肝主疏泄调畅情志功能的中枢神经生物学机制探讨

Exploration on Central Neurobiological Mechanisms of Gan in Taking Charge of Dispersion and Regulating Emotion

结合中医整体观和平衡观以及现代心理应激理论,以心理应激反应为切入点,提出研究假说:中医学肝主疏泄调畅情志的功能存在着一定的具体的中枢神经生物学机制;采用“方—证—效—脏腑功能本质”的研究思路,通过建立慢性心理应激反应模型模拟“肝失疏泄、情志异常”的综合病理变化过程。就已取得的研究结果进行分析认为:肝主疏泄之所谓“疏泄”,其中枢神经生物学机制在整体上与调节下丘脑-垂体-肾上腺轴有关,具体而言,可能与调节慢性心理应激反应(情志活动异常)过程中中枢多种神经递质及其合成酶、神经肽、激素、环核苷酸系统以及Fos蛋白表达的变化有关,表现出多层次、多靶点以及多环节的作用特点;作用的脑区涉及到下丘脑(包括不同核团)海马,杏仁核等。

Methods and thoughts of the further research on central neurobiological mechanisms of Gan in taking charge of dispersion and regulating emotion are discussed. By applying the holistic approach and homeostasis theory, combined with modern psychological stress theory, the authors put forward their hypothesis of study. They offered that the TCM theory of 'Gan takes charge of dispersion and could regulate emotion' is affirmatively to have certain mechanisms of central neurobiology. So, cut-in from the point of psychological stress reaction, adopting the research thoughts of 'prescription-syndrome-therapeutic effectiveness-essence of Zang-Fu function', a model of chronic psychological stress reaction (CPSR) for imitating the process of comprehensive pathologic change due to Gan fails to take charge of dispersion and leads to emotional disorder was established. It is considered based on analysis of materials obtained from previous studies, that the central neurobiologic mechanism of so called dispersion, which Gan in charge of, is related to the regulation of hypothalamus-pitutary-adrenal gland axis. Concretely, the function of Gan in TCM may be, in the gross, related with the changes of multiple neurotransmitters and their synthetase produced in the process of CPSR (emotional disorder) regulation, such as neuropeptides, hormones, cyclic necleotide system and Fos protein expression, showing the characteristics of multiple links, multiple levels and multiple targets, with the effects involve several brain regions including various clusters of nuclei in hypothalamus, hippocampus and amygdala, etc.