摘要
抑郁症与神经-内分泌-免疫系统失衡密切相关,抑郁情绪的产生机制涉及神经-内分泌-免疫系统多靶点间的交互作用。“亢害承制”理论阐释了人体的自稳调节能力,是指导临床遣方用药的重要法则。笔者团队将神经-内分泌-免疫系统失衡与抑郁症的中医病因病机联系,结合“亢害承制”理论,认为抑郁症的病机为肝亢乘脾、土湿木陷、形神失和,肝肾藏泻失衡、阴阳失调、承制失司,这与微观上小胶质细胞-边缘系统稳态失衡,下丘脑-垂体-肾上腺轴-炎症环路失衡两大病理环节高度契合。治疗上应遵循中医“扶制抑害”思想,抑木扶土、疏土达木、调燮枢机,滋水涵木、温肾补肝、解郁安神,治肝、调脾、补肾,彰显“以平为期”的核心治则,从而恢复人体的承制功能。
Depression is closely associated with a neuro-endocrine-immune(NEI)system imbalance.The"excessive vitality leading to restraint and counter-regulation(Kang Hai Cheng Zhi)"theory elucidates the self-regulating mechanism for maintaining dynamic equilibrium in the body,and serves as an importance principle guiding treatment formulation and medication selection.Based on the correlation between NEI system imbalance and the traditional Chinese medicine pathogenesis of depression,and integrating the"Kang Hai Cheng Zhi"theory,the author posits that the pathogenesis of depression lies in overactive liver invading spleen,earth dampness impeding wood′s ascendancy,and disharmony between body and mind,as well as imbalance in storage and discharge functions of liver and kidney,disharmony between Yin and Yang,and disrupted counter-regulation.This dosely aligns with two key pathological methanisms at the micro level:microglial-limbic system homeostatic imbalance and hypothalamic-pituitary-adrenal axis-inflammatory circuit dysregulation.Clinically,the treatment principle for depression adheres to supporting the counter-regulation to restrain excess,with herbal interventions using strategies such as restraining wood to support earth,dredging earth to unblock wood,and harmonizing pivotal functions,as well as nourishing water to nurture wood,warming kidney to tonify liver,and relieving depression to calm the spirit.These approaches aim to regulate the liver,spleen,and kidney,embodying the core therapeutic tenet of"striving for equilibrium,"thereby restoring the body′s self-regulating capability.
作者
佟佳曦
王肄迪
李爱心
孙艳茹
郝闻致
薛哲
刘玥芸
陈月月
陈家旭
TONG Jiaxi;WANG Yidi;LI Aixin;SUN Yanru;HAO Wenzhi;XUE Zhe;LIU Yueyun;CHEN Yueyue;CHEN Jiaxu(School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;Guangzhou Key Laboratory of Formula-Pattern of Traditional Chinese Medicine,School of Traditional Chinese Medicine,Jinan University,Guangzhou 510632,China)
出处
《北京中医药大学学报》
北大核心
2025年第7期903-908,共6页
Journal of Beijing University of Traditional Chinese Medicine
基金
国家自然科学基金项目(No.82430126,No.82405240)。
关键词
抑郁症
亢害承制
神经-内分泌-免疫系统
depression
excessive vitality leading to restraint and counter-regulation(Kang Hai Cheng Zhi)
neuro-endocrine-immune system
