Wake Rei, Miyaoka Tsuyoshi, Furuya Motohide, Hashioka Sadayuki, Horiguchi Jun
Department of Psychiatry, Shimane University School of Medicine, 89-1 Enyacho, Izumo 693-8501, Japan.
CNS Neurol Disord Drug Targets. 2016;15(5):551-63. doi: 10.2174/1871527315666160413120541.
A neuropsychiatric syndrome, Autism spectrum disorder (ASD) is qualified via impairments in qualitative communication, social interaction, and stereotyped or restricted, repetitive patterns of behavior, interests, or activities. While all ASDs are considered to have qualitative deficits in social relatedness to others, many people with ASDs have other symptoms, including irritability (which includes aggression, self-injurious behavior, and severe tantrums). In order to decrease these behaviors, it is often helpful to make use of behavioral therapy. In addition, due to the intensity and severity of irritability, adjunctive medications are sometimes needed. Although many of the adjunctive medications have been tested and demonstrated to be useful in treating ASD, no clear standardized treatment has emerged. While the adjunctive medications have shown efficacy, the associated side effects have proven to be a barrier to their accepted use. A traditional Japanese medicine, Yokukansan (YKS), is composed of seven kinds of dried herbs and is widely clinically prescribed for treating psychiatric disorders by acting mainly on the glutamatergic and serotonergic nervous systems. YKS may be safe and useful in treating dementia patients' behavioral and psychological symptoms according to indications from recent studies. We introduce in this review, the ameliorative effects of YKS on Asperger's disorder in open-label studies and on ASDs including pervasive developmental disorder not otherwise specified (PDD-NOS). This review will suggest that YKS is well tolerated and effective for the treatment for subjects with ASD who have severe hyperactivity/noncompliance and irritability/agitation. Additionally, the serotonergic, glutamatergic, anti-inflammatory and neurogenesis effects are explored which are thought to be involved in the mechanisms underlying the efficacy of YKS.
自闭症谱系障碍（ASD）是一种神经精神综合征，其特征在于定性沟通、社交互动以及行为、兴趣或活动的刻板或受限、重复模式方面存在障碍。虽然所有自闭症谱系障碍都被认为在与他人的社交关系方面存在定性缺陷，但许多自闭症谱系障碍患者还有其他症状，包括易怒（包括攻击行为、自伤行为和严重发脾气）。为了减少这些行为，采用行为疗法通常会有所帮助。此外，由于易怒的强度和严重程度，有时需要辅助药物治疗。尽管许多辅助药物已经经过测试并证明对治疗自闭症谱系障碍有用，但尚未出现明确的标准化治疗方法。虽然辅助药物已显示出疗效，但相关的副作用已被证明是其被广泛应用的障碍。一种传统的日本药物， yokukansan（YKS），由七种干草药组成，主要通过作用于谷氨酸能和5-羟色胺能神经系统，在临床上广泛用于治疗精神疾病。根据最近的研究表明，YKS在治疗痴呆症患者的行为和心理症状方面可能是安全有效的。在本综述中，我们介绍了YKS在开放标签研究中对阿斯伯格综合征以及对包括未另行指定的广泛性发育障碍（PDD-NOS）在内的自闭症谱系障碍的改善作用。本综述将表明，YKS对患有严重多动/不依从以及易怒/激动的自闭症谱系障碍患者具有良好的耐受性且治疗有效。此外，还探讨了5-羟色胺能、谷氨酸能、抗炎和神经发生作用，这些作用被认为与YKS疗效的潜在机制有关。
