Cerebral ischemia reperfusion injury(CIRI)is a secondary brain injury that may occur in patients with ischemic stroke during the process of blood flow recovery.NOD-like receptor protein 3(NLRP3)inflammasome plays an important role in the occurrence and development of CIRI.Regulating the activity of NLRP3 inflammasome can induce cell pyroptosis,induce neuroinflammatory response,promote macrophage/microglial polarization,destroy the blood-brain barrier,affect angiogenesis and neurogenesis,thereby affecting CIRI.Traditional Chinese medicine has obvious advantages in the treatment of CIRI.In this paper,with NLRP3 inflammasome as the core,we systematically elucidated the mechanism of action of traditional Chinese medicines on CIRI,and found that traditional Chinese medicines monomers(such as baicalin,polygalasaponin F)and traditional Chinese medicines compound formulas(such as Huangqi guizhi wuwu decoction,Yiqi shengqing formulation)can inhibit NLRP3 inflammasome activity,reduce inflammatory response and oxidative stress,and improve neuronal injury,thereby reducing CIRI.

The core of diagnosing and treating diseases in traditional Chinese medicine lies in syndrome differentiation. The eight principles of syndrome differentiation serve as guidance for syndrome differentiation. As one of the eight principles of syndrome differentiation， the differentiation of deficiency and excess is the basic and critical method. Ischemic stroke is currently the leading cause harming the health of Chinese residents. Although the hypotheses about the cause of ischemic stroke have evolved from external wind to the later internal wind and to the modern theory of toxin damaging the brain collaterals， they all believe that this disease is rooted in internal deficiency and external excess. According to available studies， although stroke is characterized by complex pathogenesis and rapid progression of syndromes， the key cause evolution has a regularity， that is， from excess to deficiency. This article analyzes the historical evolution of the etiology， pathogenesis， and syndrome differentiation schemes of stroke. There are diverse schemes for the syndrome differentiation of stroke， which make it difficult to choose in clinical practice. In view of this problem， this paper puts forward a new approach of staging sequential treatment of ischemic stroke based on the differentiation of deficiency and excess according to the evolution law of the key cause of stroke. Furthermore， we conducted a randomized controlled study on 100 patients with ischemic stroke to evaluate this new approach. The results showed that the staging sequential treatment of ischemic stroke based on the differentiation of deficiency and excess demonstrated definite clinical efficacy. In addition， this article reviews the previous research results of our team and the research achievements of other teams to preliminarily explore the relationship between stroke syndromes and biomarkers， aiming to provide an objective basis for unveiling the pathogenesis of stroke. In summary， according to the key cause evolution （from excess to deficiency）， the treatment of ischemic stroke by stages based on differentiation of deficiency and excess can facilitate the rapid intervention and improve the clinical efficacy on ischemic stroke.

Cerebral ischemia-reperfusion injury(CIR1)refers to the recovery of blood supply after cerebral ischemia,which leads to further damage and the dysfunction of brain tissue.Modern medicine has made some progress in the prevention and treatment of CIRI,but it still faces some challenges and limitations.Therefore,it is of great clinical value to find effective interventions to prevent and treat CIRI.AMP-activated protein kinase(AMPK)and its downstream proteins are important targets for the treatment of CIRI and play key roles in the regulation of cellular energy homeostasis.Traditional Chinese medicine for CIRI has multi-target and multi-pathway activities and multiple effects.It can activate a cascade of reactions in the AMPK signaling pathway and can be used to treat CIRI by regulating autophagy,oxidative stress,inflammatory response,and apoptosis,and has achieved certain result.Therefore,this paper summarizes the structure and mechanisms of the AMPK-related signaling pathway,elaborates on its relationship with CIRI,and systematically summarizes the research status of traditional Chinese medicine's ability to regulate the AMPK signaling pathway in the prevention and treatment of CIRI.This paper aims to provide new ideas for the prevention and treatment of CIRI using traditional Chinese medicine and the development of new drugs.

Stroke is a disease that seriously threatens human health.Traditional Chinese medicine believes that turbid phlegm and sthenia fever are common pathological factors of stroke.The early diagnosis of stroke usually depends on advanced imaging techniques,such as MRI and CT,and there is still a lack of diagnostic biomarkers.Therefore,exploring the biological markers of Phlegm-Heat and Bowel-Excess Syndrome of stroke,combining macro-dialectics with micro-dialectics,can provide objective data support for the prevention and treatment of stroke by traditional Chinese medicine,which is of great significance for the diagnosis,treatment and prognosis evaluation of stroke.This paper reviews and summarizes the clinical biochemical indicators,microbiome,genomics,transcriptomics,proteomics,metabolomics and other aspects,aiming to find specific biomarkers related to Phlegm-Heat and Bowel-Excess Syndrome of stroke,so as to provide molecular basis for the objective research system of stroke"syndrome"and new ideas for the study of syndrome essence.

Stroke is a disease that seriously threatens human health.Traditional Chinese medicine believes that turbid phlegm and sthenia fever are common pathological factors of stroke.The early diagnosis of stroke usually depends on advanced imaging techniques,such as MRI and CT,and there is still a lack of diagnostic biomarkers.Therefore,exploring the biological markers of Phlegm-Heat and Bowel-Excess Syndrome of stroke,combining macro-dialectics with micro-dialectics,can provide objective data support for the prevention and treatment of stroke by traditional Chinese medicine,which is of great significance for the diagnosis,treatment and prognosis evaluation of stroke.This paper reviews and summarizes the clinical biochemical indicators,microbiome,genomics,transcriptomics,proteomics,metabolomics and other aspects,aiming to find specific biomarkers related to Phlegm-Heat and Bowel-Excess Syndrome of stroke,so as to provide molecular basis for the objective research system of stroke"syndrome"and new ideas for the study of syndrome essence.