Article(id=1322931636224012533, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.12.022, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1750003200000, receivedDateStr=2025-06-16, revisedDate=1780502400000, revisedDateStr=2026-06-04, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341080955, onlineDateStr=2026-10-30, pubDate=1782316800000, pubDateStr=2026-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341080955, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341080955, creator=13701087609, updateTime=1793341080955, updator=13701087609, issue=Issue{id=1322931549481599694, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='12', pageStart='2001', pageEnd='2192', issueExtLink='null', onlineDate='null', pubDate='1782316800000', pubDateStr='2026-06-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341060276, creator='13701087609', updateTime=1793343118019, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940180335829530, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940180335829531, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2162, endPage=2167, ext={EN=ArticleExt(id=1322931636484059383, articleId=1322931636224012533, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application progress on ginger and its derivative therapies in the nursing of stroke patients, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This paper reviewed the clinical application of ginger extract,external treatment methods,and dietary intervention in neuroprotection during the acute phase of stroke,functional recovery during the rehabilitation period, and management of complications.It focused on analyzing the molecular mechanisms by which components such as 6-gingerol and curcumin to improve cerebral ischemia-reperfusion injury and to promote neural plasticity remodeling through anti-inflammatory,antioxidant,anticoagulant,and neurotrophic pathways.Combining modern nursing practice,it explored the innovative application models of ginger-derived therapies in stroke nursing,including traditional Chinese nursing techniques such as abdominal heat application and acupoint patch application.It provided theoretical basis for the construction of a combined Chinese and western medicine stroke nursing system.

, authors=Minjia GAO, Limin LIU, Xiaoxia WANG, Wanhong WANG, Meijuan ZENG, Lanhua ZENG, Yanjia WU, authorsList=Minjia GAO, Limin LIU, Xiaoxia WANG, Wanhong WANG, Meijuan ZENG, Lanhua ZENG, Yanjia WU, authorCompany=null, correspAuthors=Yanjia WU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322931636744106232, articleId=1322931636224012533, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=生姜及其衍生疗法在脑卒中病人护理中的应用进展, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

综述生姜提取物、外治法及膳食干预在脑卒中急性期神经保护、康复期功能恢复及并发症管理中的临床应用,重点分析6-姜酚、姜黄素等成分通过抗炎、抗氧化、抗凝血及神经营养等途径改善脑缺血再灌注损伤、促进神经可塑性重塑的分子机制。结合现代护理实践探讨生姜衍生疗法在脑卒中护理中的创新应用模式,包括脐部热熨、穴位贴敷等中医护理技术,为构建中西医结合的脑卒中护理体系提供理论依据。

, authors=高敏佳, 刘丽敏, 王晓霞, 王婉红, 曾美娟, 曾兰花, 吴燕佳*, *, authorsList=高敏佳, 刘丽敏, 王晓霞, 王婉红, 曾美娟, 曾兰花, 吴燕佳, authorCompany=null, correspAuthors=吴燕佳, authorNote=

高敏佳,护师,本科

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吴燕佳,E-mail:
WU Yanjia, E-mail:
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生姜及其衍生疗法在脑卒中病人护理中的应用进展
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高敏佳 , 刘丽敏 , 王晓霞 , 王婉红 , 曾美娟 , 曾兰花 , 吴燕佳 *, *
护理研究 | 科研综述 2026,40(12): 2162-2167
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护理研究 |科研综述 2026 , 40 (12) : 2162 -2167
生姜及其衍生疗法在脑卒中病人护理中的应用进展
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高敏佳, 刘丽敏, 王晓霞, 王婉红, 曾美娟, 曾兰花, 吴燕佳*, *
作者信息
  • 1深圳市罗湖区中医院,广东 518000
通讯作者:
吴燕佳,E-mail:
WU Yanjia, E-mail:
作者简介:

高敏佳,护师,本科

Application progress on ginger and its derivative therapies in the nursing of stroke patients
Minjia GAO, Limin LIU, Xiaoxia WANG, Wanhong WANG, Meijuan ZENG, Lanhua ZENG, Yanjia WU
Affiliations
  • 1Luohu District Hospital of Traditional Chinese Medicine of Shenzhen, Guangdong 518000 China
出版时间: 2026-06-25 doi: 10.12102/j.issn.1009-6493.2026.12.022
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综述生姜提取物、外治法及膳食干预在脑卒中急性期神经保护、康复期功能恢复及并发症管理中的临床应用,重点分析6-姜酚、姜黄素等成分通过抗炎、抗氧化、抗凝血及神经营养等途径改善脑缺血再灌注损伤、促进神经可塑性重塑的分子机制。结合现代护理实践探讨生姜衍生疗法在脑卒中护理中的创新应用模式,包括脐部热熨、穴位贴敷等中医护理技术,为构建中西医结合的脑卒中护理体系提供理论依据。

生姜  /  脑卒中  /  神经保护  /  护理  /  综述

This paper reviewed the clinical application of ginger extract,external treatment methods,and dietary intervention in neuroprotection during the acute phase of stroke,functional recovery during the rehabilitation period, and management of complications.It focused on analyzing the molecular mechanisms by which components such as 6-gingerol and curcumin to improve cerebral ischemia-reperfusion injury and to promote neural plasticity remodeling through anti-inflammatory,antioxidant,anticoagulant,and neurotrophic pathways.Combining modern nursing practice,it explored the innovative application models of ginger-derived therapies in stroke nursing,including traditional Chinese nursing techniques such as abdominal heat application and acupoint patch application.It provided theoretical basis for the construction of a combined Chinese and western medicine stroke nursing system.

ginger  /  stroke  /  neuroprotection  /  nursing  /  review
高敏佳, 刘丽敏, 王晓霞, 王婉红, 曾美娟, 曾兰花, 吴燕佳. 生姜及其衍生疗法在脑卒中病人护理中的应用进展. 护理研究, 2026 , 40 (12) : 2162 -2167 . DOI: 10.12102/j.issn.1009-6493.2026.12.022
Minjia GAO, Limin LIU, Xiaoxia WANG, Wanhong WANG, Meijuan ZENG, Lanhua ZENG, Yanjia WU. Application progress on ginger and its derivative therapies in the nursing of stroke patients[J]. Chinese Nursing Research, 2026 , 40 (12) : 2162 -2167 . DOI: 10.12102/j.issn.1009-6493.2026.12.022
脑卒中已成为全球第二大死因及首要致残原因,其高复发率、高致残率给护理工作带来严峻挑战。我国每年新发脑卒中病人人数众多,且发病率呈逐年上升趋势。脑卒中不仅导致病人肢体功能障碍、语言障碍等严重后遗症,还常伴有肺炎、深静脉血栓等并发症,显著降低了病人的生活质量,也给家庭和社会带来了沉重的经济负担[1]。脑卒中急性期如何迅速减轻脑损伤、防止病情恶化是护理工作的首要任务;康复期如何促进病人功能恢复、提高其生活自理能力则是护理工作的重点;而在长期管理阶段如何预防复发、控制并发症、提高病人依从性则是护理工作的难点。传统中医药凭借其独特的理论体系和丰富的实践经验,在脑卒中防治中发挥着越来越重要的作用。中医药强调整体观念,注重辨证施治,通过多靶点、多途径的综合调节能够有效改善脑卒中病人的临床症状和预后[2]。生姜作为药食两用经典药材,在中医药领域有着悠久的应用历史,现代药理学研究进一步揭示了生姜的多种活性成分及其药理作用,为生姜在脑卒中护理中的临床应用提供了科学依据[3]。本研究基于多学科交叉视角,系统梳理生姜及其衍生疗法在脑卒中护理中的应用进展,重点介绍了生姜在脑卒中护理中的具体作用机制,包括抗炎与抗氧化、抗凝血与纤溶平衡调节、神经可塑性促进等方面;汇总了生姜及其衍生疗法在脑卒中急性期神经保护、康复期功能重塑以及长期管理策略中的临床证据,展示了生姜在改善脑卒中病人预后、提高生活质量方面的潜力。深入研究和探索生姜及其衍生疗法的应用价值有望为脑卒中病人提供更加有效、安全的护理方案,减轻病人痛苦,提高其生活质量。
生姜作为药食同源的典型代表,其神经保护作用已成为现代医学研究的热点,生姜中的酚类化合物、多萜类物质等活性成分通过多靶点协同作用,在心脑血管疾病防治中展现出独特优势。本研究结合研究成果与临床观察数据,系统解析生姜活性成分通过抗炎抗氧化、凝血调节及神经可塑性促进三大机制实现神经保护的分子通路与转化应用前景。
生姜中的姜黄素、姜烯酚及6-姜酚等活性成分可通过抑制核因子-κB(NF-κB)信号通路,显著降低脑缺血后白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)等促炎因子表达水平。NF-κB信号通路在炎症反应中起着关键作用,其激活会导致促炎细胞因子的释放,加重神经炎症。而生姜活性成分对NF-κB信号通路的抑制能够有效减轻炎症反应,从而保护神经细胞免受炎症损伤。除此之外,生姜还能通过蛋白激酶B(Akt)抑制和NF-κB激活,触发抗炎细胞因子的释放,同时减少促炎细胞因子[4]。姜黄素作为姜中的主要活性成分之一,具有显著的抗氧化和抗炎作用。研究表明,姜黄素可以减少H₂O₂诱导的神经毒性,抑制炎症,改善记忆和情绪功能,并能减轻神经损伤和神经退行性疾病。在阿尔茨海默病和帕金森病等神经退行性疾病中,姜黄素可以调节炎症系统,维持热休克系统,并减少β淀粉样蛋白和磷酸化tau蛋白的积累。此外,姜黄素还能保护神经元免受重金属、药物和化学物质引起的损伤,并能改善心血管疾病和糖尿病等其他疾病[5]。姜黄素通过激活Nrf2途径,减轻脑损伤、炎症和氧化应激,改善神经元存活。此外,姜黄素还可以抑制NF-κB信号通路,减少炎症反应。在多种动物模型中,姜黄素表现出抗氧化、抗炎和神经保护作用,对多种神经系统疾病具有潜在的治疗价值[6]。姜黄素通过抑制NF-κB和丝裂原活化蛋白激酶(MAPK)信号通路,减少炎症因子的产生,保护神经元免受损伤[7]。
生姜提取物展现双向凝血调节作用,低剂量时通过抑制血栓素A2(TXA2)合成发挥抗血小板聚集效应,高剂量则促进组织型纤溶酶原激活剂(t-PA)分泌增强纤溶活性。TXA2是血小板聚集的重要介质,抑制其合成可减少血小板聚集,降低血栓形成的风险;而t-PA的增加则有助于溶解血栓,恢复血管通畅,维持血液流动的平衡[8]。生姜中含有姜烯酚、姜烯酮,能降低血液黏稠度,减少血小板凝集,预防心脏血管梗死和脑梗死,具有超过阿司匹林的抗凝作用。临床观察显示,脑卒中高危人群每日补充2 g生姜粉可使血浆纤维蛋白原水平降低,D-二聚体下降,其抗凝效果与阿司匹林存在协同作用[9],为联合用药提供理论依据。表明生姜提取物在预防和治疗脑卒中等心脑血管疾病方面具有潜在的应用价值,可作为辅助治疗手段与传统抗凝药物联合使用,提高治疗效果,减少药物副作用。
生姜的活性成分不仅通过抗炎和抗氧化作用保护神经元,还通过促进神经可塑性和神经再生实现神经保护。研究表明,姜中的活性成分如6-姜醇和6-姜酮可以通过激活磷脂酰肌醇3-激酶(PI3K)/Akt信号通路,促进神经生长因子(NGF)的表达,从而增强神经元的存活和突触可塑性。姜黄素还可以通过激活CAMP反应元件结合蛋白/脑源性神经营养因子(CREB/BDNF)信号通路,BDNF是一种重要的神经营养因子,对神经元的生存、分化、突触可塑性等具有关键作用,促进神经元的生长和存活,改善认知功能[10]。研究证实,6-姜酚通过激活Wnt/β-catenin通路增强神经干细胞增殖,为生姜在脑卒中康复期应用奠定分子基础。Wnt/β-catenin通路在神经干细胞的增殖和分化过程中起着重要作用,激活该通路可促进神经干细胞的增殖和神经发生,为脑卒中后神经功能的恢复提供新的细胞来源,有助于促进神经功能的重建和康复[11]。生姜活性成分的神经保护机制是多方面的,通过抗炎与抗氧化双通路调控、抗凝血与纤维蛋白溶解平衡调节以及神经可塑性促进等多种方式共同作用于神经系统,发挥保护神经细胞、改善神经功能、促进神经修复等重要作用,为防治神经系统疾病提供了新的思路和潜在的治疗手段。目前关于生姜活性成分的研究仍在不断深入和探索中,未来还需要更多的临床研究和实验验证,以进一步明确其作用机制和应用价值,为开发新型的神经保护药物提供更充分的依据。
脑卒中急性期神经保护是首要任务,旨在减轻脑损伤、防止病情恶化,并为后续康复奠定基础。生姜及其衍生疗法在这一阶段展现出独特的优势,通过多途径、多靶点的综合作用,为神经保护提供了新的策略。姜黄素作为姜科植物的核心活性成分,其神经保护机制已获多项研究证实。姜黄素快速清除衰老细胞的特性为缩短脑卒中治疗时间窗提供了新思路。姜黄素能够有效清除体内过多的活性氧自由基,减轻氧化应激损伤。脑卒中急性期自由基的大量产生会导致脂质过氧化反应增强,从而破坏细胞膜的稳定性。姜黄素通过激活细胞内的抗氧化酶系统,如超氧化物歧化酶(SOD)、过氧化氢酶(CAT)等抑制脂质过氧化反应,减少细胞膜的损伤,保护神经细胞的完整性[12]。脑卒中后炎症反应会进一步加重脑组织损伤,姜黄素通过抑制炎症信号通路如NF-κB的激活,减少炎症因子如TNF-α、IL-1β和白细胞介素-6(IL-6)的释放,减轻脑组织的炎症损伤[13]。
临床实践中姜黄素与rt-PA溶栓治疗的协同效应表现突出,一项随机对照试验发现联合使用姜黄素可使血脑屏障完整性提高,症状性出血风险降低,其机制可能与抑制基质金属蛋白酶-9(MMP-9)蛋白酶活性、调节闭锁小带蛋白1(ZO-1)蛋白表达密切相关[14]。MMP-9是一种基质金属蛋白酶,在脑卒中后其活性会显著升高,导致血脑屏障破坏,增加脑水肿和出血的风险;ZO-1是一种紧密连接蛋白,对于维持血脑屏障的完整性起着关键作用。姜黄素能够通过抑制MMP-9的活性,维持血脑屏障的完整性,减少脑组织的渗出和水肿,并调节ZO-1蛋白的表达。联合用药方案不仅能够减轻脑组织的炎症反应和氧化应激损伤,还可以改善脑组织的微环境,促进神经细胞的修复和再生。
针对脑卒中后肺炎高发问题,隔姜灸疗法展现出独特优势。临床观察表明该疗法通过刺激风府、廉泉等穴位,能使肺炎发生率下降,同时提升血清IgA水平,增强机体的抗感染能力。IgA在呼吸道和消化道等黏膜部位发挥着重要的免疫防御作用,能够有效阻止病原体的入侵,降低脑卒中后肺炎等感染并发症的发生风险[15]。隔姜灸还能够通过调节Toll样受体4(TLR4)/NF-κB信号通路抑制炎症因子的过度释放,减轻炎症风暴对肺组织的损伤,还可以促进抗炎因子的产生,平衡机体的免疫炎症反应,加速肺炎的恢复过程。
随着治疗重点转向功能恢复,生姜疗法在康复阶段的应用呈现多样化趋势。研究显示,采用生姜精油按摩结合常规康复训练提升偏瘫病人Fugl-Meyer评分,核磁共振成像也显示这种干预能增强初级运动皮层与辅助运动区的功能连接[16]。神经突触可塑性是指神经元之间连接的强度和效能可以发生持久改变的能力,它是学习、记忆以及运动功能恢复的神经生物学基础,AMPK通路在调节细胞能量代谢和结构重塑方面起着重要作用,激活该通路能够促进神经细胞的生长和突触的形成。6-姜酚作为生姜中的主要活性成分之一能通过激活AMPK通路,促进神经突触可塑性,也为运动功能重建奠定基础。生姜精油按摩不仅能够刺激神经系统的功能恢复,还可以改善肌肉的血液循环和代谢,减轻肌肉痉挛和萎缩,增强肌肉的力量和协调性。康复训练中结合生姜精油按摩可以提高训练的效果,促进偏瘫病人运动功能的恢复。
隔姜灸疗法在吞咽功能康复领域也取得突破性进展。随机对照试验证实治疗2周后病人洼田饮水试验改善率达85.3%,且疗效可持续至脑卒中后2个月[17]。脑卒中后吞咽中枢的神经细胞可能会受到损伤,导致吞咽功能障碍。隔姜灸疗法能够促进吞咽中枢的神经可塑性变化,即促使神经细胞之间形成新的连接和通路,代偿受损神经细胞的功能,从而实现吞咽功能的重组和恢复。隔姜灸对特定穴位的刺激,激活三叉神经-孤束核通路,三叉神经是支配咀嚼肌和口腔感觉的重要神经,孤束核则与吞咽反射的整合和调节密切相关,激活这一通路能够增强吞咽反射的敏感性和协调性,促进吞咽功能的恢复。
临床试验数据表明,每日摄入2~3 g生姜粉可使高敏C反应蛋白(hs-CRP)水平降低,颈动脉内膜中层厚度进展延缓[18]。hs-CRP是机体炎症反应的一个敏感标志物,其水平升高与动脉粥样硬化、脑卒中等心血管疾病的发生发展密切相关。颈动脉内膜中层厚度则是评估血管内皮功能和动脉粥样硬化程度的重要指标。生姜中的6-姜烯醇等成分通过激活Nrf2/ARE抗氧化通路,降低hs-CRP的水平,保护血管内皮细胞免受氧化应激损伤,促进血管内皮细胞的修复和再生,改善血管的舒张功能,延缓动脉粥样硬化的进展,从而降低脑卒中复发的可能性。
针对脑卒中合并代谢综合征病人,姜黄素显示出“一药多效”特性。固醇调节元件结合蛋白-1c(SREBP-1c)是一种关键的转录因子,它在调节脂肪酸和三酰甘油的合成过程中起着重要作用,多中心研究证明,姜黄素能够抑制SREBP-1c的表达,减少脂肪酸的合成,降低三酰甘油的水平,改善血脂异常,降低动脉粥样硬化的风险[19]。姜黄素还可以增强葡萄糖转运蛋白4(GLUT4)转运体的活性,提升胰岛素敏感性[18-19]。GLUT4是胰岛素作用下葡萄糖进入细胞的主要转运蛋白,其活性的增强能够促进葡萄糖的摄取和利用,降低血糖水平,改善胰岛素抵抗,对于脑卒中合并糖尿病或代谢综合征病人的病情控制具有重要意义。姜黄素还能够调节肠道菌群的β多样性,减少内毒素入血。肠道菌群失调可能会导致内毒素血症,引发全身性的炎症反应和代谢紊乱,姜黄素通过调节肠道菌群的组成和多样性,增加有益菌的数量,减少有害菌的滋生,降低内毒素的产生和吸收,从而减轻炎症反应,改善代谢综合征相关的症状。
随着对生姜及其衍生疗法研究的不断深入,其在脑卒中病人护理中的应用呈现出多维度的创新发展态势。中医护理技术的优化不仅为脑卒中病人的护理提供了更多元化的手段,也进一步提升了护理的精准性和有效性,在促进病人康复、改善预后等方面发挥作用。中医护理技术蕴含着丰富的理论和实践经验,其与生姜疗法的结合为脑卒中病人带来了独特的护理优势。在众多中医护理技术中,脐部热熨疗法和穴位贴敷方案的优化,成为当前研究和应用的热点。
脐部作为人体重要的穴位集中的部位,具有特殊的生理结构和经络特性,脐部热熨疗法是通过将生姜等药物制成适宜的剂型,利用其药性和温热刺激作用于脐部,从而达到疏通经络、调和气血、健脾和胃等功效。在脑卒中病人的护理中,脐部热熨疗法展现出了多方面的价值。脐部热熨疗法能够改善病人的胃肠功能,脑卒中病人常因长期卧床、神经功能受损等原因出现胃肠功能紊乱,如便秘、食欲缺乏等。研究表明,生姜具有温中散寒、健脾和胃的作用,通过脐部热熨的方式可使药物的有效成分透过皮肤和脐部黏膜迅速吸收,直接作用于相关经络和脏腑[20]。在一项针对脑卒中后便秘病人的临床研究中发现,采用生姜脐部热熨疗法,每日1次、每次30 min,连续治疗7 d后病人便秘症状得到改善,排便频率增加,粪便性状趋于正常,该疗法提高了病人的生活质量,还有助于减轻因胃肠功能障碍导致的营养吸收不良和全身性不适等问题[21]。
脐部热熨疗法对脑卒中病人的肢体功能恢复也有积极影响。中医理论认为经络是沟通人体内外、联络脏腑肢节的通路,气血在经络中运行,滋养全身脏腑组织。脐部热熨通过刺激脐部周围的经络穴位,能够促进气血运行,改善肢体的血液循环和营养供给。有研究指出,生姜中的姜辣素等成分具有刺激血液循环、扩张血管的作用,当其通过脐部热熨进入人体后,可增强肢体的血液灌注,为受损神经和肌肉组织的修复提供有利条件[22]。临床观察显示,结合脐部热熨疗法的脑卒中病人在肢体运动功能恢复方面速度更快,肌力和关节活动度的提升更为明显,这与脐部热熨促进气血运行、改善肢体微循环的机制密切相关[23]。操作过程中脐部热熨疗法通常采用将生姜切片或制成药饼,与适当的辅料如食盐、艾叶等混合后进行热熨,其中温度的控制是关键环节,保证病人脐部皮肤能够耐受且充分发挥药物的热效应[24]。一般而言,热熨温度应保持在40~50 ℃,同时要注意观察病人皮肤的反应,避免烫伤;治疗时间的安排也需根据病人的具体病情和耐受程度进行适当调整,一般每次热熨20~30 min,每日1次或2次,一个疗程为10~15 d。脐部热熨疗法这种持续的、温和的刺激能够逐渐改善病人的机体功能状态,促进脑卒中后的整体康复进程。
穴位贴敷也是一种传统的中医外治法,其原理是将药物直接贴敷于特定的穴位上,通过药物的透皮吸收和穴位的刺激作用,调节机体的气血阴阳平衡,达到治疗和保健的目的[25]。在脑卒中病人的护理中,穴位贴敷方案的优化为神经功能恢复和并发症预防提供了新的途径。穴位贴敷对于脑卒中后遗症期病人能够有效改善肢体麻木、疼痛等症状。选取生姜等具有通络止痛、活血化瘀功效的药物,结合病人的具体症状选择相应的穴位进行贴敷,如肩髃、曲池、合谷等穴位用于上肢症状的改善,环跳、阳陵泉、昆仑等穴位用于下肢症状的缓解[26]。药物在穴位处持续发挥作用,通过刺激穴位周围的神经末梢,促进局部血液循环,缓解肌肉痉挛和神经压迫,从而减轻病人的不适症状。临床研究报道,在脑卒中后遗症期采用生姜等药物穴位贴敷治疗,经过4周的治疗后,病人的肢体麻木、疼痛症状评分降低,肢体活动灵活性提高,表明穴位贴敷在改善脑卒中后遗症方面具有良好的临床效果[27]。
穴位贴敷还对脑卒中病人的睡眠质量有改善作用,脑卒中病人常因病情影响、心理压力等因素出现睡眠障碍,而良好的睡眠对于神经功能的恢复至关重要。研究发现,生姜具有温经散寒、安神助眠的作用,将其与具有镇静安神功效的中药如酸枣仁、茯苓等制成贴敷剂,贴敷于神阙、涌泉、印堂等穴位,能够调节病人的神经系统功能,促进睡眠[28]。研究显示,经过穴位贴敷治疗,病人的睡眠质量评分明显提高,入睡时间缩短,睡眠深度增加,为脑卒中病人的康复营造了良好的生理和心理状态[29]。
穴位贴敷方案的制定过程中需综合考虑病人的个体差异,如体质、病情程度、穴位敏感度等,并注意药物贴敷的时间和频率[30],一般每次贴敷4~8 h,每日1次,根据病人的反应和耐受程度适当调整。贴敷期间要注意观察病人贴敷部位的皮肤情况,防止出现过敏、破溃等问题,确保穴位贴敷的安全性和有效性[31]。
随着生姜及其衍生疗法在脑卒中护理领域的应用日益广泛,深入探讨相关的科学问题和明确未来的护理研究方向成了推动该领域进一步发展的关键环节。
在生姜及其衍生疗法应用于脑卒中病人的实践中,揭示关键科学问题对于确保其安全性和有效性至关重要。剂量与效应之间的关系是决定治疗效果和安全性的重要因素,生姜含有姜辣素、6-姜酚等多种活性成分,不同成分具有不同的药理作用和药物代谢动力学特性。6-姜酚具有显著的神经保护作用,但由于血脑屏障的存在,其在脑组织中的浓度可能影响最终疗效。研究发现,6-姜酚在一定剂量范围内能够有效通过血脑屏障,并在脑内达到有效浓度发挥抗氧化、抗炎等作用[32],但过高剂量可能会引发不良反应或毒性,所以确定各活性成分的最小有效剂量和最大安全剂量对于制定精准的用药方案具有重要意义[33]。此外,不同给药途径(如口服、注射、外敷)对生姜活性成分的吸收和利用存在显著差异,需进一步探索以优化临床剂量指导[34-35]。
生姜提取物与常用药物之间的相互作用也是临床应用中必须关注的问题。生姜具有抗凝血作用,其与抗凝药物(如华法林、阿司匹林)联合使用时可能导致出血风险增加[36]。临床研究显示,同时使用生姜和华法林的病人国际标准化比值(INR)有升高的趋势,提示凝血功能受到干扰,生姜中的某些成分还可能影响细胞色素P450酶系,干扰华法林的代谢过程,导致其在体内浓度升高,抗凝效果增强[37]。而且生姜可能通过影响血管紧张素转换酶(ACE)或钙离子通道等机制与降压药产生协同作用,增强降压效果,可能导致血压过度降低[38],所以系统评估生姜提取物与抗凝药、降压药等的相互作用机制,对于指导临床合理用药、降低不良反应风险具有重要意义。
老年病人及肝肾功能不全者对生姜及其衍生疗法的应用也需要谨慎,老年病人药物代谢和排泄能力下降,对药物的耐受性和反应性与年轻人存在差异。肝肾功能不全病人因代谢和排泄功能受损也可能引发药物毒性反应,肝病病人使用生姜提取物时可能因肝脏解毒能力不足而导致药物蓄积,加重肝脏损伤,所以还需针对特殊人群制定个体化用药指南,明确适宜的剂量范围、用药频率和疗程,并密切监测生理指标和不良反应,确保治疗的安全性。
精准护理是当前护理领域的发展趋势,将生姜代谢组学研究与基因多态性分析相结合,可实现对脑卒中病人的个体化精准干预[39]。代谢组学研究能揭示生姜在体内的代谢过程和代谢产物的变化,而基因多态性则影响药物的代谢酶、转运体和受体功能,导致个体对生姜治疗的反应存在差异,结合病人的基因检测信息可建立基于基因多态性的个体化干预方案,预测疗效和不良反应风险,为每位病人量身定制最合适的治疗方案[40]。
构建脑卒中病人生姜疗法数据库也是护理研究的重要方向,数据库可整合来自临床实践、实验研究、病人随访等多渠道的数据资源,包括病人的基本信息、病情特征、生姜治疗方法、治疗效果和不良反应等[41]。对海量数据的收集、整理和分析,再利用机器学习算法挖掘数据中的潜在规律和关联能为优化护理路径提供科学依据。如分析大量病人的治疗数据识别影响生姜疗法疗效的关键因素,建立预测模型,为临床决策提供参考。基于大数据分析的结果还能够优化护理流程,提高护理效率和质量,促进护理经验的共享和传播,推动护理技术和方法的不断创新和进步。
生姜及其衍生疗法在脑卒中护理中展现出多靶点作用机制,包括抗炎与抗氧化、抗凝血与纤溶平衡调节及神经可塑性促进,临床研究显示其在急性期神经保护、康复期功能恢复及并发症管理中均有效。脐部热熨疗法、穴位贴敷方案等方式为脑卒中病人提供个性化护理。未来研究需进一步明确剂量效应关系、药物相互作用及特殊人群应用注意事项,同时构建生姜疗法数据库,推动护理技术与方法创新,以提升护理效率和质量,促进中西医结合的脑卒中护理体系发展。

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doi: 10.12102/j.issn.1009-6493.2026.12.022
  • 接收时间:2025-06-16
  • 首发时间:2026-10-30
  • 出版时间:2026-06-25
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  • 收稿日期:2025-06-16
  • 修回日期:2026-06-04
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    1深圳市罗湖区中医院,广东 518000

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吴燕佳,E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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