栀子及其方剂配伍治疗抑郁症研究进展  

Research Progress of Gardenia Jasminoides Ellis as Antidepressant

作　　者：田磊[1] 栗俞程[1] 白明[1] 汪保英[1] 许二平[1] TIAN Lei;LI Yucheng;BAI Ming;WANG Baoying;XU Erping(Henan Key Laboratory for Modern Research on Zhongjing's Herbal Formulae,Academy of Chinese Medical Sciences,Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南省仲景方药现代研究重点实验室,河南中医药大学中医药科学院,郑州450046

出　　处：《中国实验方剂学杂志》2023年第14期239-247,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81973739,82274496);河南省中医药科学研究重大专项(2018ZYZD09);河南省优秀青年科学基金项目(202300410249);河南省科技攻关项目(222102310233)。

摘　　要：抑郁症是一种以持久的心境低落为主要特征的精神障碍类疾病,归属为中医“郁证”范畴,具有高患病率、高致残率、高自杀率及高复发率等特点,其发病机制十分复杂,遗传、心理与社会环境等因素均涉及其中。目前临床上的抗抑郁药物如三、四环类抗抑郁药,选择性5-羟色胺(5-HT)再摄取抑制剂等药物起效缓慢,长期应用不良反应显著,且临床统计约有三分之一的患者对此类药物无反应性。如何有效提升抑郁症的治疗效果已成为医学界目前急需解决的一大难题。中医药基于整体观念和辨证论治,在抑郁症的防治方面具有疗效稳定、复发率低、不良反应少、患者依从性好等独特优势。作为中药清热药的一种,栀子具有清热泻火、凉血除烦之功效,对“郁证”患者有较好的治疗效果。文献研究发现栀子活性成分如栀子苷、京尼平、西红花苷,栀子药对如栀子-川芎、栀子-刺五加、栀子-枸杞子,含栀子的中药复方如栀子豉汤、越鞠丸、栀子厚朴汤、丹栀逍遥散、解郁安神颗粒等抗抑郁疗效显著,其机制可能与调控下丘脑-垂体-肾上腺(HPA)轴、调节5-HT及多巴胺(DA)神经递质、增加海马脑源性神经营养因子(BDNF)和增强海马神经发生、调控核转录因子-κB(NF-κB)信号通路抑制神经炎症反应等有关。本文对栀子活性成分、栀子药对及含栀子的中药复方等抗抑郁的相关基础与临床研究进展的总结,为进一步推广栀子及其方剂配伍治疗抑郁症的临床应用提供参考。Depression is a mental disorder characterized by persistent gloomy mood.It belongs to the category of"depression syndrome"in traditional Chinese medicine,which has the characteristics of high prevalence rate,high disability rate,high suicide rate and high recurrence rate.Its pathogenesis is very complex,including genetic,psychological and social environmental factors.The current clinical antidepressant drugs such as tricyclic and tetracyclic antidepressants,selective serotonin reuptake inhibitors and other drugs have slow onset and significant long-term adverse reactions,and about one-third of patients have no response to such drugs.How to effectively improve the treatment of depression has become an urgent problem in the medical field.Traditional Chinese medicine(TCM)based on holistic concept and syndrome differentiation and treatment has unique advantages in the prevention and treatment of depression,such as stable curative effect,low recurrence rate,less side effects and good patient compliance.As a kind of Chinese medicine to clear heat,gardenia has the effect of clearing heat and fire,cooling blood and removing irritation,and has a good therapeutic effect on patients with"depression".The literature research found that the active ingredients of gardenia such as gardenia glycoside,jingnipin,saffron glycoside,gardenia drug pairs such as gardenia-Chuanxiong,gardenia-acanthopanax,gardenia-wolfberry,Chinese medicine compound containing gardenia such as Zhizi Chitang,Yuejuwan and Zhizi Houputang,Danzhi Xiaoyaosan,and Jie Yu An Shen granules etc.have significant antidepressant effect,and their mechanisms may be related to the regulation of hypothalamus-pituitary-adrenal(HPA)axis,regulation of neurotransmitters such as serotonin(5-HT)and dopamine(DA),increasing hippocampal brain-derived neurotrophic factor(BDNF)and enhancing hippocampal neurogenesis,and regulating NF-κB signaling pathway to inhibit neuroinflammatory response.In this paper,we summarized the related basic and clinical research progress of the antidepr

关 键 词：抑郁症 栀子 栀子豉汤 越鞠丸 栀子厚朴汤 

分 类 号：R2-0[医药卫生—中医学] R22R285.5R284R33