Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline. Its pathological mechanisms are complex, involving multiple key links such as beta-amyloid protein (Aβ) deposition, excessive phosphorylation of Tau protein, neuroinflammation and synaptic dysfunction. Traditional Chinese medicine (TCM) categorizes AD under conditions like “dementia” and “forgetfulness”, with the core pathogenesis being “deficiency at the root and excess at the surface”, where kidney essence deficiency is the root cause and phlegm turbidity and blood stasis obscuring the orifices are the surface manifestations. As a distinctive TCM therapy, aromatic orifice-opening drugs, with their pungent, fragrant and penetrating nature that can reach and regulate meridians, follow the principle of “awakening the orifices and refreshing the mind, resolving phlegm and dispelling foulness”, demonstrating unique advantages in the prevention and treatment of AD. Representative drugs include Shichɑngpu (Acori Tatarinowii Rhizoma), Yuanzhi (Polygalae Radix), Shexiang (Moschus), Bingpiɑn (Borneolum Syntheticum), etc. Modern pharmacological research has revealed their multi-target intervention potential, including inhibiting Aβ generation and aggregation, reducing Tau protein phosphorylation, anti-neuroinflammation, anti-oxidative stress, and regulating neurotransmitters and promoting neurogenesis. Commonly used TCM formulas with the effect of aromatic orifice-opening such as Angong Niuhuang Pill (安宫牛黄丸), Suhexiang Pill (苏合香丸) and Changpu Yujin Decoction (菖蒲郁金汤) have shown good efficacy in improving patients’ cognitive function, memory, and daily living abilities through compatibility and synergy. This review systematically summarizes the research and application status of aromatic orifice-opening drugs in the prevention and treatment of AD, providing theoretical basis and practical references for the intervention of AD by aromatic orifice-opening TCMs.

Alzheimer’s disease  /  aromatic orifice-opening drugs  /  compatibility of traditional Chinese medicine  /  Acori Tatarinowii Rhizoma  /  Polygalae Radix  /  Moschus  /  Borneolum Syntheticum