抑郁症与HPA轴关系及中药干预的研究进展

介绍了抑郁症与肾上腺轴的关系以及中药干预相关机制的最新研究资料。查阅CNKI数据库相关文献39篇。研究表明抑郁症患者血浆中促肾上腺皮质激素释放激素、促肾上腺皮质激素、糖皮质激素浓度升高,一方面糖皮质激素的持续升高使海马中糖皮质激素受体数量减少、盐皮质激素受体/糖皮质激素受体比例失衡,进而破坏海马神经元;另一方面,海马本身能抑制下丘脑-垂体-肾上腺轴的活性,海马神经元的破坏使抑制下丘脑-垂体-肾上腺轴的作用减弱;同时糖皮质激素的升高,使糖皮质激素受体的数量和功能降低,造成糖皮质激素对下丘脑-垂体-肾上腺轴负反馈抑制作用减弱,使其功能更为亢进,形成恶性循环。认为中医药具有多靶点、多层面、多轴点的作用特征,通过对HPA轴来干预抑郁症具有一定的现实意义。

Relationship between Depression and HPA Axis and Intervention by Traditional Chinese Medicine

It is very important that hyperactivity of hypothalamic-pituitary-adrenocortical (HPA) axis is one of the pathophysiological mechanism of depression.Previous studies have festimated that plasma level of corticotropin-releasinghormone(CRH),adrenocorticotropichormone(ACTH),glucocorticoid (GC) have increased significantly,meanwhile the sustained increasing level of GC has reduced the number of the hippocampus in the glucocorticoid receptor (GR),and mineralocorticoid receptor (MR)/GR ratio became imbalance,therefore destroying the hippocampal neurons.The hippocampus itself could mediate the activities of HPA axis,the destruction of hippocampal neurons has become so weaker to mediate the HPA axis;while the increasing level of GC,so that the number and function of GR have reduced,GC negative feedback inhibition to HPA axis has decreased to make it function more hyperactivity.