摘要
抽动障碍是一种起病于儿童时期的神经发育障碍性疾病,与多种神经化学和神经递质异常有关。现用于抽动障碍治疗的药物主要在于调节神经递质失衡。总结了近年来针对中西药如何调控神经递质治疗抽动障碍的基础实验和临床研究,综述了治疗抽动障碍的研究进展。结果表明,抽动障碍的治疗总体可能与降低兴奋性神经递质的含量以及增加抑制性神经递质的含量有关。然而,于抽动障碍患儿临床不建议进行常规脑脊液检测分析以及腰椎穿刺,很少获取脑脊液进行神经递质含量的检测,跨血脑屏障的神经递质比例也未明确。建议未来研究能进一步建立中西药影响抽动障碍患儿血浆,尤其脑脊液神经递质水平的暴露-效应关系模型,在模型引导下通过调节神经递质水平实现阿立哌唑精准用药,进一步揭示抽动障碍的发病机制及为临床应用中西药治疗抽动障碍的作用机制提供理论依据。
Tic disorder is a neurodevelopmental disorder disease that originates in childhood,and more recognized pathogenesis is the dysfunction of the dopaminergic basal ganglion circuit,which is related to a variety of neurochemical and neurotransmitter abnormalities.The drugs currently used for the treatment of tic disorder mainly aim at modulating neurotransmitter imbalances.This article summarizes the recent basic experimental and clinical research on how Chinese and western medicines regulate neurotransmitters in the treatment of tic disorder,and reviews the research status and progress of the treatment,so as to further reveal the pathogenesis of tic disorder and provide a theoretical basis for the clinical application of western medicine in the treatment of tic disorder.The results suggest that the treatment of tic disorder may be related to a decrease in the amount of excitatory neurotransmitters as a whole,as well as an increase in the amount of inhibitory neurotransmitters.However,due to the clinical dispensation of routine cerebrospinal fluid(CSF)and the invasive nature of lumbar puncture,CSF is rarely obtained for neurotransmitter content in children with tic disorder,and the proportion of neurotransmitters across the blood-brain barrier is not clear.It is expected that future studies can further establish a model of the exposure-effect relationship between Chinese and western medicines on plasma,especially cerebrospinal fluid neurotransmitter levels in children with tic disorder,and realize the precise administration of aripiprazole by adjusting the neurotransmitter levels under the guidance of the model.
作者
陈惠敏
龚宇
钱乔乔
刘智胜
何丽云
CHEN Huimin;GONG Yu;QIAN Qiaoqiao;LIU Zhisheng*;HE Liyun(Department of Neurology,Wuhan Children's Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430016,China;Department of Integrated Traditional Chinese and Western Medicine,First Clinical Medical College,Shaanxi University of Traditional Chinese Medicine,Xianyang 712046,China;Institute of Clinical Basic Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《科技导报》
CAS
CSCD
北大核心
2024年第21期39-46,共8页
Science & Technology Review
基金
湖北省科技计划项目(2022DCC020)
武汉市卫生健康委员会科研计划资助项目(WX20A13)
中国中医科学院科技创新工程课题(CI2021A00509)。
关键词
中西药
抽动障碍
神经递质
阿立哌唑
CSTC环路
Chinese and Western medicines
tic disorder
neurotransmitter
aripiprazole
cortical-striatum-thalamic-cortical circuit
