实用医学杂志 ›› 2024, Vol. 40 ›› Issue (4): 447-452.doi: 10.3969/j.issn.1006-5725.2024.04.002
蔡康林1,2,张婧恺2,冉亮弟1,2,胡大军1,冯知涛3(),黄慧莲1(
)
收稿日期:
2023-10-24
出版日期:
2024-02-25
发布日期:
2024-03-08
通讯作者:
冯知涛,黄慧莲
E-mail:ann19830418@163.com;fengzhitao2008@126.com
基金资助:
Kanglin CAI1,2,Jinkai ZHANG2,Liangdi RAN1,2,Dajun HU1,Zhitao FENG3(),Huilian. HUANG1(
)
Received:
2023-10-24
Online:
2024-02-25
Published:
2024-03-08
Contact:
Zhitao FENG,Huilian. HUANG
E-mail:ann19830418@163.com;fengzhitao2008@126.com
摘要:
抑郁症是一种常见的精神障碍,严重影响患者生存质量。目前临床西药治疗抑郁症效果不理想,需寻求新的抗抑郁药物及靶点。柴胡-白芍作为抗抑郁复方的核心和重要组成部分,两者配伍使用具有减毒增效抗抑郁作用,其机制可能与抑制炎症与氧化应激、调节单胺类神经递质、脑源性神经营养因子水平,影响下丘脑-垂体-肾上腺轴、多种氨基酸代谢和能量代谢等有关。本文通过综述柴胡-白芍配伍的协同效应以及抗抑郁药理作用,以期为阐明柴胡-白芍的配伍优势以及抗抑郁的作用机制提供参考。
中图分类号:
蔡康林,张婧恺,冉亮弟,胡大军,冯知涛,黄慧莲. 柴胡-白芍配伍抗抑郁药理作用机制研究进展[J]. 实用医学杂志, 2024, 40(4): 447-452.
Kanglin CAI,Jinkai ZHANG,Liangdi RAN,Dajun HU,Zhitao FENG,Huilian. HUANG. Research progress on antidepressant pharmacological effects and mechanisms of Bupleuri Radix⁃Paeoniae Radix Alba herb⁃pair[J]. The Journal of Practical Medicine, 2024, 40(4): 447-452.
表1
不同方法对柴胡-白芍配伍的影响"
方法 | 配比 | 影响 | 文献 |
---|---|---|---|
UPLC?QE?Orbitrap?MS醇提取法 | 1∶1 | 芍药苷,没食子酰基芍药苷或其异构体含量增加;柴胡皂苷a、3″-O-乙酰化柴胡皂苷a,4″-O-乙酰化柴胡皂苷a降低。 | 贺晶等[ |
UPLC?Q?TOF?MS水煎剂 | 1∶1 | 芍药苷含量升高,柴胡皂苷a、c含量降低 | 邢威等[ |
HS?SPME?GC?MS粉剂 | 1∶1 | 增加挥发性组分(烯类,酯类)含量和新挥发性成分产出,减少有毒物质(十二烷,苯甲醇,十六烷)产出 | 张心一等[ |
UHPLC?Q?Oritrap?MS醇提取法 | 1∶1 | 白芍可以通过调节肠道菌群预防柴胡引起的肝脏毒性。 | CHEN等[ |
UPLC?TQ?MS法 | 柴胡皂苷a、d增加空结肠对芍药苷吸收率 | CHEN等[ | |
UPLC?QE?Orbitrap?MS醇提取法 | 1∶1 | 增加12种原型及代谢产物(柴胡皂苷e、f、d、g,柴胡次皂苷f,没食子酸甲酯,氧化芍药苷,芍药内酯苷,芍药苷,邻苯三酚葡糖苷酸,甲基没食子酸,苯甲酸)含量,促进6种原型及代谢物(柴胡皂苷a、c、d,乙酰柴胡皂苷a、d,芍药代谢素I)降解 | CHEN等[ |
UPLC?QE?Orbitrap?MS醇提取法 | 1∶1 | 提高5种柴胡(柴胡皂苷a、b2,前柴胡皂苷f、g,二羟基脱氢柴胡皂苷E)的生物利用度,6种白芍(芍药苷,芍药内酯苷,没食子酸甲酯,邻苯三酚葡糖苷酸,甲基邻苯三醇葡糖苷酸,芍药代谢素II)生物利用度 | CHEN等[ |
UHPLC?QT?MS醋炙法 | 1∶1 | 柴胡(柴胡皂苷a,柴胡皂苷c)、白芍(芍药苷,氧化芍药苷)体内维持时间延长 | ZHU等[ |
图1
柴胡-白芍抗抑郁的潜在作用机制注:BDNF与Trk B结合刺激CREB,调节各个脑区神经发生;压力刺激导致HPA轴异常引起抑郁症发生;色氨酸(TRP)氧化脱羧转化为5-TH,在压力刺激引起炎症时通过犬尿氨酸途径生成3-羟基邻氨基苯甲酸(3-HAA)引起神经毒性;病理条件下,脑区参与嘌呤代谢的黄嘌呤脱氢酶(XDH)转化为黄嘌呤氧化酶(XOD)催化氧化应激的发生,引起炎症级联反应。另外顺式乌头酸脱羧酶(CAD),谷胱甘肽(GSH),溶血磷脂酰胆碱(LPC),泛素羧基末端水解酶L1(UCH-L1)也可以引起氧化应激反应。花生四烯酸(AA)在PTGS2作用下产生前列腺素(PGs),调节大脑内的神经炎症。前额叶内侧皮质(mPFC),海马(HPC),下丘脑(HHA),垂体(PIT),犬尿氨酸(KYN),去甲肾上腺素(NE),多巴胺(DA),5-羟基吲哚乙酸(5-HIAA),丙二醛(MDA),活性氧(ROS),三羧酸循环(TCA),还原性辅酶Ⅰ(NADPH)。其中“↑”箭头表示“促进”,“T”形箭头表示“抑制”。本图由Figdraw绘制。"
1 |
HERRMAN H, PATEL V, KIELING C, et al. Time for united action on depression: a Lancet-World Psychiatric Association Commission[J]. Lancet, 2022, 399(10328): 957-1022. doi:10.1016/s0140-6736(21)02141-3
doi: 10.1016/s0140-6736(21)02141-3 |
2 |
MARWAHA S, PALMER E, SUPPES T, et al. Novel and emerging treatments for major depression[J]. Lancet, 2023, 401(10371): 141-153. doi:10.1016/s0140-6736(22)02080-3
doi: 10.1016/s0140-6736(22)02080-3 |
3 |
LU J, XU X, HUANG Y, et al. Prevalence of depressive disorders and treatment in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2021, 8(11): 981-990. doi:10.1016/s2215-0366(21)00251-0
doi: 10.1016/s2215-0366(21)00251-0 |
4 |
RAFEYAN R, PAPAKOSTAS G I, JACKSON W C, et al. Inadequate Response to Treatment in Major Depressive Disorder: Augmentation and Adjunctive Strategies[J]. J Clin Psychiatry, 2020, 81(3): OT19037BR3. doi:10.4088/jcp.ot19037br3
doi: 10.4088/jcp.ot19037br3 |
5 |
SISAY T, WAMI R. Adverse drug reactions among major depressive disorders: patterns by age and gender[J]. Heliyon, 2021, 7(12): e8655. doi:10.1016/j.heliyon.2021.e08655
doi: 10.1016/j.heliyon.2021.e08655 |
6 | 朱十伟,宫文霞,陈聪聪,等. 基于~1H NMR代谢组学技术的柴胡-白芍药对对逍遥散的贡献研究[J]. 药学学报,2019,54(4):720-728. |
7 | 张雅婷,蔡皓,段煜,等. 基于代谢组学探究炮制与配伍对四逆散抗抑郁作用的贡献[J]. 中国中药杂志,2021,46(19):4993-5004. |
8 |
LI X, QIN X M, TIAN J S, et al. Integrated network pharmacology and metabolomics to dissect the combination mechanisms of Bupleurum chinense DC-Paeonia lactiflora Pall herb pair for treating depression[J]. J Ethnopharmacol, 2021, 264: 113281. doi:10.1016/j.jep.2020.113281
doi: 10.1016/j.jep.2020.113281 |
9 |
JIANG H, YANG L, HOU A, et al. Botany, traditional uses, phytochemistry, analytical methods, processing, pharmacology and pharmacokinetics of Bupleuri Radix: A systematic review[J]. Biomed Pharmacother, 2020, 131: 110679. doi:10.1016/j.biopha.2020.110679
doi: 10.1016/j.biopha.2020.110679 |
10 |
LI P, SHEN J, WANG Z, et al. Genus Paeonia: A comprehensive review on traditional uses, phytochemistry, pharmacological activities, clinical application, and toxicology[J]. J Ethnopharmacol, 2021, 269: 113708. doi:10.1016/j.jep.2020.113708
doi: 10.1016/j.jep.2020.113708 |
11 |
贺晶,高晓霞,田俊生,等. UPLC-MS背景扣除法联合代谢组学技术分析柴胡-白芍药对配伍前后化学成分变化[J]. 中草药,2018,49(8):1779-1788. doi:10.7501/j.issn.0253-2670.2018.08.007
doi: 10.7501/j.issn.0253-2670.2018.08.007 |
12 | 邢威,陈雁雁,孟健男,等. 应用UPLC-Q-TOF-MS技术分析柴胡-白芍药对化学成分[J]. 化学工程师,2021,35(1):20-24. |
13 | 孙小燕,王爽,席啸虎. 星点设计-效应面法优化柴胡和白芍配伍比例和提取工艺[J]. 山西医科大学学报,2023,54(4):521-528. |
14 | 张心一,江汉美,成立,等. HS-SPME-GC-MS分析柴胡、白芍配伍前后挥发性组分变化规律[J]. 天然产物研究与开发,2023,35(11):1907-1914,1928. |
15 |
CHEN C, GONG W, TIAN J, et al. Radix Paeoniae Alba attenuates Radix Bupleuri-induced hepatotoxicity by modulating gut microbiota to alleviate the inhibition of saikosaponins on glutathione synthetase[J]. J Pharm Anal, 2023, 13(6): 640-659. doi:10.1016/j.jpha.2023.04.016
doi: 10.1016/j.jpha.2023.04.016 |
16 |
CHEN Y, WANG J, YUAN L, et al. Interaction of the main components from the traditional Chinese drug pair Chaihu-Shaoyao based on rat intestinal absorption[J]. Molecules, 2011, 16(11): 9600-9610. doi:10.3390/molecules16119600
doi: 10.3390/molecules16119600 |
17 |
CHEN C, TIAN J, GAO X, et al. An integrated strategy to study the combination mechanisms of Bupleurum chinense DC and Paeonia lactiflora Pall for treating depression based on correlation analysis between serum chemical components profiles and endogenous metabolites profiles[J]. J Ethnopharmacol, 2023, 305: 116068. doi:10.1016/j.jep.2022.116068
doi: 10.1016/j.jep.2022.116068 |
18 |
CHEN C, YIN Q, TIAN J, et al. Studies on the Changes of Pharmacokinetics Behaviors of Phytochemicals and the Influence on Endogenous Metabolites After the Combination of Radix Bupleuri and Radix Paeoniae Alba Based on Multi-Component Pharmacokinetics and Metabolomics[J]. Front Pharmacol, 2021, 12: 630970. doi:10.3389/fphar.2021.630970
doi: 10.3389/fphar.2021.630970 |
19 |
ZHU H, ZHANG Y, DUAN Y, et al. Pharmacokinetic evaluation of Sinisan containing vinegar-processed products in depressive rats, a comprehensive perspective of 'individual herb, herb-pair, and herbal formula'[J]. J Ethnopharmacol, 2023, 317: 116817. doi:10.1016/j.jep.2023.116817
doi: 10.1016/j.jep.2023.116817 |
20 | 莫子晴,蔡皓,段煜,等. 柴胡和白芍醋炙前后组方四逆散对抑郁大鼠粪便代谢组学的比较[J]. 南京中医药大学学报,2021,37(2):216-224. |
21 | 常星,王露,程江雪,等. 基于偏最小二乘回归分析的逍遥软胶囊中柴胡-白芍药对抗抑郁作用谱-效关系研究[J]. 中草药,2023,54(8):2509-2515. |
22 |
CHEN J, LI T, QIN X, et al. Integration of Non-Targeted Metabolomics and Targeted Quantitative Analysis to Elucidate the Synergistic Antidepressant Effect of Bupleurum Chinense DC-Paeonia Lactiflora Pall Herb Pair by Regulating Purine Metabolism[J]. Front Pharmacol, 2022, 13: 900459. doi:10.3389/fphar.2022.900459
doi: 10.3389/fphar.2022.900459 |
23 |
WANG Y, GAO S M, LI R, et al. Antidepressant-like effects of the Radix Bupleuri and Radix Paeoniae Alba drug pair[J]. Neurosci Lett, 2016, 633: 14-20. doi:10.1016/j.neulet.2016.09.001
doi: 10.1016/j.neulet.2016.09.001 |
24 |
于泽胜,路腾飞,周好波,等. 柴胡白芍药对对慢性温和不可预知性应激抑郁模型大鼠脑内单胺类神经递质的影响[J]. 中草药,2016,47(16):2887-2892. doi:10.7501/j.issn.0253-2670.2016.16.019
doi: 10.7501/j.issn.0253-2670.2016.16.019 |
25 |
LI X, HOU R, QIN X, et al. Synergistic neuroprotective effect of saikosaponin A and albiflorin on corticosterone-induced apoptosis in PC12 cells via regulation of metabolic disorders and neuroinflammation[J]. Mol Biol Rep, 2022, 49(9): 8801-8813. doi:10.1007/s11033-022-07730-5
doi: 10.1007/s11033-022-07730-5 |
26 | 胡培豪,张意笠,钟晓明,等. 中医药治疗抑郁组方用药规律研究[J]. 中药药理与临床,2020,36(6):210-215. |
27 |
LI Q F, LU W T, ZHANG Q, et al. Proprietary Medicines Containing Bupleurum chinense DC. (Chaihu) for Depression: Network Meta-Analysis and Network Pharmacology Prediction[J]. Front Pharmacol, 2022, 13: 773537. doi:10.3389/fphar.2022.773537
doi: 10.3389/fphar.2022.773537 |
28 | 刘红喜,石静资,梁晓,等. 国家中药复方专利治疗抑郁症用药规律研究[J]. 中医杂志,2023,64(19):2027-2032. |
29 | 曲艺,崔向宁,但文超,等. 基于中医传承辅助平台挖掘中药复方专利中治疗抑郁的用药规律[J]. 世界科学技术-中医药现代化,2019,21(8):1670-1675. |
30 |
李东方,黄乐曦,侯季秋,等. 基于数据挖掘和网络药理学探讨冠心病合并抑郁用药规律和作用机制[J]. 中国医药导报,2022,19(22):13-19. doi:10.3969/j.issn.1673-7210.2022.22.yycyzx202222005
doi: 10.3969/j.issn.1673-7210.2022.22.yycyzx202222005 |
31 |
滕宇,赵明镜,王蕾,等. 基于数据挖掘探讨慢性心力衰竭伴焦虑、抑郁的中药用药规律[J]. 中西医结合心脑血管病杂志,2022,20(7):1160-1166. doi:10.12102/j.issn.1672-1349.2022.07.002
doi: 10.12102/j.issn.1672-1349.2022.07.002 |
32 |
李雨,罗小英,王豆,等. 基于数据挖掘的中医药治疗脑卒中后抑郁的用药规律分析[J]. 中西医结合心脑血管病杂志,2023,21(11):1935-1940. doi:10.12102/j.issn.1672-1349.2023.11.003
doi: 10.12102/j.issn.1672-1349.2023.11.003 |
33 | 牟翔宇,郭英慧,孙文君,等. 柴胡配伍白芍治疗PMDD肝气郁证的研究进展[J]. 中国实验方剂学杂志,2018,24(20):192-199. |
34 |
胡鸣旭,徐俏俏,张洪财. 柴胡白芍药对改善大肠癌术后患者抑郁及腹泻状态的量效关系研究[J]. 中国中西医结合外科杂志,2021,27(3):458-461. doi:10.3969/j.issn.1007-6948.2021.03.016
doi: 10.3969/j.issn.1007-6948.2021.03.016 |
35 | 霍易飞,高诗慧,杨宇峰,等. 基于数据挖掘糖尿病合并抑郁组方规律分析[J]. 辽宁中医药大学学报,2020,22(11):80-84. |
36 |
崔利军,杨永涛,崔伟,等. 伴自杀自伤行为的青少年情感障碍患者炎性细胞因子水平对照研究[J]. 实用医学杂志,2022,38(12):1522-1526. doi:10.3969/j.issn.1006-5725.2022.12.015
doi: 10.3969/j.issn.1006-5725.2022.12.015 |
37 |
SIMON M S, ARTEAGA-HENRIQUEZ G, FOUAD A A, et al. Anti-Inflammatory Treatment Efficacy in Major Depressive Disorder: A Systematic Review of Meta-Analyses[J]. Neuropsychiatr Dis Treat, 2023, 19: 1-25. doi:10.2147/ndt.s385117
doi: 10.2147/ndt.s385117 |
38 |
CORREIA A S, CARDOSO A, VALE N. Oxidative Stress in Depression: The Link with the Stress Response, Neuroinflammation, Serotonin, Neurogenesis and Synaptic Plasticity[J]. Antioxidants (Basel), 2023, 12(2): 470. doi:10.3390/antiox12020470
doi: 10.3390/antiox12020470 |
39 | 常泽,韩振蕴,曹云松,等. 基于网络药理学的柴胡-白芍药对抗抑郁作用机制研究[J]. 中医杂志,2020,61(8):700-705. |
40 |
CHEN Y, WANG W, FU X, et al. Investigation of the antidepressant mechanism of combined Radix Bupleuri and Radix Paeoniae Alba treatment using proteomics analysis of liver tissue[J]. J Chromatogr B Analyt Technol Biomed Life Sci, 2021, 1179: 122858. doi:10.1016/j.jchromb.2021.122858
doi: 10.1016/j.jchromb.2021.122858 |
41 | 陈聪聪,阴奇材,田俊生,等. 基于肝脏代谢组学的柴胡-白芍药对抗抑郁作用机制研究[J]. 药学学报,2020,55(5):941-949. |
42 | 张洪财,陈雁雁,王文姌,等. 柴胡-白芍药对干预大鼠抑郁症模型的血清代谢组学研究[J]. 中医药信息,2018,35(1):34-37. |
43 |
CAI H B, WU G L, HUANG C H, et al. Effect of Zhuang Jing Decoction on Learning and Memory Ability in Aging Rats[J]. Rejuvenation Res, 2016, 19(4): 303-308. doi:10.1089/rej.2015.1751
doi: 10.1089/rej.2015.1751 |
44 |
ZHANG H, ZHANG S, HU M, et al. An integrative metabolomics and network pharmacology method for exploring the effect and mechanism of Radix Bupleuri and Radix Paeoniae Alba on anti-depression[J]. J Pharm Biomed Anal, 2020, 189: 113435. doi:10.1016/j.jpba.2020.113435
doi: 10.1016/j.jpba.2020.113435 |
45 | 张洪财,王文姌,陈雁雁. 柴胡-白芍对抑郁大鼠海马神经递质的影响[J]. 哈尔滨商业大学学报(自然科学版),2017,33(5):519-522. |
46 |
LV S, ZHAO Y, WANG L, et al. Antidepressant Active Components of Bupleurum chinense DC-Paeonia lactiflora Pall Herb Pair: Pharmacological Mechanisms[J]. Biomed Res Int, 2022, 2022: 1024693. doi:10.1155/2022/1024693
doi: 10.1155/2022/1024693 |
47 |
雒明池,梁如,高树明,等. 基于cAMP-CREB-BDNF通路探讨柴胡-白芍药对抗抑郁作用机制[J]. 中草药,2018,49(17):4093-4098. doi:10.7501/j.issn.0253-2670.2018.17.019
doi: 10.7501/j.issn.0253-2670.2018.17.019 |
48 |
MIKULSKA J, JUSZCZYK G, GAWRONSKA-GRZYWACZ M, et al. HPA Axis in the Pathomechanism of Depression and Schizophrenia: New Therapeutic Strategies Based on Its Participation[J]. Brain Sci, 2021, 11(10): 1298. doi:10.3390/brainsci11101298
doi: 10.3390/brainsci11101298 |
49 |
王艳华,杨永涛,崔利军,等. 抑郁症自杀未遂与甲状腺激素、血浆皮质醇关联分析[J]. 实用医学杂志,2021,37(16):2044-2047. doi:10.3969/j.issn.1006-5725.2021.16.002
doi: 10.3969/j.issn.1006-5725.2021.16.002 |
50 |
ZHOU Y, LI T, ZHU S, et al. Study on antidepressant mechanism of Radix Bupleuri-Radix Paeoniae Alba herb pair by metabonomics combined with 1H nuclear magnetic resonance and ultra-high-performance liquid chromatography-tandem mass spectrometry detection technology[J]. J Pharm Pharmacol, 2021, 73(9): 1262-1273. doi:10.1093/jpp/rgab061
doi: 10.1093/jpp/rgab061 |
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