基于经前期综合征肝气逆证的白香丹平肝机制研究
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摘要
随着生活节奏的加快和社会压力的增大,经前期综合征、抑郁症、焦虑症等情绪障碍类疾病发病率与日俱增,给患者工作、学习及生活造成严重影响;中医称此类疾病为"情志病",认为病位在肝,"肝失疏泄"是其主要病机,中药治疗以平肝和疏肝为主切入调肝机制,其中实验类常用白香丹作为阳性对照,但是白香丹平肝机制却阐释不足,不利于"从现象描述迈向本质阐明",对于更为深入的药理药效研究凸显不足,文章以PMS肝气逆证为切入点,系统分析调肝方药白香丹的平肝机制,有利于深化"肝主疏泄"理论认识,诠释"调肝"内涵。
With the accelerated pace of life and the increase of social pressure,emotional disorders like premenstrual syndrome,depression and anxiety have the increasing incidence,affecting the patients' work,study and life seriously.TCM calls such diseases as the "emotional disease",which happens in the liver and "liver failing to sooth" is its main pathogenesis.In TCM,Baixiang Dan is commonly used in experiment as a positive control.But the mechanism of Baixiang Dan can not be explained enough,not being conducive to the theroy of "from the description of the phenomenon to the essence of clarification".For more in-depth study of pharmacological efficacy,it is insufficient.This paper taking PMS liver Qi resersing as the evidence,Baixiang Dan's mechanism is conducive to deepening the "liver dominating soothing" theory understanding,interpretating the connotation of "regulating liver".
With the accelerated pace of life and the increase of social pressure,emotional disorders like premenstrual syndrome,depression and anxiety have the increasing incidence,affecting the patients' work,study and life seriously.TCM calls such diseases as the "emotional disease",which happens in the liver and "liver failing to sooth" is its main pathogenesis.In TCM,Baixiang Dan is commonly used in experiment as a positive control.But the mechanism of Baixiang Dan can not be explained enough,not being conducive to the theroy of "from the description of the phenomenon to the essence of clarification".For more in-depth study of pharmacological efficacy,it is insufficient.This paper taking PMS liver Qi resersing as the evidence,Baixiang Dan's mechanism is conducive to deepening the "liver dominating soothing" theory understanding,interpretating the connotation of "regulating liver".
引文
[1] 黄涛,陈金亮.历代医家对情志病的认识[J].中医杂志,2012,53 (10):893-895.
[2] 高明周,潘琳琳,杨焕新,等.刘完素论治情志病浅谈[J].环球中医药,2016,9(9):1081-1082.
[3] 冯帆,吕学玉,汪卫东.情志病病因病机探微[J].中医杂志,2017,58(3):265-267.
[4] Halbreich U,Borenstein J,Pearlstein T,et al.The prevalence,impairment,impact,and burden of premenstrual dysphoric disorder(PMS/PMDD)[J].Psychoneuroendocrinology,2003,28(3):1-23.
[5] 高明周,王杰琼,安礼,等.基于体质人格的经前期综合征发病与干预探析[J].中国实验方剂学杂志,2016(13):223-228.
[6] 杜彩凤,王天芳,薛晓琳,等.经前期综合征常见证素与症状进行相关性文献分析[J].湖南中医药大学学报,2008,28(4):6-9.
[7] 张丽美.经前期综合征与肝失疏泄[J].江西中医药,2005,36(3):20-21.
[8] 乔明琦,张珍玉,徐旭杰,等.经前期综合征证候分布规律的流行病学调查研究[J].中国中医基础医学杂志,1997,3(3):31-32.
[9] 胡春雨,王文燕.从肝试论经前期综合征的体质类型[J].辽宁中医杂志,2006,33(11):1415.
[10] 乔明琦,姜坤.经前平颗粒多中心,随机双盲双模拟对照治疗经前期综合征肝气逆证 403例[J].中国新药杂志,2002,11(5):389-392.
[11] 张海红,张惠云.白香丹胶囊治疗PMS肝气逆证作用机制研究进展[J].医学研究杂志,2013,42(9):21-23.
[12] 陈志恒,孙世光,张惠云.白香丹胶囊对 PMS 肝气逆证模型大鼠海马 GABAARβ 亚基蛋白分布模式及表达水平的影响[J].中国中药杂志,2010,35(11):1452-1455.
[13] 孙冰婷,居文政,戴国梁,等.HPLC同时测定白香丹胶囊中的3种成分[J].华西药学杂志,2016,31(3):295-297.
[14] 孙冰婷,戴国梁,臧雨馨,等.白香丹胶囊中3种主要成分人血浆蛋白结合率的测定[J].中国实验方剂学杂志,2016,22(9):68-72.
[15] Diener D,Greenstein F L,Turnbough P D.Cyclical variation in digit-span and visual-search performance in women differing in the severity of their premenstrual symptoms.[J].Percept Mot Skills,1992,74(1):67-76.
[16] 宗绍波,朱德豪,魏盛.白香丹胶囊对经前期综合征肝气逆证模型大鼠学习记忆功能的影响[J].中国药理学通报,2015,31(2):284-289.
[17] 宗绍波.白香丹胶囊对PMDD肝气逆证模型大鼠学习记忆能力的影响及其机制研究[D].济南:山东中医药大学,2013.
[18] 尹征.白香丹胶囊对焦虑模型大鼠的抗焦虑作用及机制研究[D].济南:山东中医药大学,2014.
[19] 王海苹,魏盛,宗建成,等.白香丹胶囊对经前期综合征肝气逆证模型猕猴表情行为及性激素的影响[J].中成药,2010,32(5):732-735.
[20] Royston G.NEWS:The 2017 Metabolomics publication awards[J].Metabolomics,2017,13(5):62.
[21] 孙鹏.经前期综合征(PMS)肝气逆证代谢组学研究[D].济南:山东中医药大学,2009.
[22] 张惠云,罗国安,孙鹏,等.基于UPLC-Q-TOF的经前期综合征肝气逆证大鼠模型代谢表征研究[J].医学研究杂志,2010,39(1):29-34.
[23] 黎莉,孙鹏,梁琼麟,等.白香丹胶囊干预经前期综合征肝气逆证大鼠血清代谢组学研究[J].中成药,2011,33(5):762-767.
[24] 孙鹏.怒情绪应激对大鼠血管内皮生长因子(VEGF)的影响及肝方药干预作用[D].济南:山东中医药大学,2015.
[25] 柳新.白香丹胶囊对PMS肝气逆证模型大鼠的药理机制研究—含药血清对大鼠海马神经元5-HTR2C的表达及其下游IP_3/DAG/Ca2+信号通路的影响[D].济南:山东中医药大学,2012.
[26] 柳新,薛玲,高杰,等.白香丹含药血清对大鼠海马神经元中5-羟色胺2C受体的表达及其下游信号通路中IP_3的影响[J].中国药理学通报,2012,28(7):1019-1023.
[27] 谭倩.白香丹对PMS肝气逆证模型大鼠不同脑区GABA_B受体亚基分布表达及海马ERK1/2信号通路的影响[D].济南:山东中医药大学,2012.
[28] 蔡洪信.白香丹胶囊对肝气逆证大鼠海马GABA_B受体表达及其G蛋白偶联的离子通道和信号通路的影响[D].济南:山东中医药大学,2012.
[29] 陈景轩.白香丹胶囊对居住入侵诱导PMDD肝气逆证大鼠模型海马基因表达谱的影响[D].济南:山东中医药大学,2014.
[30] 许莉莉,蔡洪信,高杰,等.白香丹胶囊对愤怒情绪模型大鼠海马GABABR和KIR表达的影响[J].中药新药与临床药理,2012,23(3):267-270.
[31] 谭倩,高杰,魏盛,等.白香丹对PMS肝气逆证模型大鼠GABA_BR亚基分布及表达的影响[J].中药新药与临床药理,2012,23(4):378-381.
[32] 蔡洪信,许莉莉,田溪,等.白香丹胶囊对愤怒情绪模型大鼠海马GABA_BR和腺苷酸环化酶表达的影响[J].中成药,2012,34(6):1007-1010.
[33] 房芳芳.PMS肝气逆大鼠脑区GAD、GABA-T、GAT-1表达的变化及药物干预影响[D].济南:山东中医药大学,2013.
[34] 胡言光,薛玲.白香丹胶囊对体外培养大鼠皮层神经元5-羟色胺1A受体表达的影响[J].中药药理与临床,2007(5):151-153.
[35] 孙世光,李自发,鹿岩,等.白香丹胶囊对经前期综合征肝气逆证大鼠旷场行为学和原代培养皮层神经元细胞相对活力的影响[J].中国药房,2011,22(3):209-211.
[36] Halbreich U,O’brien P S,Eriksson E,et al.Are there differential symptom profiles that improve in response to different pharmacological treatments of premenstrual syndrome/ premenstrual dysphoric disorder?[J].CNS drugs,2006,20(7):523-547.
[37] Dimmock P W,Wyatt K M,Jones P W,et al.Efficacy of selective serotonin-reuptake inhibitors in premenstrual syndrome:a systematic review[J].The Lancet,2000,356(9236):1131-1136.
[2] 高明周,潘琳琳,杨焕新,等.刘完素论治情志病浅谈[J].环球中医药,2016,9(9):1081-1082.
[3] 冯帆,吕学玉,汪卫东.情志病病因病机探微[J].中医杂志,2017,58(3):265-267.
[4] Halbreich U,Borenstein J,Pearlstein T,et al.The prevalence,impairment,impact,and burden of premenstrual dysphoric disorder(PMS/PMDD)[J].Psychoneuroendocrinology,2003,28(3):1-23.
[5] 高明周,王杰琼,安礼,等.基于体质人格的经前期综合征发病与干预探析[J].中国实验方剂学杂志,2016(13):223-228.
[6] 杜彩凤,王天芳,薛晓琳,等.经前期综合征常见证素与症状进行相关性文献分析[J].湖南中医药大学学报,2008,28(4):6-9.
[7] 张丽美.经前期综合征与肝失疏泄[J].江西中医药,2005,36(3):20-21.
[8] 乔明琦,张珍玉,徐旭杰,等.经前期综合征证候分布规律的流行病学调查研究[J].中国中医基础医学杂志,1997,3(3):31-32.
[9] 胡春雨,王文燕.从肝试论经前期综合征的体质类型[J].辽宁中医杂志,2006,33(11):1415.
[10] 乔明琦,姜坤.经前平颗粒多中心,随机双盲双模拟对照治疗经前期综合征肝气逆证 403例[J].中国新药杂志,2002,11(5):389-392.
[11] 张海红,张惠云.白香丹胶囊治疗PMS肝气逆证作用机制研究进展[J].医学研究杂志,2013,42(9):21-23.
[12] 陈志恒,孙世光,张惠云.白香丹胶囊对 PMS 肝气逆证模型大鼠海马 GABAARβ 亚基蛋白分布模式及表达水平的影响[J].中国中药杂志,2010,35(11):1452-1455.
[13] 孙冰婷,居文政,戴国梁,等.HPLC同时测定白香丹胶囊中的3种成分[J].华西药学杂志,2016,31(3):295-297.
[14] 孙冰婷,戴国梁,臧雨馨,等.白香丹胶囊中3种主要成分人血浆蛋白结合率的测定[J].中国实验方剂学杂志,2016,22(9):68-72.
[15] Diener D,Greenstein F L,Turnbough P D.Cyclical variation in digit-span and visual-search performance in women differing in the severity of their premenstrual symptoms.[J].Percept Mot Skills,1992,74(1):67-76.
[16] 宗绍波,朱德豪,魏盛.白香丹胶囊对经前期综合征肝气逆证模型大鼠学习记忆功能的影响[J].中国药理学通报,2015,31(2):284-289.
[17] 宗绍波.白香丹胶囊对PMDD肝气逆证模型大鼠学习记忆能力的影响及其机制研究[D].济南:山东中医药大学,2013.
[18] 尹征.白香丹胶囊对焦虑模型大鼠的抗焦虑作用及机制研究[D].济南:山东中医药大学,2014.
[19] 王海苹,魏盛,宗建成,等.白香丹胶囊对经前期综合征肝气逆证模型猕猴表情行为及性激素的影响[J].中成药,2010,32(5):732-735.
[20] Royston G.NEWS:The 2017 Metabolomics publication awards[J].Metabolomics,2017,13(5):62.
[21] 孙鹏.经前期综合征(PMS)肝气逆证代谢组学研究[D].济南:山东中医药大学,2009.
[22] 张惠云,罗国安,孙鹏,等.基于UPLC-Q-TOF的经前期综合征肝气逆证大鼠模型代谢表征研究[J].医学研究杂志,2010,39(1):29-34.
[23] 黎莉,孙鹏,梁琼麟,等.白香丹胶囊干预经前期综合征肝气逆证大鼠血清代谢组学研究[J].中成药,2011,33(5):762-767.
[24] 孙鹏.怒情绪应激对大鼠血管内皮生长因子(VEGF)的影响及肝方药干预作用[D].济南:山东中医药大学,2015.
[25] 柳新.白香丹胶囊对PMS肝气逆证模型大鼠的药理机制研究—含药血清对大鼠海马神经元5-HTR2C的表达及其下游IP_3/DAG/Ca2+信号通路的影响[D].济南:山东中医药大学,2012.
[26] 柳新,薛玲,高杰,等.白香丹含药血清对大鼠海马神经元中5-羟色胺2C受体的表达及其下游信号通路中IP_3的影响[J].中国药理学通报,2012,28(7):1019-1023.
[27] 谭倩.白香丹对PMS肝气逆证模型大鼠不同脑区GABA_B受体亚基分布表达及海马ERK1/2信号通路的影响[D].济南:山东中医药大学,2012.
[28] 蔡洪信.白香丹胶囊对肝气逆证大鼠海马GABA_B受体表达及其G蛋白偶联的离子通道和信号通路的影响[D].济南:山东中医药大学,2012.
[29] 陈景轩.白香丹胶囊对居住入侵诱导PMDD肝气逆证大鼠模型海马基因表达谱的影响[D].济南:山东中医药大学,2014.
[30] 许莉莉,蔡洪信,高杰,等.白香丹胶囊对愤怒情绪模型大鼠海马GABABR和KIR表达的影响[J].中药新药与临床药理,2012,23(3):267-270.
[31] 谭倩,高杰,魏盛,等.白香丹对PMS肝气逆证模型大鼠GABA_BR亚基分布及表达的影响[J].中药新药与临床药理,2012,23(4):378-381.
[32] 蔡洪信,许莉莉,田溪,等.白香丹胶囊对愤怒情绪模型大鼠海马GABA_BR和腺苷酸环化酶表达的影响[J].中成药,2012,34(6):1007-1010.
[33] 房芳芳.PMS肝气逆大鼠脑区GAD、GABA-T、GAT-1表达的变化及药物干预影响[D].济南:山东中医药大学,2013.
[34] 胡言光,薛玲.白香丹胶囊对体外培养大鼠皮层神经元5-羟色胺1A受体表达的影响[J].中药药理与临床,2007(5):151-153.
[35] 孙世光,李自发,鹿岩,等.白香丹胶囊对经前期综合征肝气逆证大鼠旷场行为学和原代培养皮层神经元细胞相对活力的影响[J].中国药房,2011,22(3):209-211.
[36] Halbreich U,O’brien P S,Eriksson E,et al.Are there differential symptom profiles that improve in response to different pharmacological treatments of premenstrual syndrome/ premenstrual dysphoric disorder?[J].CNS drugs,2006,20(7):523-547.
[37] Dimmock P W,Wyatt K M,Jones P W,et al.Efficacy of selective serotonin-reuptake inhibitors in premenstrual syndrome:a systematic review[J].The Lancet,2000,356(9236):1131-1136.