目的:探究补阳还五汤对脑出血大鼠脑组织磷脂酰肌醇3-激酶/蛋白激酶B(phosphoinositide 3-kinase/protein kinase B,PI3K/AKT)信号通路、水通道蛋白4(aquaporin-4,AQP4)的影响,阐明作用机制,为脑出血所致脑水肿治疗提供明确的方向与靶点。方法:SD大鼠随机分为6组:假手术组、模型组、补阳还五汤低、中、高剂量组、银杏叶片组,采用Rosenberg法复制大鼠脑出血模型,免疫组化法检测PI3K、AKT蛋白表达,免疫荧光法检测水通道蛋白AQP4“极性”表达,分光光度法检测脑组织伊文思蓝(Evans Blue,EB)含量,干湿重法测定脑组织水含量。结果:与模型组比较,补阳还五汤组、银杏叶片组PI3K、AKT蛋白表达显著升高(P<0.05),AQP4在星胶细胞终足膜上的集中表达程度显著升高(P<0.05),EB含量、脑组织含水量显著降低(P<0.05)。结论:补阳还五汤对脑出血的保护作用机制可能与其能够激活PI3K/AKT信号通路,调控AQP4的“极性”表达,降低血脑屏障通透性,减轻脑水肿有关。 Objective: To investigate the effects of Buyang Huanwu Decoction (SDBS) on phosphoinositide 3-kinase / protein kinase B (PI3K / AKT) signal pathway, aquaporin- 4, AQP4), clarify the mechanism of action, provide a clear direction and target for the treatment of cerebral edema caused by cerebral hemorrhage. Methods: SD rats were randomly divided into 6 groups: sham operation group, model group, BUYH low, medium and high dose groups, Ginkgo biloba group, Rosenberg method was used to establish the model of intracerebral hemorrhage in rats. Immunohistochemistry The protein expression of PI3K and AKT was detected by immunohistochemistry. The expression of aquaporin AQP4 was detected by immunofluorescence method. The content of Evans Blue (EB) in brain tissue was detected by spectrophotometry. The water content of brain tissue was determined by wet and dry method. Results: Compared with the model group, the expression of PI3K and AKT in Buyang Huanwu Decoction group and Ginkgo biloba group were significantly increased (P <0.05), and the expression of AQP4 in the terminal apical membrane of astrocytes was significantly increased (P < 0.05), EB content, brain water content decreased significantly (P <0.05). Conclusion: The protective mechanism of Buyang Huanwu Decoction on intracerebral hemorrhage may be related to its ability to activate PI3K / AKT signaling pathway, regulate the “polarity” expression of AQP4, decrease the permeability of blood-brain barrier and reduce cerebral edema.