展[J].陕西中医,2025,46(1):130-133.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.029]
 CHEN Xiao,MA Bin,DAI Xuan,et al.Research progress of the mechanism of the treatment of acute cerebral infarction by Xinglou Chengqi decoction[J].,2025,46(1):130-133.[doi:DOI:10.3969/j.issn.1000-7369.2025.01.029]
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星蒌承气汤治疗急性脑梗死机制研究进展
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年1期
页码:
130-133
栏目:
综 述
出版日期:
2025-01-05

文章信息/Info

Title:
Research progress of the mechanism of the treatment of acute cerebral infarction by Xinglou Chengqi decoction
作者:
陈 晓12马 彬1戴 璇1程记伟1张利军12
(1.上海中医药大学附属普陀医院神经内科,上海 200333; 2.上海市长宁区天山中医医院,上海 200500)
Author(s):
CHEN XiaoMA BinDAI XuanCHENG JiweiZHANG Lijun
(Department of Neurology,Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200333,China)
关键词:
急性脑梗死 星蒌承气汤 痰热腑实证 药理作用 炎症反应 作用机制
Keywords:
Acute cerebral infarction Xinglou Chengqi decoction Heat-phlegm and sthenic-fu syndrome Pharmacological effects Inflammatory reaction Mechanism
分类号:
R 743.34
DOI:
DOI:10.3969/j.issn.1000-7369.2025.01.029
文献标志码:
A
摘要:
急性脑梗死具有高发病率、高致残、致死率的特点,是神经内科常见的脑血管疾病。痰热腑实证是急性脑梗死中常见的中医发病证候,该证型对急性脑梗死的发展和预后具有重要影响,星蒌承气汤是治疗痰热腑实证的代表方剂之一。研究发现星蒌承气汤可以通过改善血液黏度、减轻炎症反应、调节肠道菌群、改善血脑屏障、减轻细胞凋亡、抗氧化应激等多种机制发挥治疗作用。现对痰热腑实型中风及星蒌承气汤在治疗急性脑梗死中的作用机制进行综述,为该方的临床应用和进一步研究提供参考。
Abstract:
Acute cerebral infarction is a prevalent cerebrovascular disorder in the field of neurology,characterized by high incidence rates,disability rates,and mortality rates.The heat-phlegm and sthenic-fu syndrome represents a common manifestation of acute cerebral infarction,exerting significant influence on its progression and prognosis.The study found that Xinglou Chengqi decoction can exert therapeutic effects through various mechanisms,such as improving blood viscosity,alleviating inflammatory responses,regulating intestinal flora,improving the blood-brain barrier,alleviating cell apoptosis,and antioxidant stress.This review aims to summarize the therapeutic effects of Xinglou Chengqi decoction in patients with stroke due to heat-phlegm and sthenic-fu syndrome and the mechanisms of action of Xinglou Chengqi decoction in the treatment of acute cerebral infarction,providing references for the clinical application and further study of this prescription.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(82074162); 上海市普陀区卫生健康系统临床特色专病建设项目(2023tszb04)
更新日期/Last Update: 2025-01-09