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Cerebral hemorrhage is one of the most critical neurological emergencies and a leading cause of death and disability in adults. In recent years, its incidence has been rising annually, yet mortality and disability rates remain alarmingly high. In the search for effective treatments for cerebral hemorrhage, the traditional Chinese medicinal herb Shuizhi (leech) has attracted increasing attention from medical researchers due to its unique property of promoting blood circulation and removing blood stasis. Based on multiple scientific studies, including the experimental research on the therapeutic effects of leeches on cerebral hemorrhage, and drawing upon real clinical cases, this article systematically elaborates on the significant role of leeches in treating cerebral hemorrhage.

The experimental study on the therapeutic effects of leeches on cerebral hemorrhage was conducted by a domestic medical research team. In this study, 56 SD rats were used to establish an animal model of cerebral hemorrhage by injecting autologous blood into the left caudate nucleus using a stereotaxic instrument. The rats were randomly divided into six groups: a high-dose leech treatment group (equivalent to 900 mg/kg crude drug), a medium-dose group (450 mg/kg), a low-dose group (225 mg/kg), as well as 7-day and 14-day experimental control groups, and a sham operation group.

The researchers systematically observed the effects of leech treatment on neurological deficits, brain water content, biochemical parameters in brain tissue (including superoxide dismutase [SOD] and malondialdehyde [MDA]), blood hormone levels (T3, T4, growth hormone [GH], prolactin [PRL], etc.), and histopathological changes in brain tissue across all groups.

The results were highly encouraging. Neurological function recovery in the leech-treated groups was significantly accelerated, and the restoration of abnormal blood levels of T3, T4, GH, and PRL was also markedly superior to that of the control group. At the brain tissue level, the decrease in SOD activity and the increase in MDA content were significantly attenuated in the leech-treated groups, indicating that leeches can effectively mitigate oxidative stress damage in brain tissue.

Histopathological examination further revealed the therapeutic mechanism of leeches: brain edema was significantly reduced, neuronal ischemic necrosis was diminished, and the numbers of newly formed capillaries, phagocytes, and astrocytes increased significantly, with increased glial fiber production. Notably, the high-dose treatment group exhibited the most pronounced effects, demonstrating a clear dose-response relationship.

An independent study reached similar conclusions. By injecting thrombin into the rat brain to establish a brain edema model, researchers found that in the leech-treated group, neurological deficit scores and perihematomal brain water content, as well as Na⁺ and Ca²⁺ levels, were significantly reduced, while K⁺ levels were markedly increased. This study confirmed that thrombin released during the blood coagulation process after cerebral hemorrhage is a key factor in causing brain edema, and that leeches can effectively treat thrombin-induced brain edema while also dissolving clots and improving microcirculation.

The core component responsible for leeches' therapeutic effects is hirudin — a natural polypeptide isolated from the salivary glands of leeches. Modern pharmacological studies have revealed that hirudin exerts its preventive and therapeutic effects on cerebral hemorrhage through multiple pathways:

• Antithrombin activity: directly inhibiting the toxic effects of thrombin

• Inhibition of apoptosis: regulating the expression of apoptosis-related proteins and reducing neuronal cell death

• Reduction of oxidative stress: protecting brain tissue from free radical damage

• Suppression of inflammatory responses: mitigating inflammatory damage following cerebral hemorrhage

• Inhibition of aquaporin-4 expression: reducing brain edema

• Prevention of glial fibrillary acidic protein upregulation: inhibiting excessive reactive gliosis and protecting neural tissue

Researchers including Zhang Ying used hirudin to treat rats with acute experimental cerebral hemorrhage and found that 10 U of hirudin could significantly reduce pathological changes such as perihematomal edema, glial cell swelling, and neuronal necrosis. Early administration of hirudin, in conjunction with control of brain edema, can reduce acute-phase brain tissue injury, potentially shorten the disease course, and improve prognosis.

From December 1983 to June 1985, a medical institution used the traditional Chinese medicine leech to treat 48 patients with cerebral hemorrhage. Clinical observations demonstrated that leeches could promote the absorption of intracranial hematomas and improve neurological function, thereby reducing mortality and disability rates.

A study focusing on hypertensive cerebral hemorrhage with intracerebral hematoma included 10 patients (8 males and 2 females, all over 45 years of age). All patients were diagnosed through clinical manifestations, lumbar puncture, cerebral angiography, and CT scans. Following leech therapy, patients achieved favorable outcomes in both hematoma absorption and neurological function recovery.

This is a representative success story. Patient Liu, a 63-year-old male with an 18-year history of hypertension and cerebral arteriosclerosis, suddenly collapsed and lost consciousness due to emotional agitation, accompanied by facial distortion, left-sided hemiplegia, and slurred speech. Cranial CT confirmed a 1.6 cm * 2.7 cm hematoma in the right cerebral parenchyma, and a diagnosis of cerebral hemorrhage was established.

After initial symptomatic treatment, the patient survived but remained hemiplegic on the left side for two months, with muscle strength of Grade I in both the left upper and lower limbs. Subsequently, on top of conventional herbal decoctions, the attending physician administered raw leech powder in capsules at a dose of 5 g twice daily.

After 20 days of treatment, the patient's speech became clearer, facial distortion was less noticeable, upper limb muscle strength recovered to Grade III, and lower limb muscle strength recovered to Grade IV. After another month of continued treatment, basic limb function was restored, and follow-up cranial CT showed complete absorption of the intracranial hematoma.

The attending physician, Professor Yang Muxiang, pointed out: Leeches can break up blood stasis without damaging healthy blood, making them particularly suitable for treating cerebral hemorrhage. Leech medicine is mild in nature, possesses powerful stasis-removing effects with virtually no adverse effects on vital energy. The earlier it is administered, the faster the absorption of intracranial hematoma and the recovery of neurological function, which can reduce disability and mortality rates.

A larger-scale clinical study enrolled 425 patients with spontaneous cerebral hemorrhage, randomly divided into a treatment group (308 cases) and a control group (117 cases). The treatment group received intravenous infusion of hirudin injection, and the results showed that hirudin could effectively promote hematoma absorption, reduce the perihematomal low-density area, and facilitate neurological function recovery.

Another clinical study randomly divided cerebral hemorrhage patients into a treatment group and a control group. The treatment group received Shuxuetong and leech capsules in addition to conventional therapy. On day 14 and day 21 post-treatment, CT examination revealed that the hematoma volume and perihematomal low-density area in the treatment group were significantly reduced (P<0.01), and the neurological deficit scores were markedly decreased. The study concluded that leech capsules can promote hematoma absorption, reduce brain edema, and facilitate neurological function recovery.

In summary, multiple scientific studies — from the experimental research on the therapeutic effects of leeches on cerebral hemorrhage to clinical observations — have systematically confirmed, from the molecular level to histopathological levels, the significant therapeutic effects of leeches on cerebral hemorrhage. Leeches and their core component hirudin exert therapeutic effects through multiple mechanisms including anticoagulation, anti-apoptosis, antioxidant, anti-inflammatory, and brain edema reduction, effectively promoting hematoma absorption, protecting neuronal cells, and improving neurological function.

Over more than four decades of clinical practice since 1983, the application of leeches in the treatment of cerebral hemorrhage has been continuously expanded and deepened. Whether supported by data from experimental studies or evidenced by real-world clinical outcomes, it is fully demonstrated that: leeches are an indispensable and powerful therapeutic agent in the treatment of cerebral hemorrhage.

Jingzhou MinKang Biotechnology Co., Ltd. is deeply committed to leech farming and deep processing, dedicated to providing high-quality leech raw materials and deep-processed products for the pharmaceutical and healthcare industry. Guided by science and rooted in quality, we will continue to advance the role of leeches — a treasured component of traditional Chinese medicine — in contributing greater value to modern medicine.