基于肠道菌群学说的中医药治疗卒中后抑郁的研究进展

A review on treating post-stroke depression in traditional Chinese medicine based on gut microbiota theory

目的:探讨基于肠道菌群学说的中医药治疗卒中后抑郁(Post-Stroke Depression,PSD)的研究进展,为PSD的综合治疗提供新的思路和方法。方法:通过系统文献综述方法梳理中医药治疗PSD的研究进展,重点分析肠道菌群与PSD的关系,以及中医药如何通过调节肠道菌群结构改善PSD患者的情绪状态和神经功能。结果:研究发现,PSD患者的肠道菌群均衡性较正常人差,肠道菌群可通过神经生物途径参与PSD的发展。中医药通过调和肝脾、益气健脾等治法,能够有效调节肠道菌群结构,改善肠道微生物多样性,进而通过肠-脑轴对PSD患者的情绪状态和神经功能产生积极影响。临床疗效综合评价显示,中医药治疗能够显著改善PSD患者的抑郁症状,提高生活质量,且安全性良好。结论:中医药在调节肠道菌群、治疗PSD方面具有独特优势,有望成为PSD综合治疗的重要手段。本研究为中医药治疗PSD提供了新的理论依据和实践指导。未来的研究可以进一步探索肠道菌群与脑功能相互作用的分子机制,并开展多中心、大样本的临床试验以验证中医药治疗PSD的疗效和安全性。

Objective:To explore the research progress of traditional Chinese medicine(TCM)in the treatment of post-stroke depression(PSD)based on the gut microbiota theory,providing new ideas and methods for the comprehensive treatment of PSD.Methods:Through systematic literature review method,the research progress of TCM in treating PSD was summarized,focusing on the relationship between gut microbiota and PSD,and how TCM ameliorated the emotional state and neurological function of PSD patients by regulating intestinal microbial communities.Results:The result showed that the balance of gut microbiota in PSD patients was worse than normal individuals,and gut microbiota could participate in the development of PSD through neurobiological pathways.TCM could effectively regulate intestinal microbial communities by the methods of harmonizing liver and spleen,and tonifying Qi(气)and invigorating spleen,and improve the diversity of gut microbiota,thus exerting a positive affect on the emotional state and neurological function of PSD patients through the gut-brain axis.The comprehensive evaluation of clinical efficacy showed that TCM treatment could significantly relieve depressive symptoms of PSD patients,and improve the quality of life,with good safety.Conclusion:TCM shows unique advantages in regulating gut microbiota and treating PSD,and is expected to become an important means of comprehensive treatment for PSD.The results of this study provide a new theoretical basis and practical guidance for the treatment of PSD in TCM.Future research can in-depth explore the molecular mechanisms of the interaction between gut microbiota and brain function,and conduct multi-center,large-sample clinical trials to verify the efficacy and safety of TCM in treating PSD.