基于脑-肠学说探讨中医药抗抑郁症思路

Discussion About Removing Depression with TCM Based on the Brain-Gut Theory

抑郁症病机为情志内伤,肝气郁结,脾失健运,致脏腑气血阴阳失衡,中医药可通过调控肝、脾脏腑功能治疗抑郁症。现代研究证实,脑-肠轴通路和抑郁症有较强的相关性。脑肠肽不仅存在于大脑中,也存在于胃肠道内,与胃肠功能和情绪密切相关。由于消化系统-神经系统存在一定联系,即脑-肠轴的存在,可以把胃肠道及肠道菌群看成一个整体,对神经系统做出代谢、免疫及神经递质的应答从而影响其功能。中医药不仅可调控机体脑肠肽的分泌和含量,从而调控免疫系统、影响迷走神经调节,还可以直接调控机体肠道菌群丰富度及结构,进一步影响抑郁行为。中医药对抑郁症发病机制的研究尚未完全明确,以后可增加中药通过改善肠道神经分泌、免疫、肠道菌群治疗抑郁症的相关研究。

The pathogenesis of depression is internal emotional injury,stagnation of liver qi,spleen failing to activate,resulting in the imbalance of qi,blood,yin and yang in the viscera.TCM can treat depression by regulating the function of the liver,spleen and viscera.Brain gut peptide exists not only in the brain,but also in the gastrointestinal tract,which is closely related to gastrointestinal function and emotion.Because there is a certain connection between digestive system and nervous system,that is,the existence of brain intestinal axis,the gastrointestinal tract and intestinal flora can be regarded as a whole to make metabolic,immune and neurotransmitter responses to the nervous system,so as to affect its function.TCM can not only regulate the secretion and content of brain intestinal peptide,so as to regulate the immune system and affect the regulation of vagus nerve,but also directly regulate the abundance and structure of intestinal flora,and further affect depressive behavior.The research on the pathogenesis of depression by TCM has not been completely clear.In the future,we can increase the relevant research on the treatment of depression by Chinese medicinals by improving intestinal nerve secretion,immunity and intestinal flora.