中药调控小胶质细胞改善卒中后抑郁的研究进展

doi:10.3969/j.issn.1006-5725.2025.18.023

Abstract

Abstract:

Post-stroke depression （PSD）， a common stroke complication characterized by depressed mood and diminished interest， severely affects patients' recovery and quality of life. Microglial abnormal activation and polarization play key roles in PSD pathogenesis， closely associated with neuroinflammation and imbalance in neurotransmitter metabolism. In contrast， traditional Chinese medicine （TCM） demonstrates unique multi-target and multi-level mechanisms： regulating microglial function， ameliorating post-stroke neuroinflammatory environments， and promoting neuroplasticity， thereby potentially alleviating PSD symptoms. This review summarizes TCM's effects on microglial activation/polarization states and its therapeutic advances in PSD， providing novel perspectives and strategies for clinical management.

Key words: post-stroke depression, microglia, traditional Chinese medicine, regulatory mechanisms

CLC Number:

R743.3

Qi LI,Jing GAO,Ming ZHANG,Xu ZHANG,Yachen FENG,Rui PAN,Chunxiao WANG,Qiongdi REN. Modulation of microglia by traditional Chinese medicine improves post⁃stroke depression[J]. The Journal of Practical Medicine, 2025, 41(18): 2945-2952.

Figures/Tables 4

Fig.1

Fig. 2

Tab.1

Mechanisms of action of single herbs and extracts in regulating microglia in PSD treatment"

分类

中药

成分

作用通路

作用靶点

参考文献

单味中药及提取物

黄芪

黄芪甲苷

NLRP3/Caspase-1信号通路

—

↓小胶质细胞过度自噬，维持细胞稳态

↓神经炎症，↑神经元存活，↑神经递质水平

［19］

［20］

人参

人参皂苷

—

↓小胶质细胞过度活化，↓其释放促炎细胞因子的水平

↑海马区神经元存活，↑5-HT和DA含量，↑BDNF表达

［21］

［22］

柴胡

柴胡皂苷

—

TLR4/NF-κB通路

调节甲状腺激素和性激素分泌，调节小胶质细胞与神经内分泌系统的相互作用，↓抑郁症状

调节小胶质细胞的活化和极化状态，↓神经炎症

［23］

［24］

川芎

川芎嗪

—

↓小胶质细胞表面受体活化，↓炎症信号的传导，↓小胶质细胞的活化和极化

↓M1型小胶质细胞相关促炎因子的产生，↑M2型小胶质细胞的极化，↑其抗炎和神经保护作用

［25］

［26］

黄连

黄连素

cAMP/PKA/CREB信号通路

—

↑抑郁相关神经递质水平，↓小胶质细胞活化，↓炎症因子的产生

↓小胶质细胞活化程度，↓M1型极化，↑M2型极化

［27，29］

［28］

清风藤

青藤碱

NF-κB信号通路

多个信号通路

↓NF-κB信号通路，↓促炎基因转录，↓小胶质细胞活化和炎症反应

如可通过↓NF-κB调节NLRP3信号通路发挥抗抑郁作用

［30］

［31］

丹参

丹参酮ⅡA

BNDF信号通路

—

↓BNDF信号通路的激活，↓小胶质细胞释放的促炎细胞因子，↓炎症反应

↓小胶质细胞活化标志物表达，↑IL-10分泌

［32］

［33］

银杏

银杏内酯

MAPK信号通路

—

↓MAPK信号通路的激活，↓小胶质细胞释放的炎症介质

改善小胶质细胞的极化状态，↑M2型极化，↑其抗炎和神经保护作用

［34］

［35］

白藜芦、葡萄、虎杖、花生、决明等

白藜芦醇

NF-κB信号通路

—

↓NF-κB信号通路，↓NF-κB的核转位，↓下游促炎基因的表达，调节小胶质细胞功能，↓炎症反应

↑神经细胞抗氧化防御能力，↑神经元存活和功能，↓炎症介质释放，↓神经炎症对神经元的损伤

［36］

［37］

管花肉苁蓉

松果菊苷

BDNF信号通路

—

激活BDNF信号通路，进而调节小胶质细胞功能，↓炎症介质释放

↓细胞凋亡，↓神经炎症对神经元的损伤，同时↑抗氧化系统的抗氧化能力，↑BDNF

［38］

［14］

Tab.1

Tab. 2

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Modulation of microglia by traditional Chinese medicine improves post⁃stroke depression

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