以西班牙病理学家卡哈尔的神经元学说为根基的西方脑科学和脑病研究已发展100多年,然而,研究结果与人们的预期相差甚远。尽管微环境概念已提出150多年,但在脑科学领域,人们始终将研究的焦点集中在神经元上,而在活体上占据脑容积20%的脑细胞外间隙一直未受到重视。通过系统综述脑缺血性中风神经治疗研究的发展历程,分析了神经元学说体系下脑卒中神经保护药物研发失败的原因和重视脑细胞外间隙研究的重要意义,阐述以神经元为脑的唯一代理的神经元学说的潜在漏洞,论述了脑细胞微环境研究的广阔应用前景,提出脑细胞生存微环境研究是神经元学说不可或缺的重要补充,是脑科学未来的研究方向和重点。
In the neuroscience, the neuron doctrine has been considered as the gold standard for more than 100 years. In the meantime, unfortunately, the achievements during past several decades have been proved to be far away from what would have been expected: the mystery of human's memory and emotion is still an open question, and the Alzheimer's disease and the stroke etc. still cause the disability and crush the dignity of human beings. Although Claude Bernard had stressed the importance of the internal environment 150 years before, not much attention has been paid to the micro-environment around neurons (brain extracellular space), although this space occupies about 20% of the brain volume in vivo. The significance of the micro-environment of neurons is emphasized in this paper based on a review and analysis of the unsuccessful investigations on neuro-protective agents against cerebral ischemic stroke. The defects of neuron's doctrine are discussed. The nature of the micro-enviorment around neurons is a neglected issue in the neuroscience for a long time and it will be an indispensable complement of the neuron's doctrine.