抗抑郁仲景方药的作用机制研究进展  

Action Mechanisms of Zhongjing’s Antidepressant Prescriptions:A Review

作　　者：尚立芝[1] 李耀洋 谢文英[1] 李瑞琴[1] SHANG Li-zhi;LI Yao-yang;XIE Wen-ying;LI Rui-qin(Academy of Chinese Medical Sciences,The First Clinical School,College of Traditional Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学中医药科学院,第一临床医学院中医学院,郑州450046

出　　处：《中国实验方剂学杂志》2021年第24期25-32,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省高等学校重点科研项目(20B360011,21A630020);河南省科技攻关计划项目(1721023110195);河南省大学生创新创业训练计划支持项目(S202010471003)。

摘　　要：抑郁症以高发病率、高复发率及高致残率威胁人类健康。目前抑郁症的病因复杂,发病机制不清,主要涉及单胺类神经递质及其受体异常、下丘脑-垂体-肾上腺(HPA)轴亢进、炎症、神经元损伤与重塑等假说。基于发病机制的抗抑郁化药有一定的疗效,但存在治愈率低、依从性低、停药后复发及不良反应大等问题。抑郁症在仲景理论中属于郁证、脏躁、不寐、百合病等,病位主要在肝,涉及脾、心、肾三脏,病机主要为气机郁滞、脏腑失调,治宜理气解郁、调畅气机。抗抑郁仲景方药治疗抑郁症的临床疗效显著,体现出多途径作用的特点和优势。本文基于抑郁症发病机制,梳理并总结了近20年来仲景方药干预抑郁症的国内外文献,从实验和临床研究方面对仲景方药干预抑郁症的作用机制进行综述,以期为临床治疗抑郁症提供借鉴。Depression is a threat to human health due to high incidence,recurrence,and disability rates.At present,the complex etiology and pathogenesis of depression are still unclear,and such hypotheses as monoamine neurotransmitters and their receptor abnormality,hyperactivity of hypothalamic-pituitary-adrenal(HPA)axis,inflammation,and neuron damage and remodeling have been put forward.Anti-depressants developed based on the pathogenesis have a certain effect,but there also exist some problems like low cure rate,poor compliance,relapse after discontinuation,and obvious side effects.According to Zhongjing’s theory,depression falls into the categories of depression syndrome,visceral agitation,insomnia,and lily disease,and it is mainly located in the liver,involving the spleen,heart,and kidney.The pathogenesis mainly lies in qi stagnation and zang-fu organ dysfunction.Attention should be focused on regulating qi and relieving depression.Zhongjing’s antidepressant prescriptions have exhibited good clinical efficacy in the treatment of depression,reflecting the multi-pathway action advantages of Chinese herbs.Based on the pathogenesis of depression and domestic and foreign literature on the intervention of depression with Zhongjing’s prescriptions available in the past 20 years,this paper summarized the mechanisms of Zhongjing’s prescriptions against depression from the experimental and clinical research aspects,in order to provide reference for clinical treatment of depression with Zhongjing’s prescriptions.

关 键 词：抑郁症 仲景方药 多靶点 发病机制 研究进展 

分 类 号：R2-0[医药卫生—中医学] R289