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陕西中医药大学 第一临床医学院,附属医院,陕西 咸阳 712000
Received:14 December 2021,
Published Online:15 February 2022,
Published:05 April 2022
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马建福,王豆,李涛等.郁金治疗卒中后抑郁的药理机制研究进展[J].中国实验方剂学杂志,2022,28(07):276-282.
MA Jian-fu,WANG Dou,LI Tao,et al.Pharmacological Mechanism of Curcumae Radix in Treatment of Post-stroke Depression: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(07):276-282.
马建福,王豆,李涛等.郁金治疗卒中后抑郁的药理机制研究进展[J].中国实验方剂学杂志,2022,28(07):276-282. DOI: 10.13422/j.cnki.syfjx.20220740.
MA Jian-fu,WANG Dou,LI Tao,et al.Pharmacological Mechanism of Curcumae Radix in Treatment of Post-stroke Depression: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(07):276-282. DOI: 10.13422/j.cnki.syfjx.20220740.
卒中后抑郁是中风后最常见的精神并发症,严重危害患者的生活质量,甚至生命安全,是临床治疗的一大难点。其发病机制复杂多样,目前较为认可的机制包括炎症机制、神经递质机制、内分泌机制等。中医认为患者卒中后,气滞、血瘀、痰浊上蒙清窍则发为情志病,而郁金作为临床常用的传统中药,功可活血止痛,行气解郁。通过总结邓铁涛、张学文等多位国医大师及其他医师的用药规律,发现郁金是临床上治疗郁证、卒中、卒中后抑郁用药频率最高的单味中药之一,现代药理研究也发现郁金含有
β
-谷甾醇、莪术二酮、姜黄素等多种药用成分。该文首次对郁金有效成分的药理作用及其治疗卒中后抑郁的药理机制进行综述,并创新性地对各种基源郁金的炮制方法进行归纳梳理,以明确郁金对卒中后抑郁的重要作用及郁金治疗卒中后抑郁的最佳药用选择。结果发现郁金所具有的调节神经递质、抑制神经炎症、保护神经元、调节神经内分泌、抗血栓等作用可通过多成分、多靶点、多途径对卒中后抑郁起到防治作用,其中以黄丝郁金酒制品效果最佳。
Post-stroke depression, a common mental complication after stroke, seriously affects the quality of life and even endangers the life safety of patients. It is difficult to be cured due to the complex and diverse pathogenesis. At present, the widely accepted pathogenesis mechanisms include inflammatory mechanism, neurotransmitter mechanism, and endocrine mechanism. According to the theory of Chinese medicine, Qi stagnation, blood stasis, and phlegm turbidity lead to the occurrence of mental diseases after stroke. Curcumae Radix, as a commonly used Chinese herbal medicine, can activate blood circulation for relieving pain, regulate Qi, and relieve depression. The summary of the medication rules of DENG Tie-tao, ZHANG Xue-wen and other Chinese medical physicians showcases that Curcumae Radix is frequently used in the clinical treatment of depression, stroke, and post-stroke depression. Modern pharmacological studies have demonstrated that Curcumae Radix contains
β
-sitosterol, curdione, curcumin and other medicinal ingredients. This study reviewed the pharmacological effects of effective components in Curcumae Radix and the pharmacological mechanism in the treatment of post-stroke depression and summarized the processing methods of Curcumae Radix, aiming to clarify the important role and determine the optimal processing method of Curcumae Radix in the treatment of post-stroke depression. The results indicate that Curcumae Radix has the effects of regulating neurotransmitters, inhibiting neuroinflammation, protecting neurons, regulating neuroendocrine and antithrombosis, which can prevent and treat post-stroke depression through multiple components, targets, and pathways. The wine-processed
Curcuma longa
has the best effect.
李楠 , 张续 , 顾志强 , 等 . 卒中后抑郁的研究进展 [J]. 中国实用神经疾病杂志 , 2021 , 24 ( 2 ): 172 - 177 .
RUIZ N A L , DEL ANGEL D S , OLGUIN H J , et al . Neuroprogression:The hidden mechanism of depression [J]. Neuropsychiatr Dis Treat , 2018 , 14 : 2837 - 2845 .
WIJERATNE T , SALES C . Understanding why post-stroke depression may be the norm rather than the exception:The anatomical and neuroinflammatory correlates of post-stroke depression [J]. J Clin Med , 2021 , 10 ( 8 ): 1674 .
刘莎 , 杨志宏 , 朱晓娜 , 等 . 卒中后抑郁中医药治疗研究进展 [J]. 中医药学报 , 2021 , 49 ( 2 ): 83 - 87 .
杨宝秀 , 陈少玫 . 卒中后抑郁的中医药研究进展 [J]. 中医临床研究 , 2021 , 13 ( 12 ): 34 - 37,50 .
周帅 , 赵瑞瑞 , 薛明新 . 卒中后抑郁中医临床研究进展 [J]. 中国中医药信息杂志 , 2020 , 27 ( 3 ): 141 - 144 .
莫嘉浩 , 华荣 , 许洪彬 , 等 . 首批国医大师治疗脑卒中急性期的用药规律分析 [J]. 中草药 , 2020 , 51 ( 16 ): 4284 - 4290 .
王伟斌 . 基于古今医案的郁证辨治规律研究 [D]. 北京 : 中国中医科学院 , 2019 .
国家药典委员会 . 中华人民共和国药典:一部 [M]. 北京 : 中国医药科技出版社 , 2020 : 217 .
苏敬 . 唐·新修本草辑复本 [M]. 尚志钧,辑校.合肥 : 安徽科学技术出版社 , 1981 .
缪希雍 . 神农本草经疏 [M]. 夏魁周,赵瑗,校注.北京 : 中国中医药出版社 , 1997 .
陈士铎 . 本草新编 [M]. 柳长华,徐春波,校注.北京 : 中国中医药出版社 , 1996 .
郑金生 . 本草备要 [M]. 北京 : 中国医药科技出版社 , 2019 .
王小波 , 蔡业峰 , 黄培新 . 黄培新教授治疗卒中后抑郁经验总结 [J]. 时珍国医国药 , 2017 , 28 ( 8 ): 2017 - 2018 .
臧秋迟 , 王一阳 , 毛宇 , 等 . 国医大师熊继柏教授从痰论治中风经验 [J]. 中国中医急症 , 2021 , 30 ( 11 ): 2037 - 2040 .
张红玉 , 张丽莎 , 张杰 , 等 . 温郁金化学成分的研究 [J]. 中成药 , 2016 , 38 ( 7 ): 1534 - 1537 .
蔡艳虹 , 林坤河 , 甘国勇 , 等 . 桂郁金化学成分、药理作用及质量评价研究进展 [J]. 中国药物评价 , 2018 , 35 ( 6 ): 423 - 427 .
曲扬 , 刘超 , 任欣宇 , 等 . 黄丝郁金的化学成分 [J]. 中国药科大学学报 , 2013 , 44 ( 3 ): 207 - 209 .
陈金凤 , 熊亮 , 刘菲 , 等 . 蓬莪术姜黄素类化学成分研究 [J]. 中草药 , 2020 , 51 ( 1 ): 16 - 20 .
刘梅 , 郭小红 , 孙全 , 等 . 温郁金的化学成分和药理作用研究进展 [J]. 现代药物与临床 , 2021 , 36 ( 1 ): 204 - 208 .
VILLA R F , FERRARI F , MORETTI A . Post-stroke depression:Mechanisms and pharmacological treatment [J]. Pharmacol Ther , 2018 , 184 : 131 - 144 .
CORALLO F , SCARFI C , ARCADI F A , et al . Role of functional pharmacological therapy in post-stroke depression:A narrative review [J]. J Int Med Res , 2020 , doi: 10.1177/0300060520950557 http://dx.doi.org/10.1177/0300060520950557 .
黄世敬 , 陈宇霞 , 潘菊华 . 郁金治疗抑郁症的配伍应用及其抗抑郁研究进展 [J]. 北京中医药 , 2014 , 33 ( 6 ): 477 - 479 .
ZHAO D , ZHENG L , QI L , et al . Structural features and potent antidepressant effects of total sterols and β -sitosterol extracted from sargassum horneri [J]. Mar Drugs , 2016 , 14 ( 7 ): 123 .
刘晓峰 , 曹馨元 , 尹永霞 , 等 . 百花花楸果中 β -谷甾醇及其衍生物的制备及抗抑郁活性研究 [J]. 中国药房 , 2021 , 32 ( 1 ): 64 - 70 .
栗俞程 . 姜黄素干预代谢综合征和抑郁症的新机制研究 [D]. 南京 : 南京大学 , 2010 .
ZHANG Y , LI L , ZHANG J . Curcumin in antidepressant treatments:An overview of potential mechanisms,pre-clinical/clinical trials and ongoing challenges [J]. Basic Clin Pharmacol Toxicol , 2020 , 127 ( 4 ): 243 - 253 .
袁敏皎 , 袁捷 , 韩祖成 . 基于中医传承辅助平台挖掘中医药治疗卒中后抑郁的用药规律 [J]. 中国医药导报 , 2021 , 18 ( 5 ): 159 - 162 .
赵涵 , 程一升 , 张辉 . 醒脑解郁汤治疗卒中后抑郁的疗效及对血清NE、5-HT水平影响 [J]. 中华中医药学刊 , 2021 , 39 ( 11 ): 202 - 205 .
金伟民 , 戴方瑜 . 菖蒲郁金汤联合逍遥散加减治疗中风后抑郁临床观察 [J]. 新中医 , 2016 , 48 ( 12 ): 17 - 19 .
YANG Y , ZHU L , ZHANG B , et al . Higher levels of c-reactive protein in the acute phase of stroke indicate an increased risk for post-stroke depression:A systematic review and meta-analysis [J]. Neurosci Biobehav Rev , 2021 , 34 ( 21 ): 361 .
GUO H , ZHU L , TANG P , et al . Carthamin yellow improves cerebral ischemia‑reperfusion injury by attenuating inflammation and ferroptosis in rats [J]. Int J Mol Med , 2021 , 47 ( 4 ): 52 .
PENG Y , AO M , DONG B , et al . Anti-inflammatory effects of curcumin in the inflammatory diseases:Status,limitations and countermeasures [J]. Drug Des Devel Ther , 2021 , 15 : 4503 - 4525 .
兰晶 , 潘敬芳 . 姜黄素对脑缺血再灌注损伤大鼠PI3K/Akt/mTOR的影响 [J]. 重庆医学 , 2017 , 46 ( 1 ): 36 - 39 .
石红 , 石磊 , 李建雄 . 莪术二酮对肝部分切除老年小鼠术后认知功能和海马区炎性因子表达的影响 [J]. 西安交通大学学报:医学版 , 2017 , 38 ( 5 ): 749 - 752 .
LIAO P C , LAI M H , HSU K P , et al . Identification of β -sitosterol as in vitro anti-inflammatory constituent in moringa oleifera [J]. J Agric Food Chem , 2018 , 66 ( 41 ): 10748 - 10759 .
GULYAEVA N V . Functional neurochemistry of the ventral and dorsal hippocampus:Stress,depression, dementia and remote hippocampal damage [J]. Neurochem Res , 2019 , 44 ( 6 ): 1306 - 1322 .
YANG B , WANG L , NIE Y , et al . proBDNF expression induces apoptosis and inhibits synaptic regeneration by regulating the RhoA-JNK pathway in an in vitro post-stroke depression model [J]. Transl Psychiatry , 2021 , 11 ( 1 ): 578 .
SHAN D , ZHENG Y , FROUND K . Brain-derived neurotrophic factor as a clinical biomarker in predicting the development of post-stroke depression:A review of evidence [J]. Cureus , 2021 , 13 ( 6 ): e15662 .
YANG B , LUO G , ZHANG C , et al . Curcumin protects rat hippocampal neurons against pseudorabies virus by regulating the BDNF/TrkB pathway [J]. Sci Rep , 2020 , 10 ( 1 ): 22204 .
KANDEZI N , MOHAMMADI M , GHAFFARI M , et al . Novel insight to neuroprotective potential of curcumin:A mechanistic review of possible involvement of mitochondrial biogenesis and PI3/Akt/GSK3 or PI3/Akt/CREB/BDNF signaling pathways [J]. Int J Mol Cell Med , 2020 , 9 ( 1 ): 32 .
PARK J Y , SOHN H Y , KOH Y H , et al . Curcumin activates Nrf2 through PKC δ -mediated p62 phosphorylation at Ser351 [J]. Sci Rep , 2021 , 11 ( 1 ): 8430 .
HADIZADEH-BAZAZ M , VAEZI G , KHAKSARI M , et al . Curcumin attenuates spatial memory impairment by anti-oxidative,anti-apoptosis,and anti-inflammatory mechanism against methamphetamine neurotoxicity in male Wistar rats:Histological and biochemical changes [J]. Neurotoxicology , 2021 , 84 : 208 - 217 .
MAHMOUDI R , GHAREGHANI M , ZIBARA K , et al . Alyssum homolocarpum seed oil (AHSO), containing natural alpha linolenic acid, stearic acid, myristic acid and β -sitosterol, increases proliferation and differentiation of neural stem cells in vitro [J]. BMC Complement Altern Med , 2019 , 19 ( 1 ): 113 .
KOGA T , SAKAMOTO T , SAKURADANI E , et al . Neurite outgrowth-promoting activity of compounds in PC12 cells from sunflower seeds [J]. Molecules , 2020 , 25 ( 20 ): 4748 .
CHANG Z , HE L J , TIAN D F , et al . Therapeutic targets and mechanism of Xingpi Jieyu decoction in depression:A network pharmacology study [J]. Evid Based Complement Alternat Med , 2021 , 2021 : 5516525 .
GUO J , WANG J , SUN W , et al . The advances of post-stroke depression:2021 update [J]. J Neurol , 2021 , doi: 10.1007/s00415-021-10597-4 http://dx.doi.org/10.1007/s00415-021-10597-4 .
ZHOU Y , MA Y , WU Q , et al . Comparison of thyroid hormone levels between patients with major depressive disorder and healthy individuals in China [J]. Front Psychiatry , 2021 , 12 : 750749 .
李照雪 , 胡思远 , 王吉烨 , 等 . 基于促甲状腺功能的姜黄素延长低温冷冻小鼠生存时间的作用机制研究 [J]. 中国药理学通报 , 2017 , 33 ( 9 ): 1291 - 1297 .
LI H B , XU M L , DU M M , et al . Curcumin ameliorates hypertension via gut-brain communication in spontaneously hypertensive rat [J]. Toxicol Appl Pharmacol , 2021 , 429 : 115701 .
谢晓彬 , 张卫 . 卒中后抑郁病因机制研究进展 [J]. 中医临床研究 , 2020 , 12 ( 5 ): 145 - 148 .
SHI C , LUO X , WANG J , et al . Incorporation of β -sitosterol into the membrane prevents tumor necrosis factor- α -induced nuclear factor- κ B activation and gonadotropin-releasing hormone decline [J]. Steroids , 2015 , 96 : 1 - 6 .
VILLA R F , FERRARI F , MORETTI A . Post-stroke depression:Mechanisms and pharmacological treatment [J]. Pharmacol Ther , 2018 , 184 : 131 - 144 .
KEIHANIAN F , SAEIDINIA A , BAGHERI R K , et al . Curcumin,hemostasis, hrombosis,and coagulation [J]. J Cell Physiol , 2018 , 233 ( 6 ): 4497 - 4511 .
王秀 , 夏泉 , 许杜娟 , 等 . 莪术中莪术二酮抗凝血和抗血栓作用的实验研究 [J]. 中成药 , 2012 , 34 ( 3 ): 550 - 553 .
秦宇雯 , 费程浩 , 张伟 , 等 . 姜黄属中药活血化瘀功效关联物质研究进展 [J]. 中国中药杂志 , 2022 , 47 ( 1 ): 24 - 35 .
陈志敏 , 权亮 , 周海婷 , 等 . 郁金炮制沿革及质量评价方法研究现状 [J]. 中草药 , 2018 , 49 ( 16 ): 3969 - 3976 .
彭颖 , 敖明月 , 权亮 , 等 . 炮制对川产郁金活血化瘀作用影响研究 [J]. 中华中医药学刊 , 2021 , doi: 21.1546.R.20211104.1455.054.html http://dx.doi.org/21.1546.R.20211104.1455.054.html .
陈志敏 . 郁金饮片分级及炮制机理研究 [D]. 成都 : 成都中医药大学 , 2019 .
张军 , 石典花 . 四种不同药材来源郁金饮片中吉马酮和姜黄素含量的高效液相色谱法测定 [J]. 时珍国医国药 , 2016 , 27 ( 8 ): 1846 - 1849 .
王晓华 , 朱华 , 陈旭 , 等 . 郁金化学成分及其质量控制研究进展 [J]. 安徽农业科学 , 2012 , 40 ( 10 ): 5873 - 5875 .
权亮 . 醋郁金炮制工艺、质量标准及其药效学研究 [D]. 成都 : 成都中医药大学 , 2019 .
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