加味丹栀逍遥散“肝脑同治”抑郁症机理探究  

Anti-depression mechanism of‘simultaneous treatment liver and brain’of modified Danzhi Xiaoyao Powder

作　　者：邵文雪 许二平[2] 栗俞程[2] SHAO Wenxue;XU Erping;LI Yucheng(School of Traditional Chinese Medicine,Henan University of Chinese Medicine,Zhengzhou 450046,China;Academy of Chinese Medical Sciences,Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]河南中医药大学中医学院,郑州450046 [2]河南中医药大学中医药科学院,郑州450046

出　　处：《中华中医药杂志》2023年第7期3392-3398,共7页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81973739)。

摘　　要：“肝脑同治”抑郁症理论源于本课题组临床经验总结,为阐明其机理,从中医理论、现代医学、临床应用和方药研究角度进行初步探究,认为“肝脑同治”中医理论本质为“肝心同治”,即调节心脏功能以治疗抑郁症脑部病变,协调心肝二脏相互作用以干预病程进展。现代研究证实抑郁症存在肝脑共病的病理基础,且肝脑相互影响,疏肝可健脑,醒脑可畅肝。肝、脑可以肾精作为联络中介,填精益髓可调节下丘脑-垂体-肝轴和神经内分泌网络,关键脑区的γ-氨基丁酸、5-羟色胺和Ca^(2+)信号通路是肝主疏泄、调畅情志的重要脑中枢机制,肝-脑炎症轴对肝脑之间信息传递具有重要的沟通调节作用。加味丹栀逍遥散为丹栀逍遥散加味入归心经的石菖蒲、远志所组成,以加强宁心安神、醒脑开窍之功,协同疏肝理气、和血养脾药物以增肝脑同治之效;逍遥散类方抗抑郁症机制研究为该方“肝脑同治”抑郁症提供了科学依据。文章探究“肝脑同治”抑郁症机理,以期为进一步实验研究及临床应用提供支撑,促进中医理论的现代化和临床疗效的提高。The theory of‘simultaneous treatment liver and brain’in treating depression stems from clinical experience summary of the research group.In order to clarify its mechanism,the auther initially explored it from the perspectives of traditional Chinese medicine(TCM)theory,modern medicine,clinical application and prescription research.It is believed that the TCM theory essence of‘simultaneous treatment liver and brain’is‘simultaneous treatment liver and heart’,that is,regulating heart function to treat brain lesions in depression,and coordinating the interaction between heart and liver to interfere the progress of depression.Modern medical studies confirms the pathological basis of liver and brain comorbidity in depression,and shows there is a mutual influence between the liver and brain.Dispersing liver can strengthen brain,and restoring consciousness can dispersing liver.Kidney essence can be used as a contact intermediary between liver and brain replenishing essence and tonifying spinal marrow;can regulate hypothalamic-pituitary-liver axis and neuroendocrine network.Theγ-aminobutyric acid,5-hydroxy-tryptamine and Ca^(2+)signaling pathways in key brain regions are important brain mechanisms for liver controlling dispersion and regulating emotions.Liver-brain inflammation axis plays an important role in regulating information transmission between liver and brain.Modified Danzhi Xiaoyao Powder is composed of Danzhi Xiaoyao Powder plus Acorus calamus and Polygala tenuifolia,which interring into the heart meridian to strengthen the role of calming the heart for tranquillization;and arouse the brain and open the orifices and coordinating the herbs of disperse the liver and rectify qi and nourishing blood and invigorating spleen to achieve the effect of enhancing simultaneous treatment liver and brain.The study of anti-depression mechanism of Xiaoyao Powder categorized formulas provides the scientific basis for‘simultaneous treatment liver and brain’in depression.This paper exploring the mechanism of‘si

关 键 词：肝脑同治 抑郁症 中医理论 现代医学 临床应用 方药研究 

分 类 号：R277.7[医药卫生—中医学]