酸枣仁汤及其组分治疗抑郁症的研究进展

Research Progress of Suanzaoren Decoction(酸枣仁汤)and Its Components in Treatment of Depression

抑郁症是一种以情感病态变化为主要症状的常见精神疾病,其发病机制尚未明确。抑郁症在中医学属于“郁证”范畴,酸枣仁汤是张仲景在《金匮要略》中所载经典名方。临床上,酸枣仁汤用于治疗多种病因诱导的抑郁症,如更年期抑郁、产后抑郁、心肌梗死伴抑郁、维持性血液透析抑郁等;实验研究发现,酸枣仁汤抗抑郁的作用机制可能与抑制促炎因子释放、促进脑源性神经营养因子及其受体表达、调节神经递质、保护大脑神经胶质细胞、干预氨基酸及其受体水平、影响海马神经元中功能基因的转录和翻译等相关;酸枣仁汤中单味药抗抑郁主要成分为酸枣仁生物碱、酸枣仁皂苷、川芎挥发油、川芎嗪、知母皂苷、芒果苷、茯苓多糖、茯苓水提物、甘草总黄酮、甘草苷等。从酸枣仁汤的临床研究文献中发现酸枣仁汤治疗抑郁症疗效显著,从实验研究的相关文献证实了酸枣仁汤及其组分抗抑郁的药理机制,为酸枣仁汤治疗抑郁症的遣方组药、药效及作用机制研究提供参考依据。

Depression is a common mental illness whose main symptom is changes in affective morbidity,and its pathogenesis is not yet clear.Depression belongs to the category of"depression syndrome"in traditional Chinese medicine and Suanzaoren Decoction(酸枣仁汤)is the classic prescription contained in ZHANG Zhongjing's Synopsis of the Golden Chamber.Clinically,Suanzaoren Decoction is used to treat depression induced by various causes,such as menopausal depression,postpartum depres-sion,myocardial infarction with depression,maintenance hemodialysis depression,etc.The experimental studies have found that the antidepressant mechanism of Suanzaoren Decoction may be related to inhibiting the release of pro-inflammatory factors,pro-moting the expression of brain-derived neurotrophic factors and their receptors,regulating neurotransmitters,protecting brain glial cells,interfering with the levels of amino acids and their receptors,and affecting the transcription and translation of functional genes in hippocampal neurons.The main antidepressant components of the single medicine in Suanzaoren Decoction are alkaloids from Suanzaoren(Semen Zizyphi Spinosae),jujuboside,volatile oil of Chuanxiong(Rhizoma Chuanxiong),Anemarrhena sapo-nins,mangiferin,Poria polysaccharides,Poria water extract,total flavonoids of Gancao(Radix Et Rhizoma Glycyrrhizae),glycyrrhi-zin,etc.This article has found that Suanzaoren Decoction has a significant effect on depression from the clinical research litera-ture of Suanzaoren Decoction.The relevant literature of experimental studies has confirmed the antidepressant pharmacological mechanism of Suanzaoren Decoction and its components to provide the reference for the study of prescriptions,drug effects and mechanism of action.