经典名方小柴胡汤抗抑郁研究进展

Research Progress on Antidepressant of the Classic Prescription Xiaochaihu Decoction(小柴胡汤)

抑郁症属于中医“郁证”范畴,在新冠疫情背景下的抑郁症发病更是呈逐年上升趋势,中医药因其多途径、多层次、多靶点、多机制的作用方式在治疗抑郁症方面发挥着独特优势。小柴胡汤为治疗少阳证的经典名方,出自东汉张仲景的《伤寒杂病论》,其和解少阳且长于疏肝理气解郁,现代药理学研究也验证了其抗抑郁作用且临床应用广泛,但是关于小柴胡汤抗抑郁的机制还尚未有定论,因此作者基于临床应用、作用机制和化学成分对近十年来现有小柴胡汤抗抑郁的研究进行综述,探究小柴胡汤抗抑郁的机制,发现小柴胡汤抗抑郁的机制与单胺类神经递质及受体、HPA轴、脑源性神经营养因子(BDNF)及炎症反应等密切相关,且可能是协同作用的结果,为深入研究小柴胡汤治疗神经系统疾病及其机制提供理论依据。

Depression belongs to the category of“depression syndrome”in traditional Chinese medicine.The incidence of depression in the context of the new coronavirus pneumonia epidemic is increasing year by year.Traditional Chinese medicine has unique advantages in the treatment of depression due to its multi-channel,multi-level,multi-target and multi-mechanism.Xiaochaihu Decoction(小柴胡汤)is a classic prescription for the treatment of Shaoyang syndrome,which is derived from ZHANG Zhongjing's Treatise on Febrile and Miscellaneous Diseases in the Eastern Han Dynasty.It is good at harmonizing Shaoyang and is better than soothing liver and regulating Qi to relieve depression.Modern pharmacological research has also verified its antidepressant effect and is widely used in clinical practice.However,the mechanism of antidepressant effect of Xiaochaihu Decoction has not yet been determined.Therefore,based on clinical application,mechanism of action and chemical composition,the author reviews the existing antidepressant research of Xiaochaihu Decoction in the past ten years,and explores the antidepressant mechanism of Xiaochaihu Decoction.It is found that the antidepressant mechanism of Xiaochaihu Decoction is closely related to monoamine neurotransmitters and receptors,HPA axis,brain-derived neurotrophic factor(BDNF)and inflammatory response,and may be the result of synergistic effect,which provides a theoretical basis for further study of Xiaochaihu Decoction in the treatment of neurological diseases and its mechanism.