阿尔茨海默病(AD)是一种多因素相关的复杂性疾病,目前临床治疗效果不佳.仅针对单靶点或单致病途径的药物不易取得好的疗效.另一个重要原因是干预时机太晚,当诊断出痴呆时患者脑内已有大量神经元死亡.因此,应当针对多靶点、多途径治疗,同时将治疗时机提前到痴呆发生前,才有可能在AD的药物干预领域实现新的突破.本文综述了作者近十多年来在中药治疗AD方面的研究工作,包括中药新复方参乌胶囊、中药提取物何首乌二苯乙烯苷、山茱萸环烯醚萜苷、淫羊藿黄酮和淫羊藿苷对多种拟AD动物模型和细胞模型的影响及其作用机制.这些中药的特点是作用在AD复杂发病机制的多靶点和多途径,尤其是具有神经保护和神经营养/再生作用,且对线粒体和突触具有明显的保护作用,可望用于AD的早期干预或轻度认知障碍期(MCI)的治疗,从而阻止或延缓痴呆的发生与进程.
Alzheimer's disease (AD) is a multifactorial complex disease. The failure of recent development of AD therapeutic agents in clinical trials is mainly due to their single-target or single-pathogenic pathway effect. The poor clinical outcome of AD treatment is also due to the late intervention. A large number of neuronal death has already happened at the time of diagnosis. Aiming at the complex diseases with unclear causes and many related factors, the multi-target and multi-link treatment characteristics of traditional Chinese medicine have advantages over the single target treatment. Therefore, we have committed to the research of traditional Chinese medicine in treatment of AD and the development of new drugs since 1995. In this paper, our research results for more than 10 years were reviewed. Our study showed that traditional Chinese medicine formula (Shenwu capsule) and single herb extracts (Tetrahydroxy-stilbene glucoside, Cornel iridoid glycoside, Epimedium flavone and Icariin) could act on the complex pathogenesis of AID at multi-targets and multi-pathways, especially have both neuroprotective and neurotrophic/regenerative effects, and protect mitochondria and synapses, thus have significant features and advantages for the treatment of AD.