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1.广西中医药大学,南宁 530001
2.广西中医药大学 第一附属医院,南宁 530200
3.防城港市中医医院,广西 防城港 538000
Received:19 July 2024,
Accepted:12 November 2024,
Published Online:16 October 2024,
Published:05 March 2025
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徐锦江,武丽,张齐等.基于信号通路调控探讨中医药干预抑郁症的研究进展[J].中国实验方剂学杂志,2025,31(05):319-328.
XU Jinjiang,WU Li,ZHANG Qi,et al.Traditional Chinese Medicine Intervention in Depression Based on Signaling Pathway Regulation: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(05):319-328.
徐锦江,武丽,张齐等.基于信号通路调控探讨中医药干预抑郁症的研究进展[J].中国实验方剂学杂志,2025,31(05):319-328. DOI: 10.13422/j.cnki.syfjx.20241612.
XU Jinjiang,WU Li,ZHANG Qi,et al.Traditional Chinese Medicine Intervention in Depression Based on Signaling Pathway Regulation: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(05):319-328. DOI: 10.13422/j.cnki.syfjx.20241612.
抑郁症是一种常见的精神障碍疾病,患者表现为持续性心境低落或精神障碍,当前治疗以调节神经递质水平为主,治疗效果欠佳。其发病机制复杂,目前尚无统一共识,信号通路转导异常在抑郁症的发病中起着至关重要的作用,包括Toll样受体4/NOD样受体蛋白3(TLR4/NLRP3)、核转录因子-
κ
B(NF-
κ
B)、Janus/激酶/转录激活因子(JAK/STAT)、丝裂原活化蛋白激酶/胞外信号调节激酶(MAPK/ERK)、脑源性神经营养因子/酪氨酸激酶受体B(BDNF/TrkB)、环磷酸腺苷(cAMP)/蛋白激酶A(PKA)/cAMP应答元件结合蛋白质(CREB)等多个通路。中医药以整体观和辨证论治为核心,从宏观层面调节多系统平衡、多器官功能,在抑郁症治疗中展现出独特优势。中医学认为抑郁的发病与脏腑功能失调相关,涉及肝气郁结、心神失养、肾精亏虚、脾失健运等,中药复方治疗以疏肝、健脾、宁心、填精为主,如逍遥散、滋水清肝饮、柴胡加桂枝龙骨牡蛎汤等;中药活性成分中以补益、理气药为主,如红景天苷、人参皂苷Rb
1
、黄芪素、麝香酮等;中医外治以针刺为主,治以开窍、醒神,选用百会、神庭、印堂等穴位,此外推拿、督灸疗法也可通过调控信号通路干预抑郁症。该文综述了信号通路在抑郁症发病中的核心作用,以及中医药调控信号通路干预抑郁症的作用机制,以期发现改善抑郁患者症状的新疗法。
Depression is a common psychiatric disorder characterized by persistent low mood or mental disorders. Current treatments primarily focus on regulating neurotransmitter levels, but their effectiveness is limited. Th
e mechanisms underlying its onset are complex, and there is no unified consensus. Abnormal signaling pathway transmission plays a crucial role in the development of depression, involving multiple pathways, including Toll-like receptor 4/nucleotide-binding oligomerization domain-like receptor protein 3 (TLR4/NLRP3), nuclear factor-
κ
B (NF-
κ
B), Janus kinase/signal transducer and activator of transcription (JAK/STAT), mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK), brain-derived neurotrophic factor/tyrosine kinase receptor B (BDNF/TrkB), cyclic AMP/protein kinase A/cAMP response element-binding protein (cAMP/PKA/CREB), and others. Traditional Chinese medicine(TCM) is based on a holistic approach and the principle of treatment based on the differentiation of syndromes, regulating the balance of multiple systems and organ functions from a macroscopic perspective. This approach has shown unique advantages in the treatment of depression. TCM attributes the onset of depression to dysfunction of the organ systems, involving liver Qi stagnation, heart spirit deficiency, kidney essence depletion, and spleen dysfunction. TCM compound treatments focus on soothing the liver, strengthening the spleen, calming the heart, and replenishing essence, with formulas such as Xiaoyaosan, Zishui Qinggan Yin, and Chahu Jia Guizhi Longgu Muli Tang. The active components of Chinese herbs mainly aim to tonify and regulate Qi, such as salidroside, ginsenoside Rb
1
, astragaloside, and muscone. External TCM treatments, primarily acupuncture, aim to open the orifices and invigorate the spirit. Acupoints such as Baihui, Shenting, and Yintang are commonly used. Additionally, massage and moxibustion therapy can intervene in depression by regulating signaling pathways. This article reviews the core role of signaling pathways in the development of depression and the mechanism of TCM regulation of signaling pathways to intervene in depression, aiming to discover new therapeu
tic approaches that can improve the symptoms of depressed patients.
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