益肾法治疗女性更年期抑郁症的神经生物学机制探析

女性更年期抑郁症(FCD)是一种发病率高、危害大,尚无理想治疗药物的更年期女性常见疾病。"海马神经元再生障碍"被认为是抑郁症发病的主要机制,各种原因导致的海马神经元再生障碍都可能导致抑郁症发生。女性更年期体内雌激素水平的突然下降,雌激素的脑保护作用减弱,既直接影响海马神经元的抗应激损伤能力和新生功能,也可诱发下丘脑-垂体-肾上腺皮质(HPA)轴功能相对亢进,体内皮质酮水平上调,间接加重海马损伤。可见FCD的发生与更年期时雌激素水平下降相关的"海马神经元再生障碍"有着密切关联。而中医学认为FCD发病多为肾阴虚火旺,治疗以益肾滋阴为主。文章就"益肾"在FCD治疗中的现代科学机制进行了探讨,并提出"益肾"通过增强脑内雌激素效应而促进海马新生神经元再生、纠正HPA轴的亢进而治疗FCD的学术假说。

Analysis for the neurobiological mechanism of tonifying kidney treating female climacteric depression

Female climacteric depression (FCD) is a common disease in menopausal women, its incidence is high, the harm is great, and there is still no ideal treatment. "Hippocampal neurogenesis disorder" is thought to be the major pathogenesis, which could be caused by many kinds of factors. The diminished brain protection of estrogen related to decreased estrogen level could lead to imparment of hippocampal neurogenesis directly and indirectly. Thus it can be seen that the incidence of FCD is closely related to the dysfunction of hippocampal neurogenesis caused by low estrogen and the functional disorder of hypothalamic pituitary adrenal (HPA) axis in climacteric women. Traditional Chinese Medicine believes that "kidney is communicated to the brain", "kidney houses essence, essence transforms into marrow, and brain is the sea of marrow." Boosting kidney can help generate marrow and fortify the brain.