Xu Hanying, Lu Jing, Tang Xiaolei, Li Pengfei, Wu Lei, Wang Jian, Zhang Ying, Zhang Dongmei
Department of Encephalopathy, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, People's Republic of China.
Research Center of Traditional Chinese Medicine, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin, People's Republic of China.
Drug Des Devel Ther. 2025 Jun 4;19:4789-4808. doi: 10.2147/DDDT.S513343. eCollection 2025.
Intracerebral hemorrhage (ICH) is a severe cerebrovascular disorder associated with high morbidity and mortality. Ferroptosis, a regulated form of cell death characterized by iron accumulation and lipid peroxidation, plays a critical role in secondary injury following ICH. Traditional Chinese Medicine (TCM) has demonstrated distinct therapeutic benefits in cerebrovascular disease, and emerging evidence suggests its potential to modulate ferroptosis. This review explores the therapeutic effects of TCM and TCM-based interventions for ICH, with a focus on their regulation of ferroptosis-related mechanisms. In ICH, ferroptosis is driven by disrupted iron metabolism, lipid peroxidation, oxidative stress, and neuroinflammation-key contributors to secondary brain injury. TCM interventions, including herbal medicines, active compounds, and acupuncture, may counteract these processes by restoring iron homeostasis and reducing oxidative stress, thereby improving neurological outcomes. Given the critical role of ferroptosis in ICH pathophysiology, TCM represents a promising avenue for targeting ferroptosis-related pathways and advancing therapeutic strategies.
脑出血（ICH）是一种严重的脑血管疾病，具有高发病率和死亡率。铁死亡是一种受调控的细胞死亡形式，其特征是铁积累和脂质过氧化，在脑出血后的继发性损伤中起关键作用。中医（TCM）在脑血管疾病中已显示出显著的治疗益处，新出现的证据表明其具有调节铁死亡的潜力。本综述探讨了中医及基于中医的干预措施对脑出血的治疗效果，重点关注其对铁死亡相关机制的调节作用。在脑出血中，铁死亡由铁代谢紊乱、脂质过氧化、氧化应激和神经炎症驱动，这些是继发性脑损伤的关键因素。中医干预措施，包括草药、活性化合物和针灸，可能通过恢复铁稳态和降低氧化应激来对抗这些过程，从而改善神经功能结局。鉴于铁死亡在脑出血病理生理学中的关键作用，中医是靶向铁死亡相关途径和推进治疗策略的一个有前景的途径。
