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1.河北中医学院,石家庄 050200
2.河北省中西医结合肺病研究重点实验室,石家庄 050091
张碧涛,在读硕士,从事中医证候病理生理基础研究,E-mail:549550430@qq.com
王少贤,博士,教授,从事中医证候病理生理基础研究,E-mail:muhudie@163.com
纸质出版日期:2022-12-05,
网络出版日期:2022-04-19,
收稿日期:2022-01-21,
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张碧涛,李媛媛,辛泰然等.逍遥散治疗抑郁症的研究进展[J].中国实验方剂学杂志,2022,28(23):273-282.
ZHANG Bitao,LI Yuanyuan,XIN Tairan,et al.Xiaoyaosan in Treatment of Depression: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(23):273-282.
张碧涛,李媛媛,辛泰然等.逍遥散治疗抑郁症的研究进展[J].中国实验方剂学杂志,2022,28(23):273-282. DOI: 10.13422/j.cnki.syfjx.20221229.
ZHANG Bitao,LI Yuanyuan,XIN Tairan,et al.Xiaoyaosan in Treatment of Depression: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2022,28(23):273-282. DOI: 10.13422/j.cnki.syfjx.20221229.
逍遥散出自《太平惠民和剂局方》,全方由柴胡、当归、白芍、白术、茯苓、煨姜、薄荷、炙甘草组成。逍遥散作为中医调治情志活动异常的经典名方,临床实践及实验研究均证实其可用于抑郁、焦虑症及多种躯体疾病继发的抑郁状态,如逍遥散加减联合西药或其他疗法治疗妇科疾病、内科疾病、消化系统疾病等基础上伴随抑郁症发病,可明显改善患者汉密尔顿抑郁量表、抑郁自评量表等评分,疗效良好,患者依从性较高,无明显不良反应。目前逍遥散治疗抑郁症的发病机制主要集中于单胺神经递质5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)等,下丘脑-垂体-肾上腺轴促肾上腺皮质激素(ACTH)、皮质酮(CORT)等,免疫炎症因子水平白细胞介素-1
β
(IL-1
β
)、白细胞介素-6(IL-6)、肿瘤坏死因子-
α
(TNF-
α)
等,肠道微生态及脑肠轴食欲素、胃饥饿素、瘦素等,进而调节机体神经生化机制、内分泌机制、免疫机制和脑区结构异常等达到防治抑郁症的目的,但逍遥散抗抑郁的作用机制研究尚待进一步深入探讨。该文通过整理相关文献,对逍遥散治疗抑郁症的临床应用和基础作用机制进行了综合分析,以期为逍遥散临床防治抑郁症,提高患者生存质量提供有益的指导;同时也为逍遥散抗抑郁作用机制的深入研究,提供参考。
Xiaoyaosan, a classical prescription for mental disorder recorded in
Formulary of the Bureau of Taiping People's Welfare Pharmacy
(《太平惠民合剂局方》), is composed of Bupleuri Radix, Angelicae Sinensis Radix, Paeoniae Radix Alba, Atractylodis Macrocephalae Rhizoma, Poria, Zingiberis Rhizoma Praeparatum, Menthae Haplocalycis Herba, and Glycyrrhizae Radix Et Rhizoma Praeparata Cum Melle. Clinical practices and experiments have proved that it can be used for primary depression, anxiety, as well as the depression induced by various somatic disorders, such as gynecological diseases, internal diseases, and digestive system diseases, as evidenced the improvement of Hamilton depression rating scale score, self-rating depression scale score, etc. Xiaoyaosan has been verified to be remarkably effective, with high compliance and no obvious adverse reactions in patients. Xiaoyaosan mainly acts on monoamine neurotransmitters 5-hydroxytryptamine (5-HT), norepinephrine (NE), and dopamine (DA), adrenocorticotropic hormone (ACTH) and corticosterone (CORT) in hypothalamic-pituitary-adrenal axis, pro-inflammatory cytokines interleukin-1
β
(IL-1
β
), interleukin-6 (IL-6), and tumor necrosis factored (TNF)-
α
, and orexin, ghrelin, and leptin in intestinal microecology and brain-gut axis, to regulate the neurobiochemical mechanism, endocrine mechanism, immune mechanism, and abnormal brain structure, thereby preventing and alleviating depression. However, the antidepressant mechanism of Xiaoyaosan needs to be further discussed. Through literature research, this paper analyzes the clinical application and basic mechanism of Xiaoyaosan in the treatment of depression, which is expected to serve as a reference for the application of this prescription in the clinical prevention and treatment of depression and improvement of the quality of life of patients, and further research on the antidepressant mechanism of Xiaoyaosan.
逍遥散抑郁症临床应用作用机制研究进展
Xiaoyaosandepressionclinical applicationmechanismresearch progress
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