中医药靶向神经血管单元治疗急性缺血性脑卒中的临床思考

神经血管单元（neurovascular unit，NVU）概念的提出，为治疗急性缺血性脑卒中（acute ischemic stroke，AIS）提供了新靶点，即应针对包括神经元、微循环及神经胶质在内的整体进行治疗，弥补以往单一针对神经元或血管治疗的局限性。同时，国内外针对AIS后NVU保护的药物研究陆续展开，临床试验存在诸多失败。中医药具有多组分、多靶点及整体调节的优势特点，符合靶向NVU多靶点整体治疗的临床要求。目前中医药靶向NVU治疗AIS的临床研究极少，亦缺乏规范系统的临床疗效评价，更少有针对中医药改善AIS NVU损伤的血液标记物的临床研究。笔者从上述多方面进行思考，以期为进一步中医药靶向NVU治疗AIS的临床研究做好铺垫。

英文摘要:

Neurovascular unit （NVU） concept proposed for the treatment of acute ischemic stroke （AIS） provides a new target，i.e.， we should target as an integrity including neurons，glia，and microcirculation，thus supplementing limitations of previous treatment targeting neurons or blood vessels alone. Meanwhile，many clinical trials have failed after NVU protection against AIS drug research has developed at home and abroad. Chinese medicine has multi component， multi target， and overall regulation advantages， and is in line with clinical requirement for overall treatment targeting multiple targets of NVU. Currently clinical studies of Chinese medicine treatment of AIS targeting NVU are few. Standardized and systematic clinical efficacy evaluation is lack. Clinical studies for improving AIS NVU injured blood markers by Chinese medicine are rarer. We hope to pave the way for performing clinical studies on Chinese medicine treatment of AIS targeting NVU.

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