

浏览全部资源
扫码关注微信
1.湖北中医药大学 基础医学院,武汉 430065
2.中国船舶重工集团公司 第七一二研究所,武汉 430065
Received:21 May 2020,
Published Online:01 December 2020,
Published:20 February 2021
移动端阅览
李浩,黄晓宇,谢光璟等.睡眠剥夺认知功能损伤发生的机制及中医药干预研究进展[J].中国实验方剂学杂志,2021,27(04):225-232.
LI Hao,HUANG Xiao-yu,XIE Guang-jing,et al.Mechanism of Sleep Deprivation and Cognitive Impairment and Research Progress of Traditional Chinese Medicine Intervention[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(04):225-232.
李浩,黄晓宇,谢光璟等.睡眠剥夺认知功能损伤发生的机制及中医药干预研究进展[J].中国实验方剂学杂志,2021,27(04):225-232. DOI: 10.13422/j.cnki.syfjx.20210145.
LI Hao,HUANG Xiao-yu,XIE Guang-jing,et al.Mechanism of Sleep Deprivation and Cognitive Impairment and Research Progress of Traditional Chinese Medicine Intervention[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(04):225-232. DOI: 10.13422/j.cnki.syfjx.20210145.
充足的睡眠是保证机体健康运转的重要组成因素,以睡眠不足为主要特征的一类慢性睡眠疾病可统称为睡眠剥夺(SD),在来源上分为原发性与继发性两种。作为近年来高发的疾病类型之一,SD已愈发受到全社会的关注和重视。SD可对认知行为产生广泛而深远的影响,如清醒程度降低、警觉性下降及注意力不集中;感官知觉能力低下;学习记忆能力下降等,涉及到对人体多个系统功能的影响,并与多种疾病发生有密切关联,可能会给患者甚至其亲友的正常生活带来严重困扰。SD引起的认知功能损伤现象已在临床测试与多种动物行为学实验中得到了充分验证,主要涉及到突触可塑性改变、内质网应激加强、昼夜节律紊乱、能量代谢失衡等病理损伤机制。针对SD的西医药物治疗多具有副作用大、成瘾性强等负面因素,但中医药干预着眼整体观念,效用持久,效果显著,且副作用轻微,在临床上改善睡眠障碍的并发症方面也得到了广泛的认可。本文通过综述SD研究现状与分类,其导致认知功能损伤的病理机制相关在分子层面的探索方向与成果,近5年来中药复方、针灸等中医药干预疗法及运动、五音等辅助疗法的治疗效果与经验,以期进一步总结阐明SD与认知行为间的互作影响机制,为研究SD疾病的相关病理机制及今后的临床治疗提供理论基础。
Adequate sleep is an important factor to ensure the healthy functioning of the body. A type of chronic sleep diseases characterized by insufficient sleep can be collectively referred to as sleep deprivation (SD), which is divided into primary and secondary sources in terms of sources. As one of the most frequent types of diseases in recent years, SD has received more and more attention and attention from the whole society. SD can have a wide-ranging and far-reaching impact on cognitive behavior, such as decreased wakefulness, decreased alertness, and inattention, decreased sensory perception, decreased learning and memory capabilities, et al, involving the impact on multiple system functions of the human body, and It is closely related to the occurrence of many diseases, and may cause serious troubles to the normal life of patients and even their relatives and friends. The cognitive impairment caused by SD has been fully verified in clinical tests and various animal behavior experiments, mainly involving pathological damage such as changes in synaptic plasticity, enhanced endoplasmic reticulum stress, circadian rhythm disorders, and energy metabolism imbalance. Western medicine treatments for SD mostly have negative factors such as high side effect and strong addiction. However, Chinese medicine intervention focuses on the overall concept, has long-lasting effectiveness, significant effects, and mild side effects. It has also been widely recognized clinically for improving the complications of sleep disorders. This article reviews the current status and classification of SD research, its pathological mechanisms that lead to cognitive impairment and its molecular-level exploration directions and results. In recent 5 years, the therapeutic effect and experience of traditional Chinese medicine intervention therapy such as compound Chinese medicine, acupuncture and moxibustion as well as auxiliary therapy such as exercise and five sounds, in order to further summarize and clarify the interaction mechanism between SD and cognitive behavior, and provide a theoretical basis for the study of the pathological mechanism of SD disease and future clinical treatment.
APPLETON S , GILL T , LANG C , et al . Prevalence and comorbidity of sleep conditions in Australian adults:2016 Sleep Health Foundation national survey [J]. Sleep Health , 2018 , 4 ( 1 ): 13 - 19 .
KUWAHARA K , IMAI T , MIYAMOTO T , et al . Sleep duration modifies the association of overtime work with risk of developing type 2 diabetes:Japan epidemiology collaboration on occupational health study [J]. J Epidemiol , 2018 , 28 ( 7 ): 336 - 340 .
WHEATON A , JONES S , COOPER A , et al . Short sleep duration among middle school and high school students-united states [J]. MMWR Morb Mortal Wkly Rep , 2018 , 67 ( 3 ): 85 - 90 .
MCHILL A , WRIGHT K . Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease [J]. Obes Rev , 2017 , 18 : 15 - 24 .
RAO M , NEYLAN T , GRUNFELD C , et al . Subchronic sleep restriction causes tissue-specific insulin resistance [J]. J Clin Endocrinol Metab , 2015 , 100 ( 4 ): 1664 - 1671 .
MCRAE C , CURTIS AF , WILLIAMS J , et al . Effects of brief behavioral treatment for insomnia on daily associations between self-reported sleep and objective cognitive performance in older adults [J]. Behav Sleep Med , 2020 , 18 ( 5 ): 577 - 588 .
POH J , CHONG P , CHEE M . Sleepless night,restless mind:effects of sleep deprivation on mind wandering [J]. J Exp Psychol Gen , 2016 , 145 ( 10 ): 1312 - 1318 .
LO J , CHONG P , GANESAN S , et al . Sleep deprivation increases formation of false memory [J]. J Sleep Res , 2016 , 25 ( 6 ): 673 - 682 .
KAPLAN J , VENTURA J , BAKSHI A , et al . The influence of sleep deprivation and oscillating motion on sleepiness,motion sickness,and cognitive and motor performance [J]. Auton Neurosci , 2017 , 202 : 86 - 96 .
CHEN C , HARDY M , ZHANG J , et al . Altered NMDA receptor trafficking contributes to sleep deprivation-induced hippocampal synaptic and cognitive impairments [J]. Biochem Biophys Res Commun , 2006 , 340 ( 2 ): 435 - 440 .
RAVASSARD P , PACHOUD B , COMTE J C , et al . Paradoxical(REM)sleep deprivation causes a large and rapidly reversible decrease in long-term potentiation,synaptic transmission,glutamate receptor protein levels,and ERK/MAPK activation in the dorsal hippocampus [J]. Sleep , 2009 , 32 ( 2 ): 227 - 240 .
TOOSSI H , CID-PELLITERO E , JONES B E . Homeostatic changes in GABA and acetylcholine muscarinic receptors on gabaergic neurons in the mesencephalic reticular formation following sleep deprivation [J]. eNeuro , 2018 , doi: 10.1523/ENEURO.0269-17.2017 http://dx.doi.org/10.1523/ENEURO.0269-17.2017 .
MALLICK B , KAUR S , SAXENA R N . Interactions between cholinergic and GABAergic neurotransmitters in and around the locus coeruleus for the induction and maintenance of rapid eye movement sleep in rats [J]. Neuroscience , 2001 , 104 ( 2 ): 467 - 485 .
KAUR S , PANCHAL M , FAISAL M , et al . Long term blocking of GABA-A receptor in locus coeruleus by bilateral microinfusion of picrotoxin reduced rapid eye movement sleep and increased brain Na-K ATPase activity in freely moving normally behaving rats [J]. Behav Brain Res , 2004 , 151 ( 1/2 ): 185 - 190 .
ZAGAAR M , DAO A , ALHAIDER I , et al . Prevention by regular exercise of acute sleep deprivation-induced impairment of late phase LTP and related signaling molecules in the dentate gyrus [J]. Mol Neurobiol , 2016 , 53 ( 5 ): 2900 - 2910 .
ALHAIDER I , ALEISA A , TRAN T , et al . Sleep deprivation prevents stimulation-induced increases of levels of p-CREB and BDNF:protection by caffeine [J]. Mol Cell Neurosci , 2011 , 46 ( 4 ): 742 - 751 .
NAIDOO N . Roles of endoplasmic reticulum and energetic stress in disturbed sleep [J]. Neuromolecular Med , 2012 , 14 ( 3 ): 213 - 219 .
CHAKRABARTI A , CHEN A , VARNER J . A review of the mammalian unfolded protein response [J]. Biotechnol Bioeng , 2011 , 108 ( 12 ): 2777 - 2793 .
SHAW P , CIRELLI C , GREENSPAN R , et al . Correlates of sleep and waking in Drosophila melanogaster [J]. Science , 2000 , doi: 10.1126/science.287.5459.1834 http://dx.doi.org/10.1126/science.287.5459.1834 .
TERAO A , WISOR J P , PEYRON C , et al . Gene expression in the rat brain during sleep deprivation and recovery sleep:an Affymetrix Gene Chip study [J]. Neuroscience , 2006 , 137 ( 2 ): 593 - 605 .
CIRELLI C , TONONI G . Gene expression in the brain across the sleep-waking cycle [J]. Brain Res , 2000 , 885 ( 2 ): 303 - 321 .
NAIDOO N , FERBER M , MASTER M , et al . Aging impairs the unfolded protein response to sleep deprivation and leads to proapoptotic signaling [J]. J Neurosci , 2008 , 28 ( 26 ): 6539 - 6548 .
MACKIEWICZ M , SHOCKLEY K , ROMER M , et al . Macromolecule biosynthesis:a key function of sleep [J]. Physiol Genomics , 2007 , 31 ( 3 ): 441 - 457 .
JONES S , PFISTER-GENSKOW M , BENCA R , et al . Molecular correlates of sleep and wakefulness in the brain of the white-crowned sparrow [J]. J Neurochem , 2008 , 105 ( 1 ): 46 - 62 .
NAIDOO N , GIANG W , GALANTE R , et al . Sleep deprivation induces the unfolded protein response in mouse cerebral cortex [J]. J Neurochem , 2005 , 92 ( 5 ): 1150 - 1157 .
SHIMIZU H , SHIMODA M , YAMAGUCHI T , et al . Drosophila ATF-2 regulates sleep and locomotor activity in pacemaker neurons [J]. Mol Cell Biol , 2008 , 28 ( 20 ): 6278 - 6289 .
ARAGÓN T , VAN-ANKEN E , PINCUS D , et al . Messenger RNA targeting to endoplasmic reticulum stress signalling sites [J]. Nature , 2009 , 457 ( 2730 ): 736 - 740 .
INOUYE S , KAWAMURA H . Characteristics of a circadian pacemaker in the suprachiasmatic nucleus [J]. J Comp Physiol , 1982 , 146 : 153 - 160 .
BOUSKILA Y , DUDEK F . Can a population of suprachiasmatic nucleus neurons with different period lengths produce a stable circadian rhythm? [J]. Brain Res , 1995 , 670 ( 2 ): 333 - 336 .
SHEARMAN L , SRIRAM S , WEAVER D , et al . Interacting molecular loops in the mammalian circadian clock [J]. Science , 2000 , doi: 10.1126/science.288.5468.1013 http://dx.doi.org/10.1126/science.288.5468.1013 .
KUME K , ZYLKA M , SRIRAM S , et al . mCRY1 and mCRY2 are essential components of the negative limb of the circadian clock feedback loop [J]. Cell , 1999 , 98 ( 2 ): 193 - 205 .
MONGRAIN V , LASPADA F , CURIE T , et al . Sleep loss reduces the DNA-binding of BMAL1,clock,and NPAS2 to specific clock genes in the mouse cerebral cortex [J]. PLoS One , 2011 , 6 ( 10 ): e26622 .
WISOR J , PASUMARTHI R , GERASHCHENKO D , et al . Sleep deprivation effects on circadian clock gene expression in the cerebral cortex parallel electroencephalographic differences among mouse strains [J]. J Neurosci , 2008 , 28 ( 28 ): 7193 - 7201 .
FUTAMURA A , SHIROMARU A , KURODA T , et al . Clocks,Behavior,and Cognition [J]. Brain Nerve , 2017 , 69 ( 6 ): 639 - 649 .
SCHOUSBOE A , SCAFIDI S , BAK L K , et al . Glutamate metabolism in the brain focusing on astrocytes [J]. Adv Neurobiol , 2014 , 11 : 13 - 30 .
JÓŹWIAK-BĘBENISTA M , KOWALCZYK E , NOWAK J . The cyclic AMP effects and neuroprotective activities of PACAP and VIP in cultured astrocytes and neurons exposed to oxygen-glucose deprivation [J]. Pharmacol Rep , 2015 , 67 ( 2 ): 332 - 338 .
KAWAKAMI K , OHARA H , NABIKA T . Arginine vasopressin regulated ASCT1 expression in astrocytes from stroke-prone spontaneously hypertensive rats and congenic SHRpch1_18 rats [J]. Neuroscience , 2014 , 267 : 277 - 285 .
CHANG H , LIAO W , SHEU J , et al . Sleep deprivation impairs Ca 2+ expression in the hippocampus: ionic imaging analysis for cognitive deficiency with TOF-SIMS [J]. Microsc Microanal , 2012 , 18 ( 3 ): 425 - 435 .
ZIMMERMANN H . Extracellular ATP and other nucleotides—ubiquitous triggers of intercellular messenger release [J]. Purinergic Signal , 2016 , 12 ( 1 ): 25 - 57 .
LETELLIER M , PARK Y , CHATER T , et al . Astrocytes regulate heterogeneity of presynaptic strengths in hippocampal networks [J]. Proc Natl Acad Sci USA , 2016 , 113 ( 19 ): E2685 - E2694 .
SUZUKI A , STERN S A , BOZDAGI O , et al . Astrocyte-neuron lactate transport is required for long-term memory formation [J]. Cell , 2011 , 144 ( 5 ): 810 - 823 .
ALHAIDER I , ALEISA A , TRAN T , et al . Caffeine prevents sleep loss-induced deficits in long-term potentiation and related signaling molecules in the dentate gyrus [J]. Eur J Neurosci , 2010 , 31 ( 8 ): 1368 - 1376 .
DENG H , TAM T , ZEE B , et al . Short sleep duration increases metabolic impact in healthy adults:a population-based cohort study [J]. Sleep , 2017 , doi: 10.1093/sleep/zsx130 http://dx.doi.org/10.1093/sleep/zsx130 .
IRWIN M . Sleep and inflammation:partners in sickness and in health [J]. Nat Rev Immunol , 2019 , 19 ( 11 ): 702 - 715 .
MCINTYRE R . Sleep and inflammation: implications for domain approach and treatment opportunities [J]. Biol Psychiatry , 2016 , 80 ( 1 ): 9 - 11 .
HOU J , SHEN Q , WAN X , et al . REM sleep deprivation-induced circadian clock gene abnormalities participate in hippocampal-dependent memory impairment by enhancing inflammation in rats undergoing sevoflurane inhalation [J]. Behav Brain Res , 2019 , 364 : 167 - 176 .
ZHANG J , YU L , YANG H , et al . Huatuo Zaizao pill ameliorates cognitive impairment of APP/PS1 transgenic mice by improving synaptic plasticity and reducing A β deposition [J]. BMC Complement Altern Med , 2018 , 18 ( 1 ): 167 .
谢光璟 , 薄文集 , 黄攀攀 , 等 . 天王补心丹对慢性睡眠剥夺模型大鼠心肌、下丘脑视交叉上核VIP、AVP表达的影响 [J]. 中华中医药学刊 , 2018 , 36 ( 2 ): 323 - 326 .
谢光璟 , 黄攀攀 , 王平 . 基于cAMP/CREB信号通路探讨天王补心丹对复合失眠模型大鼠学习记忆水平及神经因子的影响 [J]. 辽宁中医杂志 , 2019 , 46 ( 9 ): 1991 - 1994,2016 .
谢光璟 . 养心安神法调控失眠模型大鼠CREB信号通路的机制研究 [D]. 武汉 : 湖北中医药大学 , 2018 .
吴东南 . 基于突触可塑性与神经炎症研究酸枣仁汤改善睡眠剥夺大鼠学习记忆的机制 [D]. 武汉 : 湖北中医药大学 , 2020 .
章程鹏 , 桑红灵 , 孙易娜 . 人参石菖蒲药对对睡眠剥夺大鼠海马IL-6R、NMDAR影响的实验研究 [J]. 时珍国医国药 , 2018 , 29 ( 10 ): 2339 - 2342 .
SU X , WANG C , WANG X , et al . Sweet dream liquid Chinese medicine ameliorates learning and memory deficit in a rat model of paradoxical sleep deprivation through the ERK/CREB signaling pathway [J]. J Med Food , 2016 , 19 ( 5 ): 472 - 480 .
谢光璟 , 徐波 , 黄攀攀 , 等 . 安寐丹通过线粒体介导的海马神经细胞凋亡改善睡眠剥夺模型大鼠的学习记忆水平 [J]. 中国实验方剂学杂志 , 2020 , 26 ( 24 ): 38 - 44 .
谢光璟 , 刘源才 , 胡辉 , 等 . 基于Trx系统介导的抗氧化应激探讨天王补心方对失眠模型大鼠的干预作用 [J]. 时珍国医国药 , 2019 , 30 ( 4 ): 805 - 808 .
谢光璟 , 黄攀攀 , 王平 . 天王补心丹加减改善PCPA失眠大鼠Trx系统氧化损伤的机制探讨 [J]. 中国实验方剂学杂志 , 2019 , 25 ( 6 ): 32 - 38 .
WANG Q , ZHANG Y , LI Y , et al . The memory enhancement effect of Kai Xin San on cognitive deficit induced by simulated weightlessness in rats [J]. J Ethnopharmacol , 2016 , 187 : 9 - 16 .
ZOU X , HUANG W , LU F , et al . The effects of Jiao-Tai-Wan on sleep,inflammation and insulin resistance in obesity-resistant rats with chronic partial sleep deprivation [J]. BMC Complement Altern Med , 2017 , 17 ( 1 ): 165 .
刘雁泽 . 电针单穴与腧穴配伍对睡眠剥夺模型大鼠学习记忆能力调节效应的对照研究 [D]. 吉林 : 长春中医药大学 , 2019 .
李佳 , 刘娇萍 . 针刺“神门”穴对睡眠剥夺大鼠脑电波及其认知能力的影响 [J]. 针刺研究 , 2017 , 42 ( 6 ): 502 - 506 .
LIU W , ZHUO P , LI L , et al . Activation of brain glucose metabolism ameliorating cognitive impairment in APP/PS1 transgenic mice by electroacupuncture [J]. Free Radic Biol Med , 2017 , 112 : 174 - 190 .
GUO J , HUANG W , TANG C , et al . Effect of acupuncture on sleep quality and hyperarousal state in patients with primary insomnia: study protocol for a randomised controlled trial [J]. BMJ Open , 2016 , 6 ( 3 ): e009594 .
RAJIZADEH M , ESMAEILPOUR K , MASOUMI-ARDAKANI Y , et al . Voluntary exercise impact on cognitive impairments in sleep-deprived intact female rats [J]. Physiol Behav , 2018 , 188 : 58 - 66 .
ZIELINSKI M , DAVIS J , FADEL J , et al . Influence of chronic moderate sleep restriction and exercise training on anxiety,spatial memory,and associated neurobiological measures in mice [J]. Behav Brain Res , 2013 , 250 : 74 - 80 .
肖青青 . 基于心主神明理论的徵调音乐疗法对GAD心阴亏虚证大鼠的HPA轴调节机制研究 [D]. 成都 : 成都中医药大学 , 2019 .
0
Views
14
下载量
5
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621