Xu Ke, Deng Bowen, Jia Tongtong, Ren Mihong, Chen Hai, Zhang Jing, Guo Jinlin, Li Yong, Wang Jian
College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Front Pharmacol. 2025 Jan 15;15:1510779. doi: 10.3389/fphar.2024.1510779. eCollection 2024.
(BC), also named Niuhuang in Chinese, is utilized as a resuscitation drug in Traditional Chinese Medicine (TCM) for the treatment of neurological disorders. Ischemic stroke (IS) is a significant global public health issue that currently lacks safe and effective therapeutic drugs. Ongoing efforts are focused on identifying effective treatment strategies from Traditional, Complementary, and Integrative Medicine. Noticeably, BC has been used in TCM for thousands of years to prevent or treat IS-related diseases.
The historical origins of BC in the treatment of IS were investigated through the examination of ancient Chinese medical texts. Furthermore, the chemical components of BC were analyzed, and its mechanisms of action against IS were summarized using literature sourced from databases such as Web of Science, PubMed, and China National Knowledge Infrastructure. Information on Chinese medicine preparations and clinical reports was also integrated to provide an overview of modern applications and safety considerations.
BC mainly includes chemical components such as bile pigments, bile acids, cholesterol, proteins amino acids, and trace elements. Additionally, the efficacy of BC in treating cerebral ischemia/reperfusion injury (CI/RI) is certain, particularly due to the components of bile pigments, bile acids, and amino acids that can interfere with the enzymatic cascade reaction of CI/RI through multiple components, targets, and pathways. The active components of BC exert neuroprotective effects by reducing microcirculation disturbance, excitatory amino acid toxicity, and oxidative stress injury in the acute stage; inhibiting inflammatory injury, apoptosis, and blood-brain barrier (BBB) disruption in the subacute stage; and promoting angiogenesis and neurogenesis in the restoration stage. Furthermore, as a crude drug, BC appears in many Chinese patent medicine (CPM) preparations for the treatment of IS, and clinical and preclinical studies have proved its safety.
The use of BC in the treatment of IS has a long history, proven efficacy, and widespread application. Future efforts should focus on elucidating its mechanisms of action and exploring its applications.
牛黄在中医中也被称为“Niuhuang”，是一种用于治疗神经系统疾病的开窍药。缺血性中风（IS）是一个重大的全球公共卫生问题，目前缺乏安全有效的治疗药物。目前正在努力从传统医学、补充医学和整合医学中寻找有效的治疗策略。值得注意的是，牛黄在中医中已被使用数千年，用于预防或治疗与IS相关的疾病。
通过查阅中国古代医学文献，研究牛黄治疗IS的历史渊源。此外，分析了牛黄的化学成分，并利用来自科学网、PubMed和中国知网等数据库的文献总结了其抗IS的作用机制。还整合了中药制剂和临床报告的信息，以概述其现代应用和安全性考虑。
牛黄主要包括胆色素、胆汁酸、胆固醇、蛋白质氨基酸和微量元素等化学成分。此外，牛黄治疗脑缺血/再灌注损伤（CI/RI）的疗效是肯定的，特别是由于胆色素、胆汁酸和氨基酸成分可通过多种成分、靶点和途径干扰CI/RI的酶联反应。牛黄的活性成分在急性期通过减少微循环障碍、兴奋性氨基酸毒性和氧化应激损伤发挥神经保护作用；在亚急性期抑制炎症损伤、细胞凋亡和血脑屏障（BBB）破坏；在恢复阶段促进血管生成和神经发生。此外，作为一种原料药，牛黄出现在许多治疗IS的中成药（CPM）制剂中，临床和临床前研究已证明其安全性。
牛黄用于治疗IS历史悠久，疗效确切，应用广泛。未来的研究应集中在阐明其作用机制和探索其应用方面。
