脑小血管病（cerebral small vessel disease，cSVD）是导致老年缺血性和出血性中风及引发血管性痴呆的主要原因。目前，多项基础和临床研究发现中药具有改善cSVD动物神经损伤和cSVD患者临床症状的效果，其作用机制包括减轻神经炎症、促进突触形成、调控细胞自噬、抑制细胞凋亡和焦亡、改善神经递质释放、减少毒性蛋白积累、抗氧化应激和钙超载、抗血小板聚集及调节脑肠轴功能等。通过从中药复方和中药单体2个方面总结该领域研究进展和热点问题，为今后cSVD的药物研发和临床治疗提供有益借鉴。

Cerebral small vessel disease (cSVD) is the leading cause of elderly ischemic and hemorrhagic stroke, as well as the dominant cause of vascular dementia. At present, multiple preclinical and clinical studies have found that traditional Chinese medicine (TCM) has the effect of alleviating nerve damage in cSVD animal models and improving the clinical symptoms in cSVD patients. The possible drug mechanisms include reducing neuroinflammation, promoting synapse formation, regulating cell autophagy, inhibiting cell apoptosis and necrosis, improving neurotransmitter release, reducing toxic protein accumulation, anti-oxidant stress, anti-calcium overload, anti-platelet aggregation, and regulating brain-gut axis function. This paper summarizes the research progress and hot issues in this field from two aspects: TCM formulas and monomers, which brings beneficial references for future drug development and clinical treatment of cSVD.

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国家自然科学基金资助项目（82004066）;四川省自然科学基金资助项目（2022NSFSC1386）;成都中医药大学“杏林学者”学科人才科研提升计划（YYZX2021047）