中医药对慢性疼痛-抑郁共病的作用机制研究进展  

Advances in effect mechanism research of traditional Chinese medicine on comorbid depressive symptoms in chronic pain

作　　者：刘光华 史栋梁 傅文[3] 王子华[3] 崔家康[2] LIU Guanghua;SHI Dongliang;FU Wen;WANG Zihua;CUI Jiakang(College of Orthopedics and Traumatology,Henan University of Chinese Medicine,Zhengzhou 450046,China;Bone Injury Diagnosis and Treatment Center,the Second Affiliated Hospital of Henan University of Chinese Medicine/Henan Province Hospital of TCM,Zhengzhou 450002,China;Dept.of Rheumatology and Immunology,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450014,China)

机构地区：[1]河南中医药大学骨伤学院,郑州450046 [2]河南中医药大学第二附属医院/河南省中医院骨伤病诊疗中心,郑州450002 [3]河南中医药大学第一附属医院风湿免疫科,郑州450014

出　　处：《中国药房》2024年第19期2438-2443,共6页China Pharmacy

基　　金：河南省自然科学基金项目(No.232300420270);河南省卫生健康委国家中医临床研究基地科研专项(No.2021JDZX2079,No.2022JDZX105);河南省中医药科学研究专项课题(No.2023ZY2065,No.2024ZY3045)。

摘　　要：慢性疼痛是指持续或反复发作时间超过3个月的疼痛,与抑郁、焦虑等情绪具有高共病率。慢性疼痛-抑郁共病的发病机制错综复杂,给临床诊疗带来极大困扰。本文综述了近年中药单体和复方以及针刺疗法对慢性疼痛-抑郁共病作用机制的研究进展,发现中药单体(黄酮类、酚类、萜类、香豆素类、生物碱类化合物)、中药复方(乌头汤、柴胡桂枝汤等)及针刺疗法(针刺“百会”“印堂”“合谷”“太冲”等穴位)可以通过调节中枢神经系统中神经递质、脑源性神经营养因子、炎症因子的水平以及神经胶质细胞的活性,有效改善慢性疼痛-抑郁共病。Chronic pain refers to pain that persists or recurs for more than 3 months and has a high comorbidity rate with emotions such as depression and anxiety.The complex pathogenesis of comorbid depressive symptoms in chronic pain poses great challenges to clinical diagnosis and treatment.This article reviews the research progress on the effect mechanism on the comorbid depressive symptoms in chronic pain by traditional Chinese medicine monomers,compound formulas,and acupuncture therapy in recent years.It is found that traditional Chinese medicine monomers(flavonoids,phenols,terpenes,coumarins,alkaloids),traditional Chinese medicine formulas(Aconitum carmichaeli decoction,Chaihu guizhi decoction,etc.),and acupuncture therapy(acupuncture at acupoints such as Baihui,Yintang,Hegu,and Taichong)can effectively improve comorbid depressive symptoms in chronic pain by regulating the levels of neurotransmitters,brain-derived neurotrophic factors and inflammatory factors,and the activity of glial cells in the central nervous system.

关 键 词：慢性疼痛-抑郁共病 中药单体 中药复方 神经递质 炎症 作用机制 

分 类 号：R965[医药卫生—药理学] R285[医药卫生—药学]