栀子豉汤治疗抑郁症研究新进展

New Progress in Research of Zhizichi Decoction(栀子豉汤)in Treatment of Depression

抑郁症是一种临床常见的情感阻碍性疾病,具有“三高”高发病率、高复发率、高致残率等发病特点,患者常表现出以“三低”情绪低落、意志消沉和思维迟缓为特征的临床表现。临床上,西药治疗抑郁症存在不良反应大、有效率不高、患者依从性较差等问题;中医中药治疗抑郁症具有安全性高、疗效好、不良反应少、患者依从性高等优点。栀子豉汤是张仲景所著《伤寒论》中的经典名方,具有解郁除烦,清热泻火的功效。通过检索栀子豉汤治疗抑郁症的临床观察和实验研究的相关文献,发现临床应用和实验研究均证实治疗抑郁症疗效颇好。临床研究发现,栀子豉汤常通过合方或者联合西药抑或者联合针刺治疗可有效改善患者抑郁症状,且依从性高,无不良反应。实验研究表明,栀子豉汤的抗抑郁机制主要与其能够增加抑郁患者单胺类神经递质含量;降低中枢及外周促炎因子;调节肠道菌群;保护神经细胞等有关。从理论、临床应用和实验研究三个方面对栀子豉汤治疗抑郁症进行讨论,旨在深入研究栀子豉汤治疗抑郁症的新进展,以期为临床治疗抑郁症提供新的思路和依据。

Depression is a clinically common emotional disorder with high incidence,relapse and suicide rates and other characteristics.The patients often show depression and slow thinking.Clinically,Western medicine has problems such as large side effects,low efficiency and poor patient compliance in the treatment of depression.Traditional Chinese medicine for the treatment of depression has the advantages of high safety,good efficacy,few side effects and high compliance.Zhizichi Decoction(栀子豉汤,ZZCD)is a classic formula in ZHANG Zhongjing's book Treatise on Febrile Diseases,which has the effects of relieving depression,clearing heat and purging fire.By searching the relevant literature on the treatment of depression in CNKI(China National Knowledge Internet),Wanfang Data,Pubmed,Web of Science and other databases,it is found that clinical application and experimental studies have confirmed that the treatment of depression is quite effective and experimental studies have shown that the antidepressant mechanism of ZZCD is mainly related to its ability to increase the contents of monoamine neurotransmitters in depression patients,reduce central and peripheral pro-inflammatory factors,regulate intestinal flora and protect nerve cells.This paper discussed the treatment of depression with ZZCD from three aspects:theory,clinical application and experimental research,so as to further study the new progress of ZZCD in the treatment of depression,in order to provide ideas and basis for clinical treatment of depression.