Abstract：
The use of medicinal leeches in clinical therapy has been employed for a long time, as it was originally recognized for exerting antithrombin effects. These effects were due to the ability of the leech to continuously suck blood while attached to human skin. According to Chinese Pharmacopoei, leeches used in traditional Chinese medicine mainly consist of Whitmania pigra Whitman, Hirudo nipponia Whitman, and Whitmania acranulata, but the latter two species are relatively scarce. The main constituents of leeches are protein and peptide macromolecules. They can be categorized into two categories based on their pharmacological effects. One group consists of active ingredients that directly target the coagulation system, such as hirudin, heparin, and histamine, which are widely known. The other group comprises protease inhibitor components like Decorsin and Hementin. Among these, hirudin secreted by the salivary glands of the leech is the most potent thrombin inhibitor and served as the sole remedy for preventing blood clotting until the discovery of heparin. Additionally, leeches play a significant role in various traditional Chinese medicine formulations. In recent decades, medicinal leeches have been applied in fields including anti-inflammatory treatment, cardiovascular disease management, antitumor treatment, and many other medical conditions. In this review, we present a comprehensive overview of the historical journey and medicinal applications of leeches in various medical conditions, emphasizing their pharmaceutical significance within traditional Chinese medicine. This review offers valuable insights for exploring additional therapeutic opportunities involving the use of leeches in various diseases and elucidating their underlying mechanisms for future research.
摘要：
在临床治疗中使用药用水蛭已经有很长时间了，因为它最初被认为具有抗凝血酶作用。这些作用是由于水蛭在附着于人类皮肤时持续吸血的能力。根据中国药典，中药中使用的水蛭主要包括惠特曼，HirudoNipponiaWhitman,和尖刺Whitmania,但是后两个物种相对稀缺。水蛭的主要成分是蛋白质和肽类大分子。根据它们的药理作用可以将它们分为两类。一组由直接靶向凝血系统的活性成分组成，比如水蛭素，肝素,和组胺,这是众所周知的。另一组包括蛋白酶抑制剂组分如Decorsin和Hementin。其中,水蛭唾液腺分泌的水蛭素是最有效的凝血酶抑制剂，在发现肝素之前，它是防止血液凝固的唯一药物。此外,水蛭在各种中药配方中起着重要作用。近几十年来,药用水蛭已应用于抗炎治疗等领域，心血管疾病管理，抗肿瘤治疗，和许多其他医疗条件。在这次审查中,我们全面概述了水蛭在各种医疗条件下的历史历程和药物应用，强调其在中药中的药学意义。这篇综述为探索涉及在各种疾病中使用水蛭的其他治疗机会以及阐明其未来研究的潜在机制提供了宝贵的见解。
