阿尔茨海默病（Alzheimer’s disease，AD）是一种慢性神经退行性疾病。AD发病机制复杂，且临床缺乏有效治疗药物。石菖蒲Acori Tatarinowii Rhizoma在临床防治AD的单味药使用频次中位居榜首，具有醒神益智、开窍豁痰的功效。通过系统整合AD病理机制研究进展，总结了石菖蒲的活性成分（包括挥发性成分、生物碱、有机酸、萜类）及其防治AD的作用机制。发现石菖蒲及其活性成分可通过抗神经炎症、抑制氧化应激、改善胆碱能系统、修复血脑屏障等多途径发挥防治AD的作用，阐明了其多成分、多靶点治疗AD的优势。为石菖蒲的后续临床合理应用提供了理论支撑，并为深入探究其现代作用机制提供了新的研究思路。

Alzheimer’s Disease (AD) is a chronic neurodegenerative disorder characterized by a complex pathogenesis and a lack of effective clinical treatments. Shichangpu (Acori Tatarinowii Rhizoma) is the most commonly used single herb in clinical practice for the prevention and management of AD, recognized for its cognitive-enhancing and phlegm-resolving properties. By integrating advances in research on AD pathological mechanisms, this study synthesizes current knowledge regarding the active components of Acori Tatarinowii Rhizoma—including volatile components, alkaloids, organic acids, and terpenes—and their mechanisms of action in AD prevention and treatment. Evidence indicates that Acori Tatarinowii Rhizoma and its bioactive constituents exert anti-AD effects through multiple pathways, such as suppressing neuroinflammation, inhibiting oxidative stress, enhancing cholinergic function, and restoring blood-brain barrier integrity. These findings underscore its multi-component, multi-target therapeutic potential in AD intervention. This review provides a theoretical basis for the rational clinical application of Acori Tatarinowii Rhizoma and offers new perspectives for elucidating its modern pharmacological mechanisms.

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国自然科学基金资助项目（82274612）；国自然科学基金资助项目（82305087）；国自然科学基金资助项目（82575183）；中国博士后科学基金资助项目（2025M783967）；河南省重点研发（231111312900）；河南省中医药科研专项（2025ZY3153）