Institude of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China.
Traditional Chinese Medicine Department, Xuanwu Hospital Capital Medical University, Beijing 100053, P. R. China.
Am J Chin Med. 2020;48(3):487-511. doi: 10.1142/S0192415X20500251. Epub 2020 Apr 24.
Cognitive impairment (CI) refers to the dysfunction of memory, language, visual space, execution, calculation, understanding, and judgment in one or more aspects. With global aging, CI will become prevalent worldwide. At present, there is no effective cure for CI. However, Nobel laureate Tu Youyou's research on artemisinin has inspired Chinese researchers to focus on traditional Chinese herbs (TCHs) for the treatment of CI. Traditional Chinese Medicine (TCM) has led to a theory for an independent CI system. The pathogenesis of such impairment involves deficiency, phlegm, and stagnation and involves a range of organs, including the brain, kidneys, heart, liver, and spleen. Our current understanding of the etiology and pathogenesis of this condition has led to the realization that TCHs can improve cognitive dysfunction. Clinical research has shown that TCHs can improve the neuropsychological scale score of patients, the TCM symptom score, and the patient's quality of life. Research has also suggested that TCHs can retard A deposits and tauopathy, regulate the metabolism of cholinergic neurotransmitters, and so on. However, due to their complexity, little is known of the safety and efficacy of TCHs in patients with CI. It is likely that we will be able to identify the precise mechanisms associated with the action of TCHs in such patients due to the integration of multiple technologies. This paper summarizes the pharmacokinetics, curative effect, and mechanisms of action of traditional Chinese herbs in order to provide a scientific basis for the improvement of cognitive dysfunction by TCHs.
认知障碍（CI）是指记忆力、语言、视觉空间、执行、计算、理解和判断等一个或多个方面的功能障碍。随着全球老龄化，CI 将在全球范围内普遍存在。目前，CI 没有有效的治疗方法。然而，诺贝尔生理学或医学奖得主屠呦呦对青蒿素的研究启发了中国研究人员专注于中药（TCHs）治疗 CI。中医药（TCM）导致了一个独立的 CI 系统理论。这种损伤的发病机制涉及虚、痰、瘀，涉及大脑、肾脏、心脏、肝脏和脾脏等多个器官。我们目前对这种疾病的病因和发病机制的认识导致了 TCHs 可以改善认知功能障碍的认识。临床研究表明，TCHs 可以提高患者的神经心理学量表评分、中医症状评分和患者的生活质量。研究还表明，TCHs 可以延缓 A 沉积和 tau 病，调节胆碱能神经递质的代谢等。然而，由于其复杂性，对于 TCHs 在 CI 患者中的安全性和疗效知之甚少。由于多种技术的整合，我们很可能能够确定与 TCHs 作用相关的确切机制。本文总结了中药的药代动力学、疗效和作用机制，为 TCHs 改善认知功能障碍提供了科学依据。
