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Avances en la investigación del tratamiento del accidente cerebrovascular isquémico con medicina tradicional china — mecanismos y estrategias

  • role： First author第一作者
  • Affiliation：

    Institute of Medicinal Plant Development， Chinese Academy of Medical Sciences，Beijing 100193，China

    Guizhou University of Traditional Chinese Medicine，Guiyang 550025，China

  • Email：15885534084@163.com
  • Introduction：翁茂迪，在读硕士，从事中药药理学研究，E-mail：15885534084@163.com
WENG Maodi12,  
  • Affiliation：

    Institute of Medicinal Plant Development， Chinese Academy of Medical Sciences，Beijing 100193，China

CHEN Qiuyan1,  
  • Affiliation：

    Institute of Medicinal Plant Development， Chinese Academy of Medical Sciences，Beijing 100193，China

WANG Kai1,  
  • role： Corresponding author通信作者
  • Affiliation：

    Institute of Medicinal Plant Development， Chinese Academy of Medical Sciences，Beijing 100193，China

  • Email：ly20040423@126.com
  • Introduction：罗云，博士，研究员，硕士生导师，从事中药药理学研究，E-mail：ly20040423@126.com； *
LUO Yun1*,  
  • role： Corresponding author通信作者
  • Affiliation：

    Institute of Medicinal Plant Development， Chinese Academy of Medical Sciences，Beijing 100193，China

    Guizhou University of Traditional Chinese Medicine，Guiyang 550025，China

  • Email：sun_xiaobo163@163.com
  • Introduction：孙晓波，博士，研究员，博士生导师，从事中药药理学研究，E-mail：sun_xiaobo163@163.com
SUN Xiaobo12*

resumen

El accidente cerebrovascular isquémico (IS) es un problema de salud global importante con mecanismos patológicos complejos. Aunque las terapias modernas como la trombólisis intravenosa y la trombectomía endovascular han avanzado, siguen estando limitadas por ventanas de tiempo estrictas, riesgo de hemorragia y recursos médicos desiguales. La medicina tradicional china (MTC), con sus múltiples componentes, múltiples objetivos y regulación integral, muestra un valor único en la prevención y el tratamiento del IS. Este artículo revisa los mecanismos moleculares mediante los cuales los componentes activos y las fórmulas de la MTC tratan el IS regulando la inflamación, el estrés oxidativo, la excitotoxicidad, la apoptosis y la autofagia. Los estudios indican que la curcumina, la baicalina, la astragalósido y otros componentes pueden inhibir la activación de la microglía y el inflamasoma NLRP3, reduciendo la neuroinflamación; activar la vía de señalización Nrf2/HO-1 para aliviar el estrés oxidativo; regular la función de los receptores de glutamato para antagonizar la excitotoxicidad; e inhibir la apoptosis a través de las vías Bcl-2/Bax, caspasas y PI3K/Akt. Investigaciones recientes han demostrado que la MTC también puede mantener la homeostasis del hierro regulando proteínas clave de la ferroptosis como GPX4 y ACSL4; mejorar la disbiosis al intervenir en el eje microbiota-intestino-cerebro; lograr la administración dirigida al cerebro a través de exosomas; e influir en la reparación neuronal mediante la regulación epigenética. Además, el artículo discute el mecanismo por el cual la fórmula BuYang HuanWu Tang mejora la microcirculación cerebral y promueve el remodelado neurovascular mediante la sinergia de múltiples componentes, analizando estrategias y ventajas de la medicina integrativa chino-occidental en el tratamiento del IS, proporcionando una nueva base teórica y direcciones de investigación para la transición clínica de la MTC en la prevención y tratamiento del IS.

palabra clave

accidente cerebrovascular isquémico;medicina tradicional china;ferroptosis;microbiota intestinal;epigenética

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