逍遥散抗抑郁的药理学机制研究进展  

Research progress on pharmacological mechanism of Xiaoyao San against depression

作　　者：梁文青 程凯[1] 巩子汉 孟丹华 左阳 佘楷杰 杨婧雯 岳广欣[2] LIANG Wenqing;CHENG Kai;GONG Zihan;MENG Danhua;ZUO Yang;SHE Kaijie;YANG Jingwen;YUE Guangxin(Institute of traditional Chinese medicine,Henan University of Traditional Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学中医学院,450046 [2]中国中医科学院中医基础理论研究所 [3]北京中医药大学第三附属医院

出　　处：《环球中医药》2022年第11期2243-2249,共7页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(82174251,81573846,81072730);中国中医科学院中医基础理论研究所基本科研业务费(YZ202107);中国中医科学科技创新工程重大攻关项目(CI2021A00607)。

摘　　要：抑郁症是目前高发的一种精神疾病,逍遥散是其常用的治疗方剂,其抗抑郁的药理学机制也在广泛研究当中。研究发现逍遥散可以通过提高脑源性神经营养因子(brain-derived neurotrophic factor, BDNF)表达水平、降低一氧化氮(nitric oxide, NO)含量、调节α-氨基-3-羟基-5-甲基-4-异恶唑丙酸(α-amino-3-hydroxy-5-methyl-4-isoxazole-propionicacid receptor, AMPA)受体水平改善神经可塑性,调节单胺类神经递质等抑制免疫炎症反应,调控下丘脑—垂体—肾上腺轴(the hypothalamic-pituitary-adrenal axis,HPA轴)及调节局部脏腑功能,如恢复胃肠功能、肝功能和修复血脑屏障通透性等多种途径实现抗抑郁治疗。本文通过总结逍遥散抗抑郁的药理学机制,发现多种机制之间不是独立存在,而是相互作用的,逍遥散对于每一条途径都有其调节作用,但能否影响多种途径间的相互作用,还有待于进一步深入研究和挖掘。故此,本文希望能为逍遥散抗抑郁的深层机制研究提供更多思路;为其临床治疗提供更多靶点,达到靶向治疗的目的,提高临床疗效,为逍遥散的研发提供更多方向和选择;充分发挥逍遥散的作用,展现中医药临床治疗的优势及特色。Depression is mental disease with high incidence at present, Xiaoyao San is a commonly used treatment prescription, and its pharmacological mechanism of anti-depression is also widely studied. It was found that Xiaoxiao San could improve neuroplasticity and inhibit immune inflammation by increasing the expression level of brain-derived neurotrophic factor(BDNF), decreasing the content of nitric oxide(NO), regulating the level of α-amino-3-hydroxy-5-methyl-4-isooxazolpropionic acid(AMPA) receptor, and regulating monoamine neurotransmitters. Anti-depression treatment can be achieved by regulating hypothalamic-pituitary-adrenal axis(HPA axis) and regulating local viscera functions, such as restoring gastrointestinal function, liver function and repairing blood-brain barrier permeability. This paper summarizes the pharmacological mechanism of Xiaoyao San against depression, and finds that these mechanisms do not exist independently, but interact with each other. Xiaoyao San has a regulatory effects on each pathway, but the functions of the interaction between multiple pathways remains to be further explored. Therefore, this paper would provide more ideas for the research on the mechanism of Xiaoyao San antidepressant. To provide more targets for its clinical treatment, according to the condition, targeted treatment, improve the clinical efficacy, to provide more directions and choices for the research and development of Xiaoyao San;Give full play to the role of Xiaoyao San, show the advantages and characteristics of TCM clinical treatment.

关 键 词：逍遥散 抑郁症 神经可塑性 炎症 丘脑—垂体—肾上腺轴 药理学机制 

分 类 号：R285[医药卫生—中药学]