Mechanisms of action and clinical application of Xingnao kaiqiao-type traditional Chinese medicines for post-stroke cognitive impairment
- VernacularTitle:醒脑开窍类中药治疗脑卒中后认知障碍的作用机制与临床应用
- Author:
Qiongdi REN
1
;
Ming ZHANG
2
;
Kaiqi SU
2
;
Ruyuan CUI
3
;
Rui PAN
1
;
Chunxiao WANG
1
;
Yachen FENG
1
;
Qi LI
1
;
Xu ZHANG
2
Author Information
1. Rehabilitation Center，The First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou 450003，China;School of Rehabilitation Medicine，Henan University of Chinese Medicine，Zhengzhou 450046，China
2. Rehabilitation Center，The First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou 450003，China
3. First Clinical Medical College of Henan University of Chinese Medicine，Zhengzhou 450046，China
- Publication Type:Journal Article
- Keywords:
Xingnao kaiqiao-type traditional Chinese medicines;
post‑stroke cognitive impairment;
stroke;
Mechanism of action;
Clinical application
- From:
China Pharmacy
2026;37(20):2746-2752
- CountryChina
- Language:Chinese
-
Abstract:
Post-stroke cognitive impairment （PSCI） is a highly prevalent severe complication after stroke. In traditional Chinese medicines （TCM）， its core pathogenesis is characterized by deficiency in origin and excess in superficiality： wind， phlegm and blood stasis accumulate， cloud the clear orifices and lead to loss of mental activity， and Xingnao kaiqiao is the targeted principal treatment. This review summarizes the research progress on the pharmacological mechanisms of representative Xingnao kaiqiao-type TCM including Acorus tatarinowii ， Curcumae Radix ， Polygala tenuifolia ， borneol and musk， as well as clinical applications of their related compound formulas and Chinese patent medicines in the treatment of PSCI. The results show that these TCM can improve cognitive function through multiple pathways： targeted regulation of blood-brain barrier permeability， inhibition of neuroinflammation mediated by Toll like receptor 4/nuclear factor-κB， high mobility group protein B1 in ischemic brain tissue and other pathways， and activation of brain-derived neurotrophic factor/tyrosine kinase receptor B， cyclic adenosine monophosphate （cAMP）/protein kinase A/cAMP response element-binding protein and other pathways to promote synaptic plasticity. In terms of clinical application， the evidence chains of formulas based on Acorus tatarinowii and Polygala tenuifolia are relatively complete， which are the core medications to improve cognitive function and activities of daily living； Curcumae Radix has protective potential in the prodromal stage with vascular risk factors； borneol enhances the curative effect of compound prescriptions by improving blood-brain barrier function； musk is mainly used in the acute severe stage. At present， most of the mechanism evidence comes from animal experiments， high-quality large-sample clinical studies directly targeting PSCI populations are still scarce. Subsequent large-sample multicenter studies are needed in the future， combined with multi-omics and multimodal imaging techniques to further clarify its deep-seated mechanism of action.
