芍药苷针对围绝经期综合征的作用机制研究进展  

Research Progress on Mechanism of Action of Paeoniflorin against Climacteric Syndrome

作　　者：申琦 史磊[1,3] 孙亚 高田田 戚语宸 王常瞵 王杰琼[1,2,3] SHEN Qi;SHI Lei;SUN Ya;GAO Tiantian;QI Yuchen;WANG Changlin;WANG Jieqiong(College of Pharmacy,Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong,China;Innovative Team of Shandong Traditional Chinese Medicine in the Study of Emotional and Spiritual Disease Evidence,Jinan 250355,Shandong,China;Team of Young Scientific Research and Innovation Focusing on Pharmacology Mechanism of Emotional Diseases and Syndromes in Ganzangxiang,Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong,China;Innovation Institute of Chinese Medicine and Pharmacy,Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong,China;College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong,China)

机构地区：[1]山东中医药大学药学院,山东济南250355 [2]山东中医药情志病证研究创新团队,山东济南250355 [3]山东中医药大学情志病证肝藏象药理青年科研创新团队,山东济南250355 [4]山东中医药大学中医创新研究院,山东济南250355 [5]山东中医药大学中医学院,山东济南250355

出　　处：《中华中医药学刊》2024年第11期177-184,I0035,共9页Chinese Archives of Traditional Chinese Medicine

基　　金：国家科技部科技重大新药创制专项(2017ZX091064);山东省自然科学基金面上项目(ZR2020ZD17)。

摘　　要：围绝经期综合征(climacteric syndrome,CMS)是绝经前后女性因其卵巢功能衰退、雌激素水平波动或下降,而出现的烦躁易怒、失眠多梦、潮热汗出等一系列症状。现代医学治疗CMS是以激素替代疗法(hormone replacement thera-py,HRT)为主要手段,存在不良反应大、长期使用危害性大影响疗效等问题。中医以肝郁气滞为CMS的主要病因,而白芍养血柔肝、养阴润燥,具有疏肝解郁的功效,是近代中医临床上治疗CMS的高频用药。芍药苷(paeoniflorin,PF)是中药白芍的主要活性成分,已知具有抗抑郁、保肝、保护神经、镇静催眠等多种药理作用。对国内外相关文献进行梳理归纳,就PF在肝郁气滞所致CMS中情绪障碍、睡眠障碍、认知障碍、骨质疏松症、血管舒缩症状5个方面的药理作用及机制进行综述,发现PF通过调节下丘脑-垂体-肾上腺轴活性,保护海马神经、抑制海马炎症反应,调整肠道中的炎症因子表达发挥抗抑郁作用可改善CMS的情绪障碍;PF可通过调节海马脑源性神经营养因子(BDNF)/酪氨酸蛋白激酶受体B(TrkB)通路等途径来缓解睡眠障碍;PF能通过提高海马神经因子水平、缓解神经元损伤,激活腺苷A受体来起到改善CMS认知障碍的作用;PF可以促进成骨生成、抑制成骨细胞凋亡和破骨细胞的生成,从而改善骨质疏松症。此外,还讨论了PF药物动力学中生物利用度低及PF低毒性的特点。综上,PF的临床应用提供借鉴依据,促进对其进一步深入研究。Climacteric syndrome(CMS)is a group of symptoms that women suffer before and after menopause,including irritability,insomnia,excessive dreaming,hot flashes and sweating,due to the decline of ovarian function,fluctuations or decreases in estrogen levels.The modern medical treatment of CMS is hormone replacement therapy(HRT)and it has significant side effects and long-term harmful effects on the therapeutic effect.Traditional Chinese medicine believes that the main cause of CMS is liver depression and Qi stagnation,and Baishao(Paeonia lactiflora),commonly utilized in clinical practice for its capacity to nourish blood,soften liver,nourish Yin and moisten dryness,is a high-frequency drug used in modern Chinese medicine clinical practice to treat CMS.Paeoniflorin(PF),the major active component of Baishao(Paeonia lactiflora),has been shown to have antidepressant,hepatoprotective,neuroprotective,sedative and hypnotic activities.A review of relevant domestic and international literature was conducted in this study to summarize the pharmacological effects and mechanisms of PF in emotional disorders,sleep disorders,cognitive disorders,osteoporosis and vascular constriction symptoms caused by liver depression and Qi stagnation in CMS.It was discovered that PF can improve emotional disorders by regulating the activity of the hypothalamic-pituitary-adrenal axis,protecting hippocampal neurons,inhibiting hippocampal inflammation,while adjusting the expressions of inflammatory factors in the intestines.By influencing the hippocampus brain-derived neurotrophic factor(BDNF)/tyrosine protein kinase B(TrkB)pathway,PF can treat sleep problems.By raising hippocampus neurotrophic factor levels,alleviating neuronal damage and activating adenosine A receptors,PF can ameliorate cognitive problems in CMS.PF can improve osteoporosis by increasing bone pro duction and inhibiting osteoblast death and osteoclastogenesis.Furthermore,this paper examined the properties of poor bioavailability in pharmacokinetics,and lower the toxicity of PF.Cons

关 键 词：围绝经期综合征 芍药苷 作用机制 药代动力学 毒理 

分 类 号：R271.116[医药卫生—中医妇科学]