摘要
干燥综合征(SS)是一种慢性自身免疫性疾病,常累及多脏器与系统,抑郁为常见合并症。SS与抑郁共病,患者常面临更严重的身心负担与不良预后。下丘脑-垂体-肾上腺(HPA)轴可能通过影响激素水平、脑结构、神经递质、促炎因子等途径介导SS合并抑郁症的发生发展。目前现代医学治疗手段存在一定局限性,亟需探索更有效的干预策略。中医“肾脑相济”理论深刻阐释了肾与脑的生理病理联系,在神志疾病治疗中具有独特优势。SS合并抑郁症属中医“燥郁共病”范畴,其核心病机为“肾脑失济”,以肾精亏虚、髓海失养为发病之始基,气郁血瘀、络脉阻滞为病进之标象。运用补肾填精益髓、行气化瘀通络的治则可有效改善患者临床症状,调节HPA轴功能紊乱,丰富并发展“肾脑相济”的中西医理论内涵,以期为临床治疗SS合并抑郁症提供新的理论支持和治疗思路。
Sjogren’s syndrome(SS)is a chronic autoimmune disease that often affects multiple organs and systems,with depression being a common comorbidity.The coexistence of SS and depression often imposes a more severe physical and mental burden on patients and leads to a poor prognosis.The hypothalamic-pituitary-adrenal(HPA)axis may mediate the occurrence and development of SS with depression through influencing hormone levels,brain structure,neurotransmitters,pro-inflammatory factors,etc.Modern medical treatment methods have certain limitations,and there is an urgent need to explore more effective intervention strategies.The theory of kidney-brain mutual assistance in traditional Chinese medicine profoundly explains the physiological and pathological connections between the kidney and the brain,and has unique advantages in the treatment of mental disorders.The condition of SS complicated by depression falls into the category of“co-morbidity of dryness and depression”in traditional chinese medicine.Its core pathogenesis is“the disconnection between the kidney and the brain”.The onset of the disease is based on the deficiency of kidney essence and the lack of nourishment for the sea of marrow,while Qi stagnation,blood stasis,and collateral obstruction are the manifestations of disease progression.The therapeutic principle of tonifying the kidney,enriching essence and marrow,regulating Qi,resolving blood stasis and unblocking meridians can effectively improve the clinical symptoms of patients,regulate the dysfunction of the HPA axis,enrich and develop the theoretical connotations of kidney-brain mutual assistance in both traditional Chinese and Western medicine,and provide new theoretical support and treatment ideas for the clinical treatment of SS combined with depression.
作者
黄熠
许小岑
程沁钰
陆燕
HUANG Yi;XU Xiaoceng;CHENG Qinyu;LU Yan;SO Xin Ru(Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China;Nanjing University of Traditional Chinese Medicine,Nanjing 210023,China)
出处
《陕西中医》
2026年第1期66-71,共6页
Shaanxi Journal of Traditional Chinese Medicine
基金
国家自然科学基金资助面上项目(81774104)
江苏省卫生健康委员会中医药科技发展专项课题(2020ZX09)
江苏省教育厅研究生实践创新计划项目(SJCX24-0989)
江苏省中医院科主任学术提升专项课题(Y2022ZR01)。
关键词
干燥综合征
抑郁症
肾脑相济
下丘脑-垂体-肾上腺轴
发病机制
辨治思路
Sjogren’s syndrome
Depression
Kidney-brain coordination
Hypothalamic-pituitary-adrenal axis
Theoretical implications
Treatment strategies
