补阳还五汤治疗缺血性中风的临床研究进展

Clinical Research on the Treatment of Ischemic Stroke with Buyang Huanwu Decoction

摘要: 中风是导致全球范围内高致残率与高死亡率的急性脑血管疾病，其中气虚血瘀证是脑卒中后期最常见的证型。具有益气、活血、通络之功效的补阳还五汤在治疗中风后遗症方面具有显著疗效。将有深厚根基的中医理论与现代药理学研究成果相结合，深入探讨补阳还五汤中的单味药、有效成分及其相关药对，综述其通过促进神经修复、改善微循环、抑制氧化应激及调节细胞凋亡等机制，发挥明显的神经保护与功能重建。补阳还五汤方中的单味药物以及核心药对，都能在一定程度上改善中风后出现的神经缺损症状，如偏瘫、口眼歪斜、语言不利等。其作用机制主要聚焦于神经–血管单元，凭借对神经营养因子的调节、血管新生的促进、炎症反应的抑制以及胶质瘢痕的干预，进而发挥出益气活血、化瘀通络的治疗功效。

Abstract: Stroke is an acute cerebrovascular disease that leads to high disability and mortality rates worldwide. Qi deficiency and blood stasis syndrome is the most common syndrome type in the later stage of stroke. Buyang Huanwu Decoction, which has the functions of tonifying qi, promoting blood circulation and unblocking meridians, has a significant therapeutic effect on post-stroke sequelae. By integrating the profound traditional Chinese medicine theory with modern pharmacological research achievements, this paper deeply explores the single herbs, active ingredients and related drug pairs in Buyang Huanwu Decoction, and reviews its significant neuroprotective and functional reconstruction effects through mechanisms such as promoting neural repair, improving microcirculation, inhibiting oxidative stress and regulating cell apoptosis. The single herbs in Buyang Huanwu Decoction and their active ingredients, as well as core drug pairs, can all improve to some extent the neurological deficits after stroke, such as hemiplegia, facial distortion, and speech impairment. The mechanism of action mainly focuses on the neuro-vascular unit, by regulating neurotrophic factors, promoting angiogenesis, inhibiting inflammatory responses and intervening in glial scar formation, thereby exerting the therapeutic effects of tonifying qi, promoting blood circulation, removing blood stasis and unblocking meridians.