Epigenetics,a branch of molecular biology,plays a pivotal role in the pathological progression of ischemic stroke.Epigenetic modifications are intricately involved in the complex and dynamic processes that regulate gene expression,cellular injury response,motor function,and cognitive ability following stroke.This provides an effective framework for elucidating the targets and mechanisms of action underlying traditional Chinese medicine's treatment of ischemic stroke.Currently,the etiology and pathogenesis of ischemic stroke remain incompletely understood,with modern medical treatments still lacking sufficient efficacy.Traditional Chinese medicine possesses a unique advantage in treating ischemic stroke through its multi-level and multi-target comprehensive regulation.Recent studies have discovered that traditional Chinese medicine can participate in regulating abnormal epigenetic modifications during stroke treatment.This article primarily focuses on the theoretical foundation of traditional Chinese medicine for strokes by exploring its application in DNA methylation,non-coding RNA,histone modification research as well as explaining the epigenetic effects it exerts when treating strokes.The aim is to provide insights for future research and development of traditional Chinese medicine for cerebral ischemia.

AIM:To explore the protective effect of Xiaoxuming decoction(XXMD)on synaptic plasticity in the context of cerebral ischemia-reperfusion injury following ischemic stroke.METHODS:An oxygen-glucose depriva-tion/reoxygenation(OGD/R)model was employed in vitro using mouse hippocampal neurons(HT22 cells)to simulate ischemia-reperfusion injury.Cell viability was assessed using a CCK-8 assay to determine the optimal XXMD concentra-tion.The HT22 cells were divided into two groups:control and model(OGD/R).Cellular morphological changes were ob-served using an inverted microscope.The levels of IL-1β,IL-6 and TNF-α in the supernatant were quantified by ELISA.Ultrastructural changes were examined by transmission electron microscopy.Immunofluorescence staining was used to de-tect neuron markers NeuN and synaptic proteins NF200 and MAP2.The protein levels of NF200 and MAP2 were analyzed by Western blot.RESULTS:The highest cell survival rate occurred at an XXMD concentration of 100 mg/L(P<0.05).Compared with control group,the cells in model group exhibited round shape and shrinkage,mitochondrial swelling or vacuolization,and a marked decrease in survival rate.There were significant increases in IL-1β,IL-6 and TNF-α levels(P<0.05).Immunofluorescence intensity and protein levels of NeuN,NF200 and MAP2 were notably reduced(P<0.05).Treatment with XXMD improved cell morphology,ultrastructure and survival rate(P<0.05),and decreased in-flammatory factor levels(P<0.05).Compared with model group,the cells in OGD/R+XXMD group showed significantly increased immunofluorescence intensity and protein levels of NeuN,NF200 and MAP2(P<0.05).CONCLUSION:Xiaoxuming decoction may mitigate OGD/R-induced injury,potentially by inhibiting inflammatory responses and enhanc-ing synaptic plasticity.