针刺治疗抑郁症作用机制近5年研究进展

Progress of Researches on Mechanisms of Acupuncture Underlying Improvement of Depression in the Past Five Years

近5年来,针刺治疗抑郁症的作用机制研究取得了显著进展,笔者对此进行了综述,主要包括以下几方面:(1)针刺上调海马内单胺类神经递质、γ-氨基丁酸含量和5-羟色胺1A受体结合位点,及下丘脑神经肽Y、β-内啡肽、μ受体的表达,降低海马谷氨酸含量;(2)针刺上调海马脑源性神经营养因子蛋白及基因和相关受体的表达,激活腺苷酸环化酶-环磷酸腺苷(cAMP)-蛋白激酶A-cAMP反应元件结合蛋白信号通路;(3)针刺增加海马生长相关蛋白-43水平,并抑制c-Jun氨基末端激酶活性和细胞凋亡;(4)针刺增加海马胶质纤维酸性蛋白的表达;(5)针刺调节下丘脑-垂体-肾上腺皮质轴和下丘脑-垂体-性腺轴功能;(6)针刺下调血清中细胞因子的含量。笔者还对今后的研究进行了展望。

Depression is a state of low mood and aversion to activity that has a negative effect on the patient＇s thoughts, behavior, feelings, and physical well-being In the past five years, a significant progress has been made in understanding the mechanism of acupuncture therapy for improving depression. In the present paper, the authors summarize mechanisms of acupunc- ture for depression from 1） upregulating levels of monoamine neurotransmitters, gamma-aminobutyric acid, 5-HT_1A receptor bin- ding, and hypothalamic neuropeptide Y, βendorphine, and μ-receptor expression, and down-regulating hippocampal glutamate content, etc. ; 2） upregulating expression of hippocampal brain-derived neurotrophic factor protein and mRNA and its receptor TrkB, and activating adenyl eyclase-cAMP-PKA-CREB signaling pathway; 3） increasing hippocampal growth-associated protein 43 level and suppressing hippocampal c-Jun N-terminal kinase activation and cellular apoptosis; 4） upregulating expression of glial fibrillary acidic protein （activating glia cells） ; 5） regulating activities of hypothalamus-pituitary-adrenal axis and hypothalamus-pi- tuitary-sex gland axis; 6） down-regulating serum IL-1β, IL-6, and tumor necrosis factor-α levels. Moreover, the authors also put forward some suggestions about the further research on the mechanisms of acupuncture intervention for depression in the future. [KEY WORDS] Acupuncture; Depression; Chronic stress; Mechanism