Zhang Meng, Bai Xue
Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China.
Front Pharmacol. 2022 Jan 24;13:821270. doi: 10.3389/fphar.2022.821270. eCollection 2022.
Post-stroke depression (PSD) is the most common non-cognitive neuropsychiatric complication after stroke, and about a third of patients with stroke have depression. Although a great deal of effort has been made to treat PSD, the efficacy thereof has not been satisfactory, due to the complex pathological mechanism underlying PSD. In Traditional Chinese Medicine (TCM) theory, PSD is considered to be a combination of "stroke" and "Yu Zheng" The holistic, multi-drug, and multi-objective nature of TCM is consistent with the treatment concept of systems medicine for PSD. TCM has a very long history of being used to treat depression, and various TCM prescriptions have been clinically proven to be effective in improving depression. Among the numerous prescriptions for treating depression, Shugan Jieyu capsule (SG) is one of the classic prescriptions. Additionally, clinical studies have increasingly confirmed that using SG alone or in combination with Western medicine can significantly improve the psychiatric symptoms of PSD patients. Here, we reviewed the mechanism of antidepressant action of SG and its targets in PSD pathologic systems. This review provides further insights into the pharmacological mechanism, drug interaction, and clinical application of TCM prescriptions, as well as a basis for the development of new drugs to treat PSD.
中风后抑郁(PSD)是中风后最常见的非认知性神经精神并发症,约三分之一的中风患者会出现抑郁。尽管在治疗PSD方面已经付出了巨大努力,但由于PSD潜在的病理机制复杂,其疗效并不令人满意。在中医理论中,PSD被认为是“中风”和“郁证”的结合。中医的整体性、多药并用和多靶点特性与PSD的系统医学治疗理念相一致。中医治疗抑郁症的历史悠久,各种中药方剂在临床上已被证明对改善抑郁有效。在众多治疗抑郁症的方剂中,疏肝解郁胶囊(SG)是经典方剂之一。此外,临床研究越来越多地证实,单独使用SG或与西药联合使用均可显著改善PSD患者的精神症状。在此,我们综述了SG的抗抑郁作用机制及其在PSD病理系统中的靶点。本综述为深入了解中药方剂的药理机制、药物相互作用和临床应用提供了进一步的见解,也为开发治疗PSD的新药奠定了基础。