Liu Di, Zhao YueYu, Liu RunFeng, Qiao BaoGuang, Lu XinRu, Bei YuanYuan, Niu Yin, Yang XiaoNi
College of Traditional Chinese Medicine, Shandong Second Medical University, Weifang, China.
Department of Pain, Heze Municipal Hospital, Heze, China.
Medicine (Baltimore). 2025 Mar 14;104(11):e41694. doi: 10.1097/MD.0000000000041694.
Vascular cognitive impairment (VCI) is a prevalent cognitive disorder resulting from cerebrovascular disease and encompasses a spectrum of cognitive deficits, ranging from mild impairment to vascular dementia (VD). VCI is responsible for a minimum of 20% to 40% of all cases of dementia, with its prevalence ranking second only to Alzheimer's disease on a global scale. The pathogenesis of VCI is complex and includes a lack of cholinergic nerve cells, inflammation, oxidative stress, alterations in the blood-brain barrier, and cell apoptosis. Current guideline-recommended drugs have unsatisfactory therapeutic effects. However, traditional Chinese medicine (TCM) has long been associated with treating dementia, and numerous studies regarding treating dementia with TCM have been conducted. The etiology and pathogenesis of VaD are linked to deficiencies in the spleen and kidney, as well as phlegm turbidity. Treatment involves benefiting the spleen and kidney, improving blood circulation, removing blood stasis, and dispelling phlegm. Moreover, TCM presents benefits such as few adverse effects, low cost, long-term use suitability, and preventive effects. This review outlines the pathogenesis of VCI in both modern medicine and TCM, examines traditional prescriptions and single-agent ingredients with their pharmacological effects, emphasizes TCM's unique features, and explores its multi-targeted approach to treating VCI.
血管性认知障碍（VCI）是一种由脑血管疾病引起的常见认知障碍，涵盖了一系列认知缺陷，从轻度损害到血管性痴呆（VD）。VCI至少占所有痴呆病例的20%至40%，在全球范围内其患病率仅次于阿尔茨海默病。VCI的发病机制复杂，包括胆碱能神经细胞缺乏、炎症、氧化应激、血脑屏障改变和细胞凋亡。目前指南推荐的药物治疗效果不理想。然而，中医长期以来一直与痴呆治疗相关，并且已经开展了许多关于中医治疗痴呆的研究。血管性痴呆的病因和发病机制与脾肾亏虚以及痰浊有关。治疗方法包括补益脾肾、活血化瘀、祛痰化浊。此外，中医具有不良反应少、成本低、适合长期使用以及具有预防作用等优点。本综述概述了现代医学和中医中VCI的发病机制，研究了传统方剂和单味药成分及其药理作用，强调了中医的独特特点，并探讨了其治疗VCI的多靶点方法。
