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河南省仲景方药现代研究重点实验室,河南中医药大学 中医药科学院,郑州 450046
Published:20 July 2023,
Published Online:16 January 2023,
Received:29 September 2022,
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田磊,栗俞程,白明等.栀子及其方剂配伍治疗抑郁症研究进展[J].中国实验方剂学杂志,2023,29(14):239-247.
TIAN Lei,LI Yucheng,BAI Ming,et al.Gardeniae Fructus and Its Prescriptions in Treatment of Depression: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(14):239-247.
田磊,栗俞程,白明等.栀子及其方剂配伍治疗抑郁症研究进展[J].中国实验方剂学杂志,2023,29(14):239-247. DOI: 10.13422/j.cnki.syfjx.20230301.
TIAN Lei,LI Yucheng,BAI Ming,et al.Gardeniae Fructus and Its Prescriptions in Treatment of Depression: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(14):239-247. DOI: 10.13422/j.cnki.syfjx.20230301.
抑郁症是一种以持久的心境低落为主要特征的精神障碍类疾病,归属为中医“郁证”范畴,具有高患病率、高致残率、高自杀率及高复发率等特点,其发病机制十分复杂,遗传、心理与社会环境等因素均涉及其中。目前临床上的抗抑郁药物如三、四环类抗抑郁药,选择性5-羟色胺(5-HT)再摄取抑制剂等药物起效缓慢,长期应用不良反应显著,且临床统计约有三分之一的患者对此类药物无反应性。如何有效提升抑郁症的治疗效果已成为医学界目前急需解决的一大难题。中医药基于整体观念和辨证论治,在抑郁症的防治方面具有疗效稳定、复发率低、不良反应少、患者依从性好等独特优势。作为中药清热药的一种,栀子具有清热泻火、凉血除烦之功效,对“郁证”患者有较好的治疗效果。文献研究发现栀子活性成分如栀子苷、京尼平、西红花苷,栀子药对如栀子-川芎、栀子-刺五加、栀子-枸杞子,含栀子的中药复方如栀子豉汤、越鞠丸、栀子厚朴汤、丹栀逍遥散、解郁安神颗粒等抗抑郁疗效显著,其机制可能与调控下丘脑-垂体-肾上腺(HPA)轴、调节5-HT及多巴胺(DA)神经递质、增加海马脑源性神经营养因子(BDNF)和增强海马神经发生、调控核转录因子-
κ
B(NF-
κ
B)信号通路抑制神经炎症反应等有关。本文对栀子活性成分、栀子药对及含栀子的中药复方等抗抑郁的相关基础与临床研究进展的总结,为进一步推广栀子及其方剂配伍治疗抑郁症的临床应用提供参考。
Depression is a mental disorder characterized by persistent low mood and belongs to the category of "stagnation syndrome" in traditional Chinese medicine (TCM), with the characteristics of high prevalence, high disability rate, high suicide rate, and high recurrence rate. The pathogenesis of depression is extremely complex and involves factors such as genetics, psychology, and social environment. Currently, clinical antidepressant drugs such as tricyclic and tetracyclic antidepressants, and selective serotonin reuptake inhibitors, have slow onset of action and significant adverse effects with long-term application. Furthermore, clinical statistics show that about one-third of patients do not respond to these types of medications. Enhancing the effectiveness of depression treatment has become a major challenge in the medical field. TCM, based on the holistic view and treatment based on syndrome differentiation, has unique advantages in the prevention and treatment of depression, including stable therapeutic effects, low recurrence rate, minimal side effects, and good patient compliance. As one of the heat-clearing drugs, Gardeniae Fructus has the effects of clearing heat, purging fire, cooling blood, and relieving restlessness, which makes it effective in treating patients with "stagnation syndrome". Literature studies have found that active components of Gardeniae Fructus, such as geniposide, genipin, and crocin, as well as drug pairs such as Gardeniae Fructus-Chuanxiong Rhizoma, Gardeniae Fructus-Acanthopanacis Senticosi Radix et Rhizoma Seu Caulis, and Gardeniae Fructus-Lycii Fructus, and prescriptions such as Zhizichi Tang, Yuejuwan, Zhizi Houpotang, Danzhi Xiaoyaosan, and Jieyu Anshen Granules, have shown significant antidepressant effects. The mechanism of action may be related to regulating the hypothalamic-pituitary-adrenal (HPA) axis, modulating neurotransmitters such as serotonin (5-HT) and dopamine (DA), increasing brain-derived neurotrophic factor (BDNF) in the hippocampus, enhancing neurogenesis in the hippocampus, and regulating the nuclear factor-kappa B (NF-
κ
B) signaling pathway to inhibit neuroinflammation. This article summarized the research progress on the active components of Gardeniae Fructus, drug pairs, and Chinse medicinal prescriptions containing Gardeniae Fructus, providing references for further promoting the clinical application of Gardeniae Fructus and its prescriptions in the treatment of depression.
抑郁症栀子栀子豉汤越鞠丸栀子厚朴汤
depressionGardeniae FructusZhizichi TangYueju WanZhizi Houpotang
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