中枢神经系统疾病涵盖脑部和脊髓系统的病变，这类疾病的发生和发展受到病理和环境因素的双重影响，临床治疗风险性大且治愈率低。难治性的中枢神经系统疾病如阿尔茨海默症、帕金森症、缺血性脑卒中以及脊髓损伤等，这类疾病缺乏治疗药物和针对性的治疗方案，严重威胁人类健康。赤芍是我国传统中药材，为毛茛科植物芍药Paeonia lactiflora和川赤芍Paeonia veitchii的干燥根部，主要功效为清热镇痛、活血祛瘀。研究表明中药赤芍的总提取物及其活性成分对治疗中枢神经系统疾病具有积极的意义，尤其是在抑郁症、神经退行性疾病、神经性疼痛、脑卒中、脊髓损伤以及脑部肿瘤等方面的有效性已经被证实。其发挥药效的机制可能是通过肠–脑轴、抗炎、抗氧化应激、干预神经元凋亡、调节神经递质和激素分泌等路径，但具体的分子机制和关键靶点还需深入挖掘。以“赤芍活性成分治疗中枢神经系统疾病”为主题，通过关键词的自由组合检索中国知网（CNKI）、万方数据知识服务平台、维普网以及Pubmed等数据库近年来发表的实验性研究论文，统计赤芍活性成分种类并分类综述其干预相关疾病的途径和分子机制，为中枢神经系统疾病的治疗及赤芍的开发利用提供思路和参考。

Central nervous system diseases (CNSD) refer to lesions in the brain and spinal cord systems. The occurrence and development of this type of disease are influenced by both pathological and environmental factors, with high clinical treatment risks and low cure rates. CNSD that is difficult to treat, such as Alzheimer’s disease, Parkinson’s disease, ischemic stroke, and spinal cord injury, pose a serious threat to human health due to the lack of therapeutic drugs and appropriate treatment methods. Paeoniae Radix Rubra is a kind of traditional Chinese medicinal herb, which is the dried root of the plants Paeonia lactiflora Pall. and Paeonia vetchii Lynch. It has the main functions of clearing heat and relieving pain, promoting blood circulation and removing blood stasis. Many studies have shown that the total extract and active ingredients of Paeoniae Radix Rubra have positive effects on the treatment of CNSD, especially in areas such as depression, neurodegenerative diseases, neuropathic pain, stroke, spinal cord injury, and brain tumors. The mechanisms by which these active ingredients exert their pharmacological effects may be through pathways such as gut brain axis, anti-inflammatory, antioxidant stress, intervention in neuronal apoptosis, regulation of neurotransmitters and hormone secretion, but the specific molecular mechanisms and key targets still need to be further explored. The theme of this article’s literature collection was “the active ingredients of Paeoniae Radix Rubra in the treatment of CNSD”. The retrieval method was to search for experimental research papers published in recent years through free combinations of keywords on databases such as CNKI, Wanfang Data, CQVIP, and Pubmed, etc. The types of active ingredients in Paeoniae Radix Rubra were analyzed and classified to review their intervention pathways and molecular mechanisms in related diseases. This review article provides ideas and references for the treatment of CNSD and the development and utilization of Paeoniae Radix Rubra.

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国家重点研发计划(2021YFD1600901);黑龙江省中医药经典普及化专项课题(ZWY2023-102);黑龙江中医药大学科研基金资助项目(2019MS09)