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基于荟萃分析的逍遥散治疗慢性不可预测轻度应激模型抑郁的临床前证据评价。

Preclinical evidence evaluation of Xiaoyao san in treating chronic unpredictable mild stress model of depression based on meta-analysis.

机构信息

School of Medicine and Food, Sichuan Vocational College of Health and Rehabilitation, Zigong, 643000, China.

School of Food and Bioengineering, Xihua University, Chengdu, 610039, China.

出版信息

Phytomedicine. 2023 Oct;119:154991. doi: 10.1016/j.phymed.2023.154991. Epub 2023 Aug 2.

Abstract

BACKGROUND

In view of the current challenges in the treatment of depression, in order to improve the efficacy and avoid adverse reactions, people pay attention to the treatment of traditional Chinese medicine. Xiaoyao san is a classic prescription commonly used in the treatment of depression, with the role of harmonizing liver and spleen, and shows great potential in the treatment of depression.

PURPOSE

The purpose of this study is to comprehensively evaluate the efficacy and specific mechanism of Xiaoyao san in the treatment of chronic unpredictable mild stress (CUMS) model of depression through systematic evaluation and meta-analysis, so as to provide strong preclinical evidence for the clinical treatment of Xiaoyao san and provide a new strategy for the development of antidepressants.

METHODS

The preclinical literature published before March 2023 was searched in Cochrane Library, PubMed, Web of Science, EMbase, CNKI, VMIS, Wan-Fang, and CBM and other database systems. Stata15 was used for overall effect analysis and subgroup analysis, and summarized the potential mechanism of action.

RESULTS

A total of 25 studies were included, involving 569 animals. The average score of methodological quality was 7.48/10. Meta-analysis shows that Xiaoyao san can effectively improve food intake and body weight, restore sucrose consumption, reduce the immobility time in forced swimming, and increase the total exercise distance, grid crossing and upright times in the open field experiment. Its therapeutic effect is closely related to improving the abnormal activation of Hypothalamic-pituitary-adrenal axis and inhibiting the expression of glutamate.

CONCLUSION

To sum up, in CUMS animal model, Xiaoyao san can significantly improve the symptoms of depression, restore the lost pleasure behavior and curiosity about the new environment, relieve tension and anxiety, and improve the occurrence of depression in many ways, which may be a new treatment strategy for CUMS model of depression.

摘要

背景

鉴于目前抑郁症治疗的挑战,为了提高疗效并避免不良反应,人们关注中药治疗。逍遥散是一种常用于治疗抑郁症的经典方剂,具有调和肝脾的作用,在治疗抑郁症方面显示出巨大的潜力。

目的

本研究通过系统评价和荟萃分析,全面评估逍遥散治疗慢性不可预测轻度应激(CUMS)抑郁模型的疗效和具体机制,为逍遥散的临床治疗提供强有力的临床前证据,并为抗抑郁药的开发提供新策略。

方法

检索 Cochrane 图书馆、PubMed、Web of Science、EMbase、CNKI、VMIS、万方和 CBM 等数据库系统,检索发表于 2023 年 3 月之前的与逍遥散治疗抑郁症的临床前文献。采用 Stata15 进行总效应分析和亚组分析,并总结潜在作用机制。

结果

共纳入 25 项研究,涉及 569 只动物。方法学质量评分平均为 7.48/10。荟萃分析表明,逍遥散能有效改善摄食和体重,恢复蔗糖消耗,减少强迫游泳中的不动时间,增加旷场实验中的总运动距离、网格穿越和直立次数。其治疗效果与改善下丘脑-垂体-肾上腺轴的异常激活和抑制谷氨酸的表达密切相关。

结论

综上所述,在 CUMS 动物模型中,逍遥散能显著改善抑郁症状,恢复失去的快感行为和对新环境的好奇心,缓解紧张和焦虑,多方位改善抑郁的发生,可能是 CUMS 模型抑郁的一种新的治疗策略。

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