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Pharmacy Information 2025
产后抑郁症的病理机制与治疗药物
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Abstract:
产后抑郁症(Postpartum Depression, PPD)是一种女性分娩后可能出现的情绪障碍，影响着中国约16%的女性。其病理机制涉及神经递质失衡、神经内分泌变化及神经炎症等因素。神经递质如5-HT、DA和NE的失衡与情绪调节密切相关，在PPD的发生发展中起关键作用。分娩后雌激素和孕激素水平的急剧下降可能干扰大脑神经可塑性和神经递质系统，引发PPD。此外，神经炎症，特别是NLRP3炎症小体的激活，也显著加剧了PPD的病理过程。传统的抗抑郁药物通过调节神经递质水平来改善症状，但哺乳期用药需谨慎考虑药物对婴儿的影响。中药治疗则展现出独特的优势，中药的多靶点作用机制和较小的副作用，使其在PPD治疗中具有广阔的应用前景。
Postpartum Depression (PPD) is a mood disorder that can occur in women following childbirth, affecting approximately 16% of women in China. The pathogenesis of PPD involves neurotransmitter imbalances, neuroendocrine alterations, and neuroinflammation. Imbalances in neurotransmitters such as serotonin (5-HT), dopamine (DA), and norepinephrine (NE) are closely associated with emotional regulation and play a pivotal role in the onset and progression of PPD. The sharp decline in estrogen and progesterone levels following childbirth may disrupt neural plasticity and neurotransmitter systems in the brain, potentially leading to PPD. Furthermore, neuroinflammation, particularly the activation of the NLRP3 inflammasome, significantly exacerbates the pathological process of PPD. Traditional antidepressants improve symptoms by modulating neurotransmitter levels, but their use during lactation requires careful consideration of their impact on infants. Traditional Chinese medicine (TCM) offers unique advantages in the treatment of PPD, with its multitarget action mechanisms and minimal side effects, making it a promising approach in the management of PPD.
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