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归脾丸(散)与其有效成分抗抑郁作用机制研究进展
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Abstract:
抑郁症是一种严重影响人类工作和生活的精神类疾病，就治疗总费用和生产力损失而言，抑郁症居世界疾病负担首位，严重影响社会和人类健康。近几年的研究表明，中医药在治疗抑郁方面具有一定优势，以归脾丸作为干预抑郁症的经典方剂其抗抑郁作用已被临床反验证，但归脾丸及其有效成分的抗抑郁作用机制尚不清楚，本文通过对以往国内外研究的文献进行系统梳理，发现其主要是从调节下丘脑–垂体–肾上腺(HPA)轴，影响单胺类神经递质分泌，调节脑源性神经营养因子(brain-derived neurotrophic factor, BDNF)的水平，抑制炎症反应，调节肠道菌群的结构，影响氨基酸类神经递质的分泌，影响雌激素的水平等方面发挥抗抑郁作用的。其有效成分主要包括抗炎抗凋亡的黄芪甲苷，以提高BDNF水平为主的酸枣仁皂苷和茯苓多糖，以调节HPA轴为主的远志皂苷，多通路调节的主要包括调节HPA轴，BDNF，单胺神经递质，抗炎抗氧化等途径的人参皂苷、阿魏酸和甘草酸等。
Depression is a kind of mental disease that seriously affects people’s work and life. In terms of the total cost of treatment and loss of productivity, depression ranks first in the world’s disease burden, which seriously affects social and human health. Studies in recent years have shown that traditional Chinese medicine has certain advantages in the treatment of depression. The anti- depressant effect of Guipi pill as a classic prescription for depression intervention has been clinically counter-verified, but the mechanism of anti-depressant action of Guipi pill and its effective components is still unclear. This paper systematically reviews the literature of previous domestic and foreign studies. It was found that it plays an antidepressant role in regulating the hypothalamic-pituitary-adrenal axis (HPA), affecting the secretion of monoamine neurotransmitters, regulating the level of brain-derived neurotrophic factor (BDNF), inhibiting inflammatory response, regulating the structure of intestinal flora, affecting the secretion of amino acid neurotransmitters, and affecting the level of estrogen. The active components mainly include astragaloside IV, which is anti-inflammatory and anti-apoptotic, jujube saponins and poria polysaccharide, which mainly improves the level of BDNF, and radix saponins, which mainly regulate the HPA axis. The multi- pathway and multi-point anti-depressants include ginsenosides, ferulic acid and glycyrrhizic acid, which are mainly involved in regulating the HPA axis, BDNF, monoamine neurotransmitter, anti-inflammatory and antioxidant pathways.
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