Wang Peng-Qian, Wu Yin, Zhang Miao, Huo Hai-Ru, Du Xin-Ling, Sui Feng
Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Graduate School of China Academy of Chinese Medical Sciences, Beijing 100700, China.
Zhongguo Zhong Yao Za Zhi. 2018 Jun;43(12):2448-2453. doi: 10.19540/j.cnki.cjcmm.2018.0076.
Chaihu Jia Longgu Muli Tang is a classical Chinese formulas treating Shaoyang syndrome complicated with Yangming syndrome according to Treatise on Febrile Diseases. This formula is used in mental disorder, nervous system, gynecologic, andrologic, and cardiovascular disease. However, its therapeutic effect on ischemia stroke and its mechanism is far from clear. In clinical practice, we have found that this formula is effective in treating ischemic stroke, which can shorten the course of the disease and reduce recurrence. The characteristics of this formula include: Shaoyang cardinal disadvantageous syndrome, mental and nervous symptoms, retained fluid punched upward syndrome and accumulation of heat in the stomach and intestines. By combining traditional Chinese medicine (TCM) pathogenesis and efficacy with modern pathology and pharmacology, we proposed that the TCM pathogenesis of stroke, which is characterized by hyperactivity of heat combining with phlegm, stasis and water drink, is consistent with syndromes and corresponding pathology targeted by Chaihu Jia Longgu Muli Tang, including the stress brain edema zone around the ischemic lesion, the increase of intracranial pressure, the excitement of sympathetic nerve, the release of monoamine neurotransmitter, the hypofunction of autonomic nervous system after stroke, and gastrointestinal stress response. Furthermore, the pharmacological mechanism of Chaihu Jia Longgu Muli Tang is concentrated on regulation the neuroendocrinology system centered by hypothalamic-pituitary-adrenal axis (HPA), participating in the process of neuron regeneration and apoptosis, oxidative stress, hyperactivity of sympathetic nerve, and inflammatory reaction. These pathological processes are consistent with the pathological changes after ischemic stroke. Therefore, Chaihu Jia Longgu Muli Tang is a key formula for treating ischemic stroke.
柴胡加龙骨牡蛎汤是《伤寒论》中治疗少阳证合并阳明证的经典方剂。该方用于精神障碍、神经系统、妇科、男科及心血管疾病。然而，其对缺血性中风的治疗作用及其机制尚不清楚。在临床实践中，我们发现该方治疗缺血性中风有效，可缩短病程并减少复发。该方的特点包括：少阳枢机不利证、精神神经症状、水饮上逆证及胃肠积热证。通过将中医病机与功效与现代病理学和药理学相结合，我们提出中风的中医病机以热盛兼夹痰、瘀、水饮为特征，与柴胡加龙骨牡蛎汤所针对的证候及相应病理一致，包括缺血灶周围应激性脑水肿区、颅内压升高、交感神经兴奋、单胺类神经递质释放、中风后自主神经系统功能减退及胃肠应激反应。此外，柴胡加龙骨牡蛎汤的药理机制集中于调节以下丘脑-垂体-肾上腺轴（HPA）为中心的神经内分泌系统，参与神经元再生与凋亡、氧化应激、交感神经兴奋及炎症反应过程。这些病理过程与缺血性中风后的病理变化一致。因此，柴胡加龙骨牡蛎汤是治疗缺血性中风的关键方剂。
