冠心病合并抑郁症发病机制及药对应用研究概况  

Research Overview of Coronary Heart Disease Complicated with Depression and Application of Chinese Medicinal Pairs

作　　者：黄子娟[1] 蒋春建 王茜[1] 吴戈 陆雅席 杨苹 杨力强[1] HUANG Zijuan;JIANG Chunjian;WANG Qian;WU Ge;LU Yaxi;YANG Ping;YANG Liqiang(Guangxi University of Chinese Medicine,Nanning 530200,China)

机构地区：[1]广西中医药大学,广西南宁530200

出　　处：《山东中医药大学学报》2023年第3期365-369,共5页Journal of Shandong University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:82060835);广西中医基础研究重点实验室课题(编号:19-245-14-06);广西一流学科建设项目重点课题(编号:2019XK054)。

摘　　要：抑郁症是影响冠心病发病与预后的独立危险因素,可加重冠心病病情。研究治疗冠心病合并抑郁症的药对更有利于阐述方剂配伍及作用机制。中医认为冠心病合并抑郁症病因病机为气滞血瘀、气虚血瘀、痰瘀互结、气阴两虚,现代医学认为其发病机制为炎症反应、自主神经功能失调、下丘脑-垂体-肾上腺轴活跃表达以及血小板激活,柴胡-芍药、瓜蒌-半夏、黄芪-川芎、人参-灵芝等药对可通过抑制炎症反应、调节神经-内分泌系统、抗血小板聚集与活化、抗细胞凋亡、调控信号通路及保护血管内皮等多种途径防治冠心病合并抑郁症。在今后研究中,应基于中医的理论基础,结合现代科研方法进一步明确冠心病合并抑郁症的发病机制,挖掘中医药作用新靶点,促进“双心病”临床遣方的应用和中药复方的研发。参考文献40篇。Depression is an independent risk factor affecting the incidence and prognosis of coronary heart disease(CHD),which can aggravate the condition of CHD.The study of Chinese medicinal pairs for treating CHD complicated with depression is more conducive to the elaboration of the compatibility and mechanism of formulas.Traditional Chinese medicine(TCM)believes that the etiology and pathogenesis of CHD complicated with depression are qi stagnation and blood stasis,qi deficiency and blood stasis,combined phlegm and blood stasis and deficiency of qi and yin.The common pathogenesis of CHD complicated with depression in modern medicine is summarized as inflammatory reaction,autonomic nervous disorder,active expression of hypothalamus-pituitary-adrenal axis and platelet activation.Chinese medicinal pairs of Chaihu(Bupleuri Radix)-Shaoyao(Paeoniae Radix Alba),Gualou(Trichoasnthis Fructus)-Banxia(Pinelliae Rhizoma),Huangqi(Astragali Radix)-Chuanxiong(Chuanxiong Rhizoma),Renshen(Ginseng Radix et Rhizoma)-Lingzhi(Ganoderma)and other traditional Chinese medicines are used to prevent and treat to CHD complicated with depression through various approaches,such as anti-platelet aggregation and activation,anti-apoptosis,regulation of signaling pathways and protection of vascular endothelium.In the future study,we should further clarify the pathogenesis of CHD complicated with depression based on TCM theoretical basis and modern scientific research methods,explore the new targets for TCM,so as to promote the clinical application of formulas for the“psychological heart disease”and the study and development of traditional Chinese compound formulas.There are 40 references in total.

关 键 词：冠心病 抑郁症 气滞 痰瘀 气阴 炎症反应 自主神经功能失调 药对 

分 类 号：R259.414[医药卫生—中西医结合] R277.749.41[医药卫生—中医内科学]