地黄及其传统复方防治抑郁症研究  

Research on Dihuang(Rehmanniae Radix)and Its Traditional Prescriptions in Prevention and Treatment of Depression

作　　者：张月月[1] 武占娟 王君明[1,3] 巫晓慧 ZHANG Yueyue;WU Zhanjuan;WANG Junming;WU Xiaohui(College of Pharmacy,Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China;Longxi Yifang Pharmaceutical Co.,Ltd.,Longxi 748100,Gansu,China;Co-construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan&Education Ministry of P.R.China,Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China)

机构地区：[1]河南中医药大学药学院,河南郑州450046 [2]陇西一方药业有限公司,甘肃陇西148100 [3]河南中医药大学呼吸疾病中医药防治省部共建协同创新中心,河南郑州450046

出　　处：《中华中医药学刊》2021年第12期137-140,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81773928);河南省高等学校青年骨干教师资助计划(2014GGJS-072)。

摘　　要：滋阴清热中药地黄及其传统复方(百合地黄汤、一贯煎、天王补心丹、血府逐瘀汤)在临床上可广泛应用于抑郁症的防治,然而其现代科学内涵尚不太清楚。通过对中国知网(CNKI)和PubMed等国内外文献数据库的检索分析,探讨地黄及其以上传统复方在防治抑郁症的现代研究现状及对策。研究结果表明,生地黄粗粉及其乙醇提取物均有显著的抗抑郁作用,其作用机制可能可能部分涉及恢复下丘脑-垂体-肾上腺轴(HPA轴)功能障碍、增强单胺能神经系统以及上调脑源性神经营养因子(BDNF)和酪氨酸激酶受体B(TrkB)的表达等途径;地黄传统复方(百合地黄汤、一贯煎、天王补心丹、血府逐瘀汤)均能产生抗抑郁作用,其中百合地黄汤(含百合地黄粉)的抗抑郁作用机制可能与抑制单胺氧化酶活性进而提高单胺类神经递质含量、抑制炎症反应、以及提高脑内神经营养因子的水平从而起到神经元保护作用等有关,一贯煎(主要为其加味方)的抗抑郁药理机制涉及5-羟色胺1A受体(5-HT1A)mRNA转录功能,天王补心丹的抗抑郁作用机制涉及抑制HPA轴活性、上调海马磷酸化糖原合酶激酶3β(p-GSK3β)和BDNF的蛋白表达,血府逐瘀汤(含血府逐瘀口服液)的抗抑郁作用机制可能涉及提高脑内5-羟色胺(5-HT)水平、上调海马5-HT1A和p-GSK3β的表达等有关。结合地黄及其传统复方在防治抑郁症方面的现代研究进展及存在的主要问题,提出"深入开展地黄及其传统复方(百合地黄汤、一贯煎、天王补心丹、血府逐瘀汤等)防治抑郁症的主要药效物质基础的确认及其体内过程研究、分子机制及作用靶点研究"之对策,以期为地黄及其传统复方在防治抑郁症方面的科学、高效、合理的应用提供实验支撑。The traditional Chinese medicine Dihuang(Rehmanniae Radix)for nourishing Yin and clearing away heat and its traditional prescriptions[Baihe Dihuang Decoction(百合地黄汤),Yiguanjian(一贯煎),Tianwang Buxin Dan(天王补心丹),Xuefu Zhuyu Decoction(血府逐瘀汤)]can be widely used in the prevention and treatment of depression,but their modern scientific connotation is not yet clear.Based on the search and analysis of domestic and foreign literature databases such as China Knowledge Network(CNKI)and PubMed,this article discussed the current research status and countermeasures of Dihuang(Rehmanniae Radix)and its traditional prescriptions in the prevention and treatment of depression.The results of the study show that Dihuang(Rehmanniae Radix)and its ethanol extract have significant antidepressant effects,and the mechanism of action may partly involve restoring the hypothalamic-pituitary-adrenal axis(HPA axis)dysfunction,enhancing the monoaminergic nervous system and up-regulating the expression of brain-derived neurotrophic factor(BDNF)and tyrosine kinase receptor B(TrkB),etc.Dihuang(Rehmanniae Radix)traditional prescriptions(Baihe Dihuang Decoction,Yiguanjian,Tianwang Buxin Dan,Xuefu Zhuyu Decoction]can all exert antidepressant effects.Among them,the antidepressant mechanism of Baihe Dihuang Decoction(containing Baihe Dihuang Powder)may be related to the inhibition of monoamine oxidase activity to increase the content of monoamine neurotransmitters,inhibit inflammation,and increase the level of neurotrophic factors in the brain to protect neurons,and the antidepressant pharmacological mechanism of Yiguanjian(mainly for its modified prescription)involves the serotonin receptor 1 A(5-HT1 A)mRNA transcription function and the antidepressant mechanism of Tianwang Buxin Pill involves the inhibition of HPA axis activity and up-regulation of hippocampal phosphorylated glycogen synthase kinase 3β(p-GSK3β)and BDNF,and the antidepressant mechanism of Xuefu Zhuyu Decoction(with Xuefu Zhuyu Oral Liquid)may involve

关 键 词：地黄乙醇提取物 地黄复方 百合地黄汤 一贯煎 天王补心丹 血府逐瘀汤 

分 类 号：R277.749.41[医药卫生—中医学]