Mechanism of Therapeutic Methods for Activating Blood and Removing Blood Stasis in Treatment of Cerebral Hemorrhage

Li-qin WANG; Na AN; Chao TIAN; Meng-chen YUAN; Han-lai ZHANG; Yi-kun SUN; Yong-hong GAO

doi:10.13422/j.cnki.syfjx.20192223

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Mechanism of Therapeutic Methods for Activating Blood and Removing Blood Stasis in Treatment of Cerebral Hemorrhage

Review | 更新时间：2021-02-09

- Mechanism of Therapeutic Methods for Activating Blood and Removing Blood Stasis in Treatment of Cerebral Hemorrhage
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 5, Pages: 220-226(2020)
- 作者机构：
  
  北京中医药大学　东直门医院，中医内科学教育部和北京市重点实验室，北京　 100700
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20192223
  CLC： R22; R242; R2-031; R285.5; R287
- Received：08 April 2019，
  
  Published Online：01 August 2019，
  
  Published：05 March 2020
- 稿件说明：
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Li-qin WANG, Na AN, Chao TIAN, et al. Mechanism of Therapeutic Methods for Activating Blood and Removing Blood Stasis in Treatment of Cerebral Hemorrhage[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 220-226.
DOI：

Li-qin WANG, Na AN, Chao TIAN, et al. Mechanism of Therapeutic Methods for Activating Blood and Removing Blood Stasis in Treatment of Cerebral Hemorrhage[J]. Chinese journal of experimental traditional medical formulae, 2020, 26(5): 220-226. DOI： 10.13422/j.cnki.syfjx.20192223.

摘要

脑出血(ICH)是指原发性非外伤性脑实质内出血，是常见的脑血管疾病之一，其发病率高，发展迅速，恢复慢且致残率高。脑出血后脑组织发生一系列病理变化，如脑内局部血肿及其占位效应、继发脑水肿、脑细胞死亡及血脑屏障破坏等，从而引发脑损伤，导致神经功能缺损，严重影响患者生存质量，甚至危及生命。因此，寻找有效的治疗方法及药物，探索其改善神经功能的靶点及机制，减轻后遗症，提高患者的生存质量具有重要的意义。中医理论认为脑出血属于“离经之血”，离经之血即为瘀血，因此，活血化瘀法在治疗脑出血中广泛应用，成为出血性中风的常规疗法。近年来学者运用现代科学方法对活血化瘀药物进行了广泛的研究，对于其作用机制进行深入探讨，发现活血化瘀法对脑出血后的一系列生理病理变化过程起着关键的干预作用，在血肿清除和改善微循环、降低死亡率和致残率方面有显著疗效。文章总结近五年活血化瘀药(三七、丹参、水蛭)，方剂(补阳还五汤、抵挡汤、脑血疏口服液、通窍活血汤等)及复方注射液(丹红注射液)治疗脑出血的作用靶点，从促进血肿吸收、减轻脑水肿、减少细胞凋亡、促进血管新生、抑制炎症反应、促进神经组织的修复和再生等方面论述了活血化瘀中药治疗脑出血的实验研究进展，对其治疗作用机制进行总结，为临床运用活血化瘀法治疗脑出血及其现代科学研究提供科学依据。

Abstract

Intracerebral hemorrhage (ICH) refers to the primary non-traumatic parenchymal hemorrhage

which is one of the common cerebrovascular diseases

with a high incidence

rapid development

slow recovery and high disabling rate. After intracerebral hemorrhage

a series of pathological changes occur in the brain tissue

such as local hematoma and its space occupying effect

secondary cerebral edema

death of brain cells and destruction of blood-brain barrier

which may lead to brain injury and neurological defects

seriously affect the quality of life of patients

and even endanger the life. Therefore

it is great medical value to find effective therapeutic methods and drugs

explore the mechanisms and targets for improving neurological function

reduce sequelae and improve the quality of life of patients. According to the theory of traditional Chinese medicine (TCM)

cerebral hemorrhage belongs to " abnormal flow of the blood"

which equals to blood stasis. In recent years

scholars conducted extensive research on drugs for promoting blood circulation to remove blood stasis with modern scientific methods

and made in-depth discussion for the mechanism

and found that therapies for activating blood and removing blood stasis

plays a key role in intervening a series of physiological and pathological changes after cerebral hemorrhage

with significant curative effects in removing hematoma

improving the microcirculation and reducing the mortality and morbidity. This article summarized drugs for promoting blood circulation to remove blood stasis (Notoginseng Radix et Rhizoma

Salviae Miltiorrhizae Radix et Rhizoma

Hirudo)

formulas (Buyang Huanwu Tang

Didangtang

Naoxueshu oral liquid

Tongqiao Huoxuetang) and compound injections (Danhong injection) for the treatment of cerebral hemorrhage targets

and discussed the experimental research progress TCM for promoting blood circulation to remove blood stasis in treatment of cerebral hemorrhage in terms of promoting hematoma absorption

reducing brain edema and apoptosis

promoting angiogenesis

inhibiting the inflammatory response

and promoting the repair and regeneration of nerve tissue in nearly five years

and summarized the therapeutic mechanism

so as to provide scientific basis for clinical application of the therapeutic methods for activating blood and removing stasis to treat cerebral hemorrhage and the modern scientific research.

关键词

Keywords

references

M I BAHAROGLU , C CORDONNIER , S R AL-SHAHI , et al . Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label，phase 3 trial [J]． Lancet ， 2016 ， 387 ( 10038 ): 2605 - 2613 .

V L FEIGIN , R V KRISHNAMURTHI , P PARMAR ， et al . Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013：The GBD 2013 study [J]. Neuroepidemiology , 2015 ， 45 ( 3 ): 161 - 176 .

D A WILKINSON , A S PANDEY , B G THOMPSON ， et al . Injury mechanisms in acute intracerebral hemorrhage [J]. Neuropharmacology , 2018 ， 134 ( Pt B ): 240 - 248 .

H ZHENG , C CHEN , J ZHANG , et al . Mechanism and therapy of brain edema after intracerebral hemorrhage [J]． Cerebrovasc Dis ， 2016 ， 42 ( 3/4 ): 155 - 169 .

王永炎．再度思考提高治疗脑血管病疗效的难点 [J]．中国中西医结合杂志， 2017 ， 37 ( 10 ): 1164 - 1166 .

杨光福．中西医结合分期分时段分型辨证治疗脑出血 [J]．北京中医药大学学报：中医临床版， 2008 ， 15 ( 2 ): 7 - 9 .

张阳．中医治疗高血压性脑出血研究进展 [J]．世界最新医学信息文摘， 2017 ， 17 ( 3 ): 20 .

张营，刘涛，于荣，等．活血化瘀治疗脑出血探讨 [J]．中西医结合心脑血管病杂志， 2018 ， 16 ( 16 ): 2427 - 2428 .

J SONG , Y LYU , P WANG , et al . Treatment of naoxueshu promotes improvement of hematoma absorption and neurological function in acute intracerebral hemorrhage patients [J]． Front Physiol , 2018 ， 9 ( 9 ): 933 .

院立新，陈澈，张根明，等．活血化瘀法治疗脑出血114例临床观察 [J]．河北中医， 2015 ， 37 ( 3 ): 357 - 359 .

H Q LI , J J WEI , L H XIA , et al . Promoting blood circulation for removing blood stasis therapy for acute intracerebral hemorrhage：a systematic review and Meta-analysis [J]． Acta Pharmacol Sin ， 2015 ， 36 ( 6 ): 659 - 675 .

L WU , Y LI , X WANG ， et al . A systematic review and Meta-analysis on the treatment of cerebral hemorrhage with Naoxueshu oral liquid [J]． Biomed Res Int ， 2017 ， 2017 : 1 - 11 .

王天磊，刘建浩，郑杨杨，等．加味补阳还五汤联合头针对气虚血瘀证脑卒中后单侧空间忽略的疗效观察 [J]．中国实验方剂学杂志， 2018 ， 24 ( 13 ): 196 - 201 .

李俊，胡小军，王青，等．通窍活血汤加减联合“回阳九针”治疗卒中后认知障碍的临床观察 [J]．中国实验方剂学杂志， 2019 ， 25 ( 4 ): 75 - 80 .

G WANG , L WANG , X G SUN ， et al . Haematoma scavenging in intracerebral haemorrhage: from mechanisms to the clinic [J]． J Cell Mol Med ， 2018 ， 22 ( 2 ): 768 - 777 .

刘志华，吴鸿．脑血疏口服液对脑出血大鼠血肿体积及神经功能的影响 [J]．中国老年学杂志， 2017 ， 37 ( 1 ): 47 - 49 .

艾鑫，刘翠．脑血疏口服液对脑出血大鼠血肿体积的影响及神经功能的保护作用 [J]．中西医结合心脑血管病杂志， 2014 ， 12 ( 7 ): 859 - 861 .

杨仲义，史载祥．活血化瘀法治疗高血压急性脑出血探讨 [J]．中国中医药信息杂志， 2007 ， 14 ( 5 ): 89 - 90 .

李萍．破血化瘀、填精补髓法对实验性脑出血大鼠NF- κ B信号通路作用机制研究 [D]．长春：长春中医药大学， 2014 .

张亚红，刘重霄，周任，等．大鼠脑出血模型中血脑屏障开放规律及应用脑血疏口服液治疗脑水肿的实验研究 [J]．中西医结合心脑血管病杂志， 2016 ， 14 ( 14 ): 1613 - 1615 .

赵雪松，陈志刚，高芳，等．三七总皂苷对脑出血大鼠脑含水量及血肿周围脑组织PAR-1、MMP-9表达的影响 [J]．北京中医药， 2016 ， 35 ( 9 ): 851-854，857 .

张智慧．通窍活血汤对大鼠脑出血的防治机制研究 [D]．成都：西南医科大学， 2016 .

仇志富，吴晓光，祖炳学，等．补阳还五汤对脑出血模型大鼠脑组织CXCR4-PI3K自噬信号传导通路及Beclin-1的影响 [J]．中国组织工程研究， 2016 ， 20 ( 27 ): 3992 - 3998 .

仇志富，吴晓光．补阳还五汤对脑损伤大鼠脑组织凋亡信号通路的影响 [J]．中国老年学杂志， 2018 ， 38 ( 16 ): 3979 - 3982 .

黄清霞．破血化瘀法对缺血缺氧诱导的体外神经细胞损伤模型神经保护作用的实验研究 [D]．长春：长春中医药大学， 2016 .

卢靖 . 破血化瘀法对氯化铝诱导的体外神经细胞凋亡模型神经保护作用的实验研究 [D]．长春：长春中医药大学， 2016 .

李红，吴黎黎，高青，等．水蛭素对脑出血大鼠蛋白酪氨酸激酶2/信号转导和转录激活因子3信号通路的影响 [J]．中国脑血管病杂志， 2017 ， 14 ( 12 ): 638 - 643 .

Q HUANG , T LAN , J LU , et al . Didang tang inhibits endoplasmic reticulum stress-mediated apoptosis induced by oxygen glucose deprivation and intracerebral hemorrhage through blockade of the GRP78-IRE1/PERK pathways [J]. Front Pharmacol , 2018 ， 9 ( 9 ): 1423 .

梁群，王丛，朱永志．中风1号对急性期脑出血大鼠Bcl-2、Bax蛋白表达的影响 [J]．中国中医急症， 2019 ， 28 ( 1 ): 14 - 16 .

张静．破血化瘀、填精补髓法对实验性脑出血大鼠血肿周围HSP70表达的作用研究 [D]．长春：长春中医药大学， 2015 .

陈博，师蔚，郭晓敏．脑血疏对脑出血大鼠海马神经细胞凋亡因子表达影响研究 [J]．现代中药研究与实践， 2017 ， 31 ( 1 ): 31 - 34 .

胡勇，张亚红，刘重霄，等．脑血疏口服液对大鼠脑出血后神经功能及血肿周围半暗带细胞凋亡的影响 [J]. 中西医结合心脑血管病杂志， 2016 ， 14 ( 15 ): 1735 - 1737 .

M CHOPP , Z G ZHANG , Q JIANG . Neurogenesis, angiogenesis, and MRI indices of functional recovery from stroke [J]. Stroke , 2007 ， 38 ( 2 Suppl ): 827 - 831 .

H J CUI , A L YANG , H J ZHOU , et al . Buyang huanwu decoction promotes angiogenesis via vascular endothelial growth factor receptor-2 activation through the PI3K/Akt pathway in a mouse model of intracerebral hemorrhage [J]. BMC Complement Altern Med , 2015 ， 15 ( 1 ): 91 .

J ZHOU , T LIU , H GUO , et al . Lactate potentiates angiogenesis and neurogenesis in experimental intracerebral hemorrhage [J]. Exp Mol Med , 2018 ， 50 ( 7 ): 78 .

杨阿莉，吴季，崔寒尽，等．补阳还五汤对脑出血大鼠脑内整合素 α 1 β 1 和 α 1 亚基表达的影响 [J]．中风与神经疾病杂志， 2015 ， 32 ( 9 ): 811 - 815 .

赵红领，李磊，苗成，等．丹参酮Ⅱ A 对脑出血大鼠脑组织HIF-1 α 和VEGF表达的影响 [J]．中风与神经疾病杂志， 2017 ， 34 ( 2 ): 130 - 132 .

Z Y ZHOU , B HUANG , S LI , et al . Sodium tanshinone Ⅱ A sulfonate promotes endothelial integrity via regulating VE-cadherin dynamics and RhoA/ROCK-mediated cellular contractility and prevents atorvastatin-induced intracerebral hemorrhage in zebrafish [J]． Toxicol Appl Pharmacol , 2018 ， 350 : 32 - 42 .

程爽，施慧芬．活血化瘀法治疗脑出血急性期研究进展 [J]．河北中医， 2015 ， 37 ( 5 ): 782 - 785 .

宁培云，赵洪勇，赵志超．丹红注射液对实验性脑出血大鼠血清TNF- α 、CRP、IL-6水平的影响 [J]．中国临床研究， 2017 ， 30 ( 7 ): 971 - 973 .

闵静，陈军芳，敖明章．三七总皂苷注射液对脑出血模型大鼠抗氧化及白细胞介素-1、肿瘤细胞坏死因子- α 的影响 [J]．中国老年学杂志， 2015 ， 35 ( 18 ): 5109 - 5110 .

沈琼，朱琰，朱旭莹．三七总皂苷早期使用对脑出血大鼠炎性反应影响的基础研究 [J]．中国中医急症， 2015 ， 24 ( 1 ): 33-34，46 .

X SHI , W YU , L LIU ， et al . Panax notoginseng saponins administration modulates pro- /anti-inflammatory factor expression and improves neurologic outcome following permanent MCAO in rats [J]． Metab Brain Dis ， 2017 ， 32 ( 1 ): 221 - 233 .

李艳青，谢荃．益气活血中药对脑出血大鼠GAP-43和Arc的影响 [J]．中医临床研究， 2016 ， 8 ( 30 ): 77 - 78 .

任吉祥，毕铁琳，周翔宇，等．破血化瘀，填精补髓方剂对脑出血大鼠脑血肿周围组织生长因子的表达 [J]．中国老年学杂志， 2014 ， 34 ( 2 ): 445 - 449 .

张毅，方永军，周锋，等．丹参酮Ⅱ A 对脑出血大鼠灶周Nestin、Neun表达的影响 [J]．陕西中医， 2015 ， 36 ( 11 ): 1555 - 1558 .

张毅，方永军，周锋，等．丹参酮Ⅱ A 磺酸钠注射液对脑出血大鼠灶周内源性神经干细胞的影响研究 [J]．实用心脑肺血管病杂志， 2015 ， 23 ( 10 ): 45 - 49 .

白华静，刘峻崎，李巾伟，等．脑出血对大鼠前脑侧脑室室管膜下区细胞的影响及三七总皂苷的作用 [J]．中华中医药杂志， 2014 ， 29 ( 6 ): 1801 - 1804 .

X KANG , H J ZHOU , J YANG , et al . Buyang Huanwu decoction(补阳还五汤)attenuates glial scar by downregulating expression of leukemia inhibitory factor in intracerebral hemorrhagic rats [J]. Chin J Integ Med , 2019 ， 25 ( 4 ): 264 - 269 .

H CUI , T LIU , P LI , et al . An intersectional study of lncRNAs and mRNAs reveals the potential therapeutic targets of Buyang Huanwu decoction in experimental intracerebral hemorrhage [J]. Cell Physiol Biochem , 2018 ， 46 ( 5 ): 2173 - 2186 .

P LI , T TANG , T LIU ， et al . Systematic analysis of tRNA-derived small RNAs reveals novel potential therapeutic targets of traditional Chinese medicine (Buyang-Huanwu-Decoction) on intracerebral hemorrhage [J]． Int J Biol Sci , 2019 ， 15 ( 4 ): 895 - 908 .

X SHI , W YU , T YANG , et al . Panax notoginseng saponins provide neuroprotection by regulating NgR 1 /RhoA/ROCK 2 pathway expression, in vitro and in vivo [J]． J Ethnopharmacol , 2016 ， 190 : 301 - 312 .

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