柴胡治疗卒中后抑郁药理研究机制进展

Review of Pharmacological Mechanism of Chaihu(BupleuriRadix)in the Treatment of Post-stroke Depression

卒中后抑郁症是脑卒中最常见和最重要的并发症,该病发病机制繁杂,临床治疗有一定挑战性。中医学认为患者卒中后脏腑气血逆乱,风、痰、瘀等病理产物胶搏,使肝气郁滞、魂无所安而病,中医药治疗卒中后抑郁效果显著,柴胡作为肝经引经药,是治疗郁证、中风常用药,也是治疗卒中后抑郁的常用药,在临床上广泛使用,具有极大发展前景。现代药理研究发现柴胡有效成分如柴胡皂苷、山柰酚、异鼠李素、槲皮素、黄芩苷等均能发挥抗抑郁效果。文章通过对已发表的论文及实验进行梳理,结合卒中后抑郁发病机制以及柴胡药理作用为契点,对柴胡治疗卒中后抑郁药理机制进行综述。结果发现柴胡可缓解HPA轴功能障碍、减少炎症因子表达、上调脑源性神经营养因子、提高脑内5-羟色胺含量、提高细胞免疫、抑制氧化应激、减少细胞自噬、减少细胞凋亡、减轻脑缺血再灌注损害等多方面发挥治疗卒中后抑郁的作用。

Post-stroke depression is the most common and important complication of stroke.The pathogenesis of this disease is complex,but the clinical treatment is challenging.According to the theory of Chinese medicine,the patients'internal organs are chaotic and the blood is reversed,and the pathological products such as wind,phlegm,and stasis are glued after stroke,which makes the liver qi stagnation and the soul unsafe and sick.Chinese medicine is effective in treating post-stroke depression.Chaihu(Bupleuri Radix),as a liver meridian inducing medicine,is a commonly used medicine in treating depression and stroke,as well as post-stroke depression,and is widely used in clinical practice with great prospects for development.Modern pharmacological studies have found that the active ingredients of Chaihu(Bupleuri Radix)such as saikosaponin,kaempferol,isorhamnetin,quercetin and baicalin,can exert antidepressant effects.This paper reviews the pharmacological mechanism of Chaihu(Bupleuri Radix)for post-stroke depression by combing published papers and experiments,combining the pathogenesis of the disorder and the pharmacological effects of Chaihu(Bupleuri Radix)as an opportunity to review the pharmacological mechanism of Chaihu(Bupleuri Radix).The results showed that Chaihu(Bupleuri Radix)could alleviate HPA axis dysfunction,reduce inflammatory factor expression,upregulate brain-derived neurotrophic factor,increase brain 5-hydroxytryptamine content,improve cellular immunity,inhibit oxidative stress,reduce cellular autophagy,reduce apoptosis and mitigate cerebral ischemia-reperfusion damage.