中医药治疗抗精神药物引起多汗症的研究进展

Research Progress of Chinese Medicine in Treating Psychotropic Drugs-Induced Hyperhidrosis

多汗症是精神药物的常见不良反应,其发生机制目前尚不明确。文章从精神药物引起多汗症的机制,以及中医药治疗此类多汗症的作用机理的进展作一综述。应用计算机检索PUBMED 1993年至2016年期间与抗精神病药物、多汗症、中医、中药、针灸等相关的文献,关键词"Psychotropic Drugs and Hyperhidrosis",同时计算机检索相关杂志1986年1月至2016年3月期间与精神药物、多汗症、中医、中药、针灸相关的文献,限定语种为"中文"和"英文",关键词"精神药物、多汗症、中医药"。选择资料:纳入标准为临床研究、实验研究类文献及临床案例报导类文献。检索发现:精神药物引起多汗症是临床很常见的症状,其发病机制与精神药物的多靶点作用有关,尤其是抗抑郁药,发生出汗的不良反应比例较高,可能与选择性的5-羟色胺再摄取抑制机制相关。治疗方面,西医直接阻断出汗通路或者外用药物止汗,不良发应较大;中医认为自汗、盗汗的基本病机是阴阳失调,腠理不固而致汗液外泄失常。中医通过服用单味药、复方及针刺疗法,取得较好疗效。在今后研究中需着重探讨其发病机制,收集更多临床案例进行观察,并实施规范化治疗。

Hyperhidrosis is a common adverse reaction against psychotropic drugs,its mechanism is still not clear.This paper made a summary from the mechanism of hyperhidrosis caused by the psychotropic drugs,and the treatment of Chinese medicine on patients with hyperhidrosis.We searched PubMed from 1993 to 2016 and relative magazines published in Chinese between January 1986 and March 2016 by using keywords ＂psychotropic drugs,hyperhidrosis and TCM＂.The study included clinical research literature,experimental research literature and clinical case reports.It was found that hyperhidrosis induced by psychotropic drugs is a common symptom,its mechanism may be rated to the multi-target effect of psychotropic drugs.Adverse reaction happens like sweeting especially in antidepressants,which may be associated with selective 5-serotonin reuptake inhibition.The treatment of western medicine,directly blocking sweat pathway or topical antiperspirant may introduce frequent adverse reaction.Chinese medicine believes that the basic pathogenesis of spontaneous perspiration and night sweat are caused by the imbalance of yin and yang and unsolidity of striae and interstice.Through single or compound medicine and acupuncture therapy,Chinese medicine can achieve better efficacy.In the future study,it is necessary to focus on the pathogenesis of the disease,collect more clinical cases,and to perform standardized treatment.