中药及其有效成分在抗癫痫中的作用与机制
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摘要
目前临床对癫痫的治疗多采用西药,但约30%～40%的癫痫患者对常用抗痫西药产生抗性,且饱受其毒副作用的影响。而中药在治疗痫性发作、减轻抗痫西药引起的并发症方面,疗效确切,但其有效成分和作用机制仍不清楚。该文总结了近年来中药单体、单味中药提取物及中药复方在防治癫痫及作用机制上的研究进展,归纳如下:(1)中药单体包括天麻素、细辛醚、钩藤碱、川芎嗪、丹参酮ⅡA、姜黄素等十余种,均具有良好的抗癫痫作用,其或通过调控炎症因子的表达、调节兴奋性神经递质及受体、调节钠/钾离子通道,或通过调控凋亡因子的表达等发挥保护神经元的效应;(2)单味中药提取物包括天麻、石菖蒲、人参、灵芝、黄芩及银杏等提取物,其抗癫痫作用主要与抑制γ-氨基丁酸A型受体、上调磷脂酰肌醇-3-激酶(PI3K)信号通路、降低谷氨酸诱导的兴奋毒及氧化应激反应、调节离子通道及减轻神经元的氧化损伤等相关;(3)中药复方包括癫痫清颗粒、胆星宁痫颗粒、活血定痫方等,可通过对兴奋性递质、凋亡因子和细胞因子的多重调控作用,提高对癫痫的治疗效应。
At present,Western medicine is widely used in the treatment of epilepsy.However,about 30%-40% of epileptic patients are resistant to them and are affected by the side effects of these drugs.Traditional Chinese medicine is effective in treating epileptic seizures and relieving complications caused by Western medicine.However,the active ingredients and mechanisms of traditional Chinese medicine remain unclear.This article reviews and summarizes the advances and mechanisms in treating epilepsy,such as Chinese medicine monomer,the extracts of single Chinese medicine and Chinese medicine compound.Chinese medicine monomers,including gastrodin,asarone,rhynchophylline,ligustrazine,tanshinone ⅡA,curcumin,etc.,have antiepileptic effects via regulating excitatory neurotransmitters and receptors,the expression of inflammatory factors,sodium/potassium ion channels and the expression of apoptotic protein,therefore protecting neurons.The extracts of single Chinese herbal including the extracts of Gastrodiae Rhizoma,Acori Tatarinowii Rhizoma,Ginseng Radix et Rhizoma,Ganoderma,Scutellariae Radix and Ginkgo Folium,etc.,have antiepileptic effects related to the inhibition of γ-aminobutyric acid receptor,upregulation of phosphatidylinositol 3-kinase signaling pathway and reduction of glutamate-induced excitotoxicity and oxidative stress response.Furthermore,these extracts can regulate ion channels and reduce oxidative damage of neurons.Chinese medicine compounds including Dianxian Qing Granules,Danxing Ningxian Granules,Huoxue Dingxian formulae,etc.,can improve the therapeutic effect on epilepsy through simultaneously regulating excitatory transmitters,apoptosis factors and cytokines.
At present,Western medicine is widely used in the treatment of epilepsy.However,about 30%-40% of epileptic patients are resistant to them and are affected by the side effects of these drugs.Traditional Chinese medicine is effective in treating epileptic seizures and relieving complications caused by Western medicine.However,the active ingredients and mechanisms of traditional Chinese medicine remain unclear.This article reviews and summarizes the advances and mechanisms in treating epilepsy,such as Chinese medicine monomer,the extracts of single Chinese medicine and Chinese medicine compound.Chinese medicine monomers,including gastrodin,asarone,rhynchophylline,ligustrazine,tanshinone ⅡA,curcumin,etc.,have antiepileptic effects via regulating excitatory neurotransmitters and receptors,the expression of inflammatory factors,sodium/potassium ion channels and the expression of apoptotic protein,therefore protecting neurons.The extracts of single Chinese herbal including the extracts of Gastrodiae Rhizoma,Acori Tatarinowii Rhizoma,Ginseng Radix et Rhizoma,Ganoderma,Scutellariae Radix and Ginkgo Folium,etc.,have antiepileptic effects related to the inhibition of γ-aminobutyric acid receptor,upregulation of phosphatidylinositol 3-kinase signaling pathway and reduction of glutamate-induced excitotoxicity and oxidative stress response.Furthermore,these extracts can regulate ion channels and reduce oxidative damage of neurons.Chinese medicine compounds including Dianxian Qing Granules,Danxing Ningxian Granules,Huoxue Dingxian formulae,etc.,can improve the therapeutic effect on epilepsy through simultaneously regulating excitatory transmitters,apoptosis factors and cytokines.
引文
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