Yuan Jiyuan, Pi Chao, Shen Hongping, Zhou Bi, Wei Yumeng, Dechsupa Nathupakorn, Zhao Ling
Molecular Imaging and Therapy Research Unit, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
Luzhou Key Laboratory of Traditional Chinese Medicine for Chronic Diseases Jointly Built by Sichuan and Chongqing, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Front Pharmacol. 2025 Aug 22;16:1638645. doi: 10.3389/fphar.2025.1638645. eCollection 2025.
Depression and anxiety are prevalent comorbidities in individuals with chronic diseases, significantly impairing their quality of life and complicating disease management. Curcumin, derived from turmeric (Curcuma longa), has garnered attention for its potential therapeutic benefits in alleviating symptoms of depression and anxiety. However, its specific effects on depressive or anxiety symptoms associated with chronic diseases (DACD) remain unclear.
This review aims to comprehensively evaluate curcumin's efficacy and underlying mechanisms through a meta-analysis of human clinical trials supplemented by findings from animal studies. A systematic literature search was conducted in PubMed, EMBASE, Web of Science, Cochrane Library, EBSCO, and OVID databases (until 25 October 2024), with PROSPERO registration number CRD42024602837. Fifteen randomized controlled trials (RCTs) involving 1,123 adult participants were included.
Meta-analysis showed a statistically significant effect of curcumin on depressive symptoms (SMD: -0.65, P = 0.01, 95% CI: -1.16 to -0.13, I = 93%) and anxiety symptoms (SMD: -0.22, P = 0.01, 95% CI: -0.40 to -0.05, I = 0%). Preclinical studies identified several mechanistic pathways through which curcumin may alleviate DACD, including anti-inflammatory and antioxidant effects via NF-κB, NLRP3, AKAP150/PKA/PP2B, miR-146a-5p/ERK, BDNF/TrkB, ROS-ERK1/2, GABA receptors, Keap1-Nrf2-ARE, and regulation of intestinal flora.
These findings highlight curcumin's potential in alleviating DACD. However, the conclusions should be interpreted with caution due to considerable heterogeneity across studies, limited sample size, variations in curcumin formulations and dosages, and potential publication bias. Nevertheless, this review provides a comprehensive overview of the current clinical and mechanistic evidence supporting curcumin's role as an adjunctive treatment for depression and anxiety associated with various chronic diseases such as type 2 diabetes, obesity, migraines, arthritis, coronary heart disease, irritable bowel syndrome, inflammatory bowel disease, and metabolic syndromes.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024602837, identifier CRD42024602837.
抑郁症和焦虑症是慢性病患者中常见的共病，严重损害他们的生活质量并使疾病管理复杂化。姜黄素源自姜黄（Curcuma longa），因其在缓解抑郁和焦虑症状方面的潜在治疗益处而受到关注。然而，其对与慢性病相关的抑郁或焦虑症状（DACD）的具体影响仍不清楚。
本综述旨在通过对人类临床试验的荟萃分析，并辅以动物研究的结果，全面评估姜黄素的疗效及其潜在机制。在PubMed、EMBASE、Web of Science、Cochrane Library、EBSCO和OVID数据库（截至2024年10月25日）中进行了系统的文献检索，PROSPERO注册号为CRD42024602837。纳入了15项涉及1123名成年参与者的随机对照试验（RCT）。
荟萃分析显示，姜黄素对抑郁症状有统计学显著影响（标准化均数差：-0.65，P = 0.01，95%置信区间：-1.16至-0.13，I² = 93%），对焦虑症状也有显著影响（标准化均数差：-0.22，P = 0.01，95%置信区间：-0.40至-0.05，I² = 0%）。临床前研究确定了姜黄素可能缓解DACD的几种机制途径，包括通过NF-κB、NLRP3、AKAP150/PKA/PP2B、miR-146a-5p/ERK、BDNF/TrkB、ROS-ERK1/2、GABA受体、Keap1-Nrf2-ARE产生的抗炎和抗氧化作用，以及对肠道菌群的调节。
这些发现突出了姜黄素在缓解DACD方面的潜力。然而，由于各研究之间存在相当大的异质性、样本量有限、姜黄素制剂和剂量的差异以及潜在的发表偏倚，对这些结论的解释应谨慎。尽管如此，但本综述全面概述了当前支持姜黄素作为2型糖尿病、肥胖症、偏头痛、关节炎、冠心病、肠易激综合征、炎症性肠病和代谢综合征等各种慢性病相关抑郁和焦虑辅助治疗作用的临床和机制证据。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024602837，标识符CRD42024602837
