中药调节下丘脑-垂体-卵巢轴干预围绝经期抑郁症的研究进展

Research Progress of Chinese medicine Regulating Hypothalamic Pituitary Ovarian Axis to Intervene Perimenopausal Depression

围绝经期抑郁症(perimenopausal depressive disorder,PDD)是一种围绝经期女性高发的情绪障碍类疾病,严重威胁患病女性的生理、心理健康。PDD的发病机制与激素水平波动、单胺类神经递质减少、下丘脑-垂体-肾上腺轴(hypothalamic pituitary adrenal axis,HPA)失调、下丘脑-垂体-卵巢轴(hypothalamic pituitary ovarian axis,HPO)失衡、γ-氨基丁酸(gamma-aminobutyric acid,GABA)系统失调等相关。其中,HPO失衡似乎更与PDD特殊的性别、发病时期关系密切,故也成了研究的热点。抑郁症一直是中医治疗的优势病种,特别是在中医理论指导下的中药治疗对于PDD的防治研究也具有丰富的理论基础与研究成果。通过对近5年的文献整理,围绕HPO轴在PDD中的作用,中医药调节HPO轴干预PDD的理论基础,中药复方、单味中药及中药单体化合物通过调节HPO轴治疗PDD的研究进展进行了综合性叙述。

Perimenopausal depressive disorder(PDD)is an emotional disorder that is highly prevalent in perimenopausal women,and is a significant threat to their physical and mental well-being.The pathogenesis of PDD is associated with hormonal fluctuations,decreased levels of monoamine neurotransmitters,imbalance of the hypothalamic-pituitary-adrenal(HPA)axis,imbalance of the hypothalamic-pituitary-ovarian(HPO)axis,imbalance of the gamma-aminobutyric acid(GABA)system and other factors.The imbalance of the HPO axis is particularly relevant to the gender-specific and pathogenic nature of PDD and has become a research focus.Depression has always been a dominant disease of TCM treatment,and TCM treatment has a strong theoretical basis and research findings for the prevention and treatment of PDD,particularly under TCM theory guidance.This article summarized the literature of the past five years,focusing on the role of the HPO axis in PDD,the theoretical basis of TCM regulating the HPO axis and intervening in PDD,and a comprehensive description of the research progress of TCM formulae,single Chinese medicine and single Chinese medicine monomer compounds in treating PDD by regulating the HPO axis.