脑-平滑肌轴：假说及其与肝藏象／抑郁症共病的关系  

Brain-Smooth Muscle Axis:A Hypothesis and Its Interrelation with the Liver Visceral Manifestation Theory of Traditional Chinese Medicine or Comorbid Depression

作　　者：黄熙[1] 王杨[1] 张英进[1] 任平[1] 张海男[1] 

机构地区：[1]中南大学湘雅医院中西医结合研究所国家中医药管理局肝藏象重点研究室,长沙410008

出　　处：《世界科学技术-中医药现代化》2011年第2期221-225,共5页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金(81072967):从脑肠轴异常-肝郁脾虚途径研究逍遥散抗抑郁促胃肠动力的分子机制,负责人:任平;国家自然科学基金(30572339):丹参与柴胡复方质量控制成分的药理学基础,负责人:黄熙;国家中医药管理局肝藏象重点研究室经费资助,负责人:黄熙

摘　　要：脑-平滑肌轴是指在特有脑区与平滑肌之间存在一个双向性地影响、反馈与调节的神经内分泌通路，通过一些局部的CYP酶与内源性活性物质，在中枢与器官／血管平滑肌之间进行调节，主要应对一些应激性疾病（特别是抑郁症共病）。证据：①抑郁症中40％～50％伴消化道躯体症状；功能性下丘脑闭经主要伴随抑郁；抑郁症夜尿〉常人3～6倍；心脑缺血引起抑郁等，共同的病理生理之一是脑-内脏或血管平滑肌障碍；②疏肝理气方药能够同步抗抑郁促肠蠕动、舒缩血管，从而突破当代一线SSRIs抗抑郁抑动力瓶颈，且吸收成分在海马、肠与血管壁富集；③枢纽：抑郁症共病与肝藏象（主疏泄情绪、消化与生殖，并藏血）的关键是B-SM轴异常；④其他如脑-肠轴、脑-皮肤轴只有中枢端（脑）共同，外周各异，BSM轴两端一致，反映共性病理生理本质。上述假说的完善与求证将为抑郁症与肝藏象的研究作出重要贡献。Brain-smooth muscle （BSM） axis refers to a bidirectionally influence and modulatory pathway between encephalic region and smooth muscle. Via local cytochrome P450 enzyme and endogenous active material, stress reaction between brain and vascular or visceral smooth muscle were modulated, specially implicated depressive comorbidities. Evidence provided by publications and recent experiments of this research group showed that firstly 40- 50% depression is comorbidity of functional gastrointestinal disorders ; a frequent comordibity of functional hypothalamus amenorrhea and depression; depression increases a 3 to 6 fold of nocturia than healthy people; myocardial and cerebral ischemia induce depression. Comorbidity mentioned above specially implicated simultaneous disorders of brain and vascular or visceral smooth muscle. Secondly, a traditional Chinese medicine formula is simultaneously effective as an anti-depressive, prokinetic and vasoactive, which highlights the therapeutic mechanism of modern antidepressive serotonin and noradrenaline reuptake inhibitor. Absorbed bioactive compounds in hippocampus, intestine and vessel wall were detected after oral administration of the formula and forced swimming rat. Thirdly, both sides of BSM axis are the same, suggesting the common pathophysiological mechanism. Among four axes, only ＂brain＂, one side of axis, is the same and other sides are different. Fourthly, the pivotal role is that one of the important pathogenetic mechanisms on liver visceral manifestation of TCM theory and stress disease is the disorder of BSM axis. The validation and improvement of BSM axis hypothesis contribute much to the study of depression, stress diseases and liver visceral manifestation in TCM.

关 键 词：脑 平滑肌 抑郁症共病 肝藏象 脑-平滑肌轴 

分 类 号：R972[医药卫生—药品]