柴胡疏肝散治疗围绝经期抑郁症机制的研究进展  

Research progress on the mechanism of Chaihu Shugan San in the treatment of perimenopausal depression

作　　者：欧莉莉 黄雨轩 陈学勤[3,4,7] 郑芳萍 刘长勤 OU Lili;HUANG Yuxuan;CHEN Xueqin;ZHENG Fangping;LIU Changqin(Xiamen Hospital of Traditional Chinese Medicine affiliated to Fujian University of Traditional Chinese Medicine,Xiamen 361015,China)

机构地区：[1]福建中医药大学附属厦门中医院,厦门361015 [2]厦门大学附属第一医院药剂科 [3]厦门大学附属第一医院中医科 [4]厦门市中医药疗效证据研究重点实验室 [5]厦门大学附属第一医院体检科 [6]厦门大学附属第一医院内分泌糖尿病科 [7]福建中医药大学第一临床医学院

出　　处：《环球中医药》2025年第2期333-338,共6页Global Traditional Chinese Medicine

基　　金：厦门市扶持中医药发展专项(XWZY-2023-0602);厦门市医疗卫生重点项目(3502Z20234016);国家自然科学基金面上项目(82474332)。

摘　　要：柴胡疏肝散是“疏肝解郁”的代表方剂之一,经过临床实践验证,其在治疗围绝经期抑郁症(perimenopausal depression, PMD)方面展现出显著疗效。本文就柴胡疏肝散治疗PMD的机制进行综述,其作用机制包含以下方面:(1)上调包括5-羟色胺、去甲肾上腺素和多巴胺在内的单胺类神经递质水平,发挥抗抑郁作用;(2)增加脑源性神经营养因子的表达并促进相关信号通路的激活,改善突触的可塑性;(3)下调下丘脑—垂体—肾上腺轴的活性,改善抑郁症状;(4)上调雌激素受体α、雌激素受体β基因的表达,发挥神经保护作用;(5)降低海马钙/钙调蛋白依赖性蛋白激酶Ⅱ的浓度和增加海马中生长抑素基因的表达,从而影响海马中第二信使环磷酸腺苷和钙离子相关通路,改善抑郁状态;提高血清睾酮水平逆转抑郁行为;另外,改善糖脂代谢状态可能与其改善抑郁行为相关。可见,柴胡疏肝散可以通过多机制治疗PMD的抑郁症状。本文通过回顾柴胡疏肝散干预PMD的相关研究,为今后的临床运用和实验室研究提供参考依据。Chaihu Shugan San is a prominent formula within the category of“Soothe the liver and relieve depression”,supported by clinical evidence demonstrating its notable efficacy in addressing perimenopausal depression(PMD).This article provides an analysis of the mechanism by which Chaihu Shugan San treats PMD.Its effective mechanism includes the following aspects:(1)increase the levels of monoamine neurotransmitters,including 5-hydroxytryptamine,norepinephrine and dopamine,improving depressive symptoms;(2)increase the expression of brain-derived neurotrophic factor and promote the activation of related signaling pathways,improving synaptic plasticity;(3)decrease the activity of hypothalamic-pituitary-adrenal axis,improving depressive symptoms;(4)increase estrogen receptorαand estrogen receptorβgene expression,exerting neuroprotection;(5)decrease the concentration of calcium/calmodulin-dependent protein kinase II in hippocampus and increase the expression of somatostatin gene in the hippocampus,thereby affecting the second messenger cyclic adenosine monophosphate and calcium ion related pathways in the hippocampus and improving depression;increase serum testosterone level reversing depressive behavior;in addition,the improvement of glucose and lipid metabolism may be related to the improvement of depressive behavior.The efficacy of Chaihu Shugan San in treating the depressive symptoms of PMD is evident through its multifaceted therapeutic mechanisms.This article reviews the related research of Chaihu Shugan San in the treatment of PMD,and provides reference for future clinical application and laboratory research.

关 键 词：柴胡疏肝散 围绝经期抑郁症 抗抑郁 机制研究 

分 类 号：R285[医药卫生—中药学]