心肌梗死后抑郁的中西医研究进展

Progress of Traditional Chinese Medicine and Western Medicine in Depression after Myocardial Infarction

心肌梗死后抑郁发病率较高,病人预后较差,尽管相关预测因素可协助诊断心肌梗死后是否发生抑郁,但相关定义和临床特征不明确,临床识别处于较低水平。心肌梗死后抑郁的生物学机制主要涉及炎症、细胞凋亡、5-羟色胺功能障碍、肠道菌群失调等,来源于心脏的信号分子与中枢神经系统的作用机制尚未明确。心脏康复5个处方是西医治疗的主要手段,其中药物处方和心理处方对心脏结局的影响尚无统一结论。中医药治疗身心疾病是符合我国国情的思维模式,但在中药、针灸、外治等方面的理论和临床研究均有不足。综述心肌梗死后抑郁的中西医研究进展,旨在为临床和科研梳理思路,针对存在的问题指导今后的研究方向,进一步探索中西医优势互补的发展道路。

The incidence of depression after myocardial infarction was high,and the prognosis was poor.Although related predictors could help diagnose whether depression occured after myocardial infarction,the relevant definitions and clinical characteristics were unclear,and clinical identification was at a low level.The biological mechanisms of depression after myocardial infarction mainly involved inflammation,apoptosis,serotonin dysfunction,and intestinal flora imbalance,while the mechanism of action between cardiac-derived signaling molecules and the central nervous system was unclear.Five prescriptions for cardiac rehabilitation were the main means of western medicine treatment,and there was no unified conclusion on the effects of drug prescriptions and psychological prescriptions on cardiac outcomes.Traditional Chinese medicine treatment of physical and mental diseases was a mode of thinking in line with my country′s national conditions,and there were insufficient theoretical and clinical researches in traditional Chinese medicine,acupuncture and external treatment.This review showed progress of traditional Chinese medicine and western medicine for post-myocardial infarction depression,in clinical and scientific research results to guide future research directions according to the existing problems,and further explored the development path of complementary advantages of traditional Chinese medicine and western medicine.