柴胡加龙骨牡蛎汤治疗围绝经期综合征的药理与临床研究进展

Progress in pharmacology and clinical study of Chaihu Longgu Muli Decoction in treatment of perimenopausal syndrome

柴胡加龙骨牡蛎汤是载于《伤寒论》的经典名方,可和解枢机、通阳泄热、镇惊安神,与围绝经期综合征(PMS)枢机不利之病机关键相契合,临床用于治疗PMS疗效突出。其作用机制主要涉及神经内分泌系统的调节;丝裂原活化蛋白激酶(MEK)/细胞外信号调节激酶(ERK)、雌激素受体β(ERβ)/脑源性神经营养因子(BDNF)/酪氨酸蛋白激酶受体B(TrkB)/5-羟色胺2A受体(5-HT_(2A))、雌激素受体α(ERα)/磷脂酰肌醇3-激酶(PI3K)/丝氨酸苏氨酸蛋白激酶(Akt)/γ-氨基丁酸(GABA)等相关信号通路的调控;ERα的O-连接β-N-乙酰葡糖胺(O-GlcNAc)修饰等。临床研究在调理睡眠、情绪诸症,改善神经内分泌及减轻炎症方面已有一定进展。对柴胡加龙骨牡蛎汤治疗PMS的药理及临床研究进行整理和分析总结,以期为临床应用及深入研究提供参考。

Chaihu Longgu Muli Decoction is a classic prescription contained in Discussion of Cold Damage.It can regulate the function of pivot,activate yang and dissipate heat,tranquilize and allay excitement,which is just in line with the key pathogenesis of dysfunction of pivot of perimenopausal syndrome(PMS).It is clinically used to treat PMS with outstanding efficacy,and its mechanism of action mainly involves the regulation of the neuroendocrine system;mitogen-activated protein kinase kinase(MEK)/extracellular signal-regulated kinase(ERK),estrogen receptor β(ERβ)/brain-derived neurotrophic factor(BDNF)/tyrosine protein kinase receptor B(TrkB)/serotonin 2A receptor(5-HT_(2A)),estrogen receptor α(ERα)/phosphatidylinositol 3-kinase(PI3K)/serine threonine protein kinase(AKT)/γ-aminobutyric acid(GABA)and other related signaling pathways regulation;O-linked β-Nacetylglucosamine(O-GlcNAc)modification of ERα.Clinical research has made some progress in regulating sleep and mood,improving neuroendocrine and reducing inflammatory response.This article collates and analyzes the pharmacological and clinical studies of Chaihu Longgu Muli Decoction in the treatment of perimenopausal syndrome,in order to provide reference for the clinical application and basic research of Chaihu plusLonggu Muli Decoction.