中医药调控BDNF/TrkB信号通路治疗卒中后抑郁的研究进展  

Research progress of BDNF/TrkB signaling pathway regulated by traditional Chinese medicine in the treatment of post⁃stroke depression

作　　者：韩瑾 宋研博 徐方飚 孙永康 袁月 王新志[1,3] HAN Jin;SONG Yanbo;XU Fangbiao;SUN Yongkang;YUAN Yue;WANG Xinzhi(Encephalopathy Center of the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,China;The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450046,China;Collaborative Innovation Center of Prevention and Treatment of Major Diseases by Chinese and Western Medicine,Zhengzhou 450099,China)

机构地区：[1]河南中医药大学第一附属医院脑病中心,河南郑州450099 [2]河南中医药大学第一临床医学院,河南郑州450046 [3]中西医防治重大疾病河南省协同创新中心,河南郑州450099

出　　处：《海南医科大学学报》2025年第4期308-320,共13页Journal of Hainan Medical University

基　　金：中医药传承与创新“百千万”人才工程(岐黄工程)—岐黄学者[国中医药人教函(2018)284号];河南省“双一流”创建学科中医学科学研究专项课题(HSRP-DFCTCM-2023-5-07,HSRP-DFCTCM-2023-8-29)。

摘　　要：卒中后抑郁(post-stroke depression,PSD)是一种卒中患者常见的神经心理障碍,主要表现为持续的情绪低落和兴趣减退。其患病率逐年升高且病程较长,对患者自身及家庭造成极大的精神和经济压力。PSD发病机制复杂,涉及社会、生物、心理、遗传等多种因素。西医治疗多采用抗抑郁焦虑的药物,如选择性5-羟色胺再摄取抑制剂(selective serotonin reuptake inhibitors,SSRIs)、5-羟色胺和去甲肾上腺素再摄取抑制剂(serotonin norepinephrine reuptake inhibitors,SNRIs)等,药物安全性及疗效的不确定性常造成患者病情迁延。中医药治疗历史悠久,具有天然、温和、安全有效的特点,与西药相配合,可达到协同、增效、减毒效果。BDNF/TrkB信号通路是由BDNF介导和直接参与的一条重要信号通路,可调节大脑神经发生、细胞发育、突触可塑性及学习记忆,在PSD中发挥重要的作用,近年来中医药基于该通路干预PSD的研究日渐增多。笔者对近年来中医药基于文献进行总结梳理,分析基于BDNF/TrkB信号通路治疗PSD的相关作用机制,系统分析总结中药单体、复方及中成药调控该信号通路中的干预作用,旨在为研发防治PSD的临床药物及促进PSD的深入研究提供理论参考依据。Post-stroke depression(PSD)is a common neuropsychological disorder in stroke patients,characterized by persistent low mood and decreased interest.Its prevalence rate increases year by year and the course of the disease is longer,which causes great mental and economic pressure to the patients themselves and their families.The pathogenesis of PSD is complex,involving social,biological,psychological,genetic,and other factors.Western medicine often uses antidepressant and anxiety drugs,such as selective serotonin reuptake inhibitors(SSRIs)and serotonin and norepinephrine reuptake inhibitors(SNRIs),un‑certainty in the safety and efficacy of drugs often leads to prolonged disease course.Traditional Chinese medicine treatment has a long history,with natural,mild,safe,and effective characteristics,and with western medicine,can achieve synergistic,synergistic,toxic reduction effects.BDNF/TrkB signaling pathway is an important signaling pathway mediated and directly involved by BDNF,which can regulate brain neurogenesis,cell development,synaptic plasticity,learning and memory,and plays an important role in PSD.In recent years,there have been increasing studies on the intervention of traditional Chinese medicine on PSD based on this pathway.The authors summarized the literature of traditional Chinese medicine in recent years,analyzed the relevant mechanism of action based on BDNF/TrkB signaling pathway in the treatment of PSD,systematically analyzed and summarized the intervention effect of traditional Chinese medicine monomer,compound and patent Chinese medicine in regulating this signaling pathway,in order to provide theoretical reference for the development of clinical drugs for the prevention and treatment of PSD and promote the in-depth study of PSD.

关 键 词：卒中后抑郁 针刺 中成药 中药复方 BDNF/TrkB信号通路 研究进展 

分 类 号：R285[医药卫生—中药学]