中医"肾生髓,脑为髓海"现代生物学基础探讨

“肾生髓,脑为髓海”的理论指导中医临床应用补肾中药来防治痴呆和提高记忆能力已经有数千年的历史。然而,这一理论的生物学基础尚未有系统的论述。作者近10年来应用拟痴呆动物模型和细胞模型等开展了补肾中药防治老年性痴呆的一系列研究。结果表明,补肾中药在老年痴呆防治中具有非常重要的地位;不同补肾中药的益脑髓功效存在较大差别;补肾中药在多种拟老年性痴呆和脑老化动物模型和细胞模型的作用特点是增强细胞能量代谢、神经营养因子表达和胆碱能神经元数量与功能,减少神经毒素生成。基于此,认为中医所指的“脑髓”,其现代生物学基础是脑内神经元和神经营养因子;脑内神经营养因子减少、神经元大量萎缩和丢失而造成“髓海不足”,可引起认知功能下降,进而可发生痴呆;中药“补肾填髓”的现代生物学基础是促进神经元细胞能量代谢和利用,激活内源性神经营养因子生成增多,同时抑制神经毒素的生成,从而减少神经元死亡,促进神经元存活与再生。

Modern biological basis of Chinese medical theory that"kidney nourishes marrow and brain is sea of marrow"

The theory that "the kidney nourishes marrow and brain is the sea of marrow" has been instructing traditional Chinese medical doctors in preventing and treating dementia in aged people for thousands of years. However, the modern biological basis of this theory has not been systemically studied. In this review, we summarized our serial pharmacological studies on the treatment of Alzheimer's disease (AD) with Chinese medicinal herbs, using multiple kinds of AD-like animal and cell models. The results show that "kidney-reinforcing" herbs of traditional Chinese medicine play a very important role in the anti-AD effects; and different "kidney-reinforcing" herbs have different effects in brain functions. The common effects of "kidney-reinforcing" herbs are improving cellular energy metabolism, increasing neurotrophic factors and the number of cholinergic neurons, and decreasing neurotoxin production. Based on above results, we propose that the essence of "brain marrow" is the neurons and neurotrophic factors in the brain; "the deficiency of brain marrow" is induced by the decrease in neurotrophic factors and the atrophy and loss of neurons in the brain, thus resulting in cognitive impairment and dementia. The modern biological basis of "reinforcing kidney to replenish marrow" by traditional Chinese medicine includes improving cellular energy metabolism and utilization, enhancing endogenous neurotrophic effects and decreasing neurotoxin production, thus reducing the cell death and increasing the survival and regeneration of neurons.