摘要
抑郁症是在目前社会快速发展过程中、生活压力增大的背景下存在的严重影响人类生活的精神类疾病,给人类社会带来了严重的健康问题及经济负担。中药方剂在治疗抑郁症方面具有较长的历史,而逍遥散作为干预抑郁症的经典方剂已被临床反复证实,但其抗抑郁作用机制及其有效成分尚不清楚。通过检索中国知网(CNKI)和Pub Med数据库对近10年来国内外研究逍遥散及类方干预抑郁症的临床及作用机制研究的文献和资料进行系统梳理,发现逍遥散及其类方主要是从调节下丘脑-垂体-肾上腺轴、下丘脑-垂体-甲状腺轴和下丘脑-垂体-性腺轴,影响海马5-羟色胺(5-HT),去甲肾上腺素(NE)神经递质、干预炎症反应过程、调节脑源性神经营养因子/环磷酸腺苷反应元件结合蛋白(BDNF/CREB)信号通路、调节肠道菌群及胃肠功能、调控肝窦内皮窗孔、修复慢性应激所致血脑屏障的通透性、影响自噬减轻神经元凋亡、对蓝斑核-去甲肾上腺(LC-NE)系统的调节作用等方面发挥抗抑郁的作用。主要有效成分是下调白细胞介素表达水平的柴胡皂苷A,减轻HPA轴功能障碍的柴胡皂苷D,抑制促肾上腺皮质激素释放因子(CRF) m RNA表达的槲皮素、调节神经递质的芍药苷、抑制HPA轴功能亢进的芍药内酯苷、减少炎症细胞因子白术内酯Ⅰ,白术内酯Ⅱ,白术内酯Ⅲ,减少促炎细胞因子m RNA的表达和抑制核转录因子-κB(NF-κB)激活的姜黄素、神经保护作用以及抗炎抗氧化的阿魏酸、抑制HPA轴过度活化的左旋薄荷酮、调节单胺类神经递质的甘草苷、异甘草苷、抑制单胺氧化酶的异甘草素等。
Depression is a psychiatric disease that seriously affects human life in the context of rapid social development and increased living pressure,and brings serious healthproblems and economic burdens to human society. Traditional Chinese medicine has a long history in the treatment of depression,and Xiaoyaosan has been repeatedly confirmed as a classic prescription for the intervention in depression,but its antidepressant mechanism and its active ingredients are still unclear. Through the search of China Knowledge Network (CNKI)and PubMed database,the literature and data on the clinical and mechanism research of Xiaoyaosan and its analogous prescriptions on depression in the past 10 years are systematically sorted out. It is found that Xiaoyao San and its analogous prescriptions are mainly focusing on the following aspects: regulating hypothalamic-pituitarygonad, hypothalamic-pituitary-thyroid, and hypothalamic-pituitary-adrenal axis, affecting 5-hydroxytryptamine( 5-HT),norepinephrine( NE) neurotransmitters in hippocampus,interfering with inflammatory reaction process,modulating the BDNF/CREB signaling pathway,regulating intestinal flora and gastrointestinal function,regulating endothelial window foramen of hepatic sinus,repairing chronic stress-induced blood-brain barrier permeability,affecting autophagy to reduce neuronal apoptosis,and regulating the leukoplakia-nuclear adrenal gland( LC-NE)system to play an antidepressant role. The main active ingredient including,saikosaponin A which could downregulate interleukin expression level,saikosaponin D which alleviates HPA axis dysfunction,quercetin which inhibits corticotropin-releasing-factor( CRF) mRNA expression,paeoniflorin which regulates neurotransmitters,and paeoni lactone which inhibits hyperfunction of HPA axis Glycosides, reduce inflammatory cytokines,atractylenolide I,atractylenolide Il,atractylenolide Ill,which could reduce the expression of pro-inflammatory cytokine mR NA and inhibit NF-κB activated,curcumin which could play the neuroprotective and ant
作者
李传朋
刘玉
魏品球
吴海滨
秦秀德
LI Chuan-peng;LIU Yu;WEI Pin-qiu;WU Hai-bin;QIN Xiu-de(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518000,China;The Fourth Clinical College of Guangzhou University of Chinese Medicine,Shenzhen 518000,China;92914 Military Hospital,Lingao 571820,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2020年第6期243-250,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
深圳市科创委课题(JCYJ20180302173504891)
深圳市“医疗卫生三名工程”项目(SZSM201612081)。
关键词
逍遥散
抗抑郁
作用途径
有效成分
研究进展
Xiaoyaosan
antidepressant
pathway of action
active ingredients
research progress
