【作者】 江泳；

【导师】 杨殿兴；

【作者基本信息】 成都中医药大学 ， 中医临床基础， 2009， 博士

【摘要】 目的：本项目通过文献及实验研究,探讨抑郁症肾阳不足的基础病机。方法：文献研究：以《中华医典》(升级版)为研究对象搜集中医古籍中有关郁证的报道；使用中国期刊网及中国生物医学文献数据库,收录1978年至2008年12月期间的医药期刊文献中有关郁证、抑郁症的文献报道。一方面理清既往中医医家中对于“阳气”、“肾阳”与郁证的相关论述；另一方面,找出肾阳不足与抑郁症发病机制之间存在关联性的理论、临床及实验依据。实验研究：将敞箱实验得分结果在符合标准范围内的30只成年雌性SD大鼠随机分为正常对照组、抑郁症模型组、肾阳虚模型组,每组动物各10只。采用多种长期不可预知的中等强度慢性刺激的方法诱导并建立抑郁大鼠模型,皮质酮注射法建立肾阳虚证大鼠模型,每周测定1次大鼠体重、行为学表现和糖水消耗实验,观察各个阶段两模型组与正常对照组以及两模型组间的差异,运用SPSS13.0统计软件分析实验数据。结果：文献研究结果：肾阳不足是抑郁症发病基础病机的研究思路具有理论、临床和间接实验依据。实验研究结果：抑郁症模型与肾阳虚模型在体重、行为学测定、糖水消耗实验方面的表现均明显异于正常对照组(P<0.05或P<0.01),且两模型组见各指标表现非常相近(P>0.05),初步提示肾阳不足与抑郁症之间确有关联。结论：肾阳不足是抑郁症发病的基础病机,温振肾阳法是治疗抑郁症的基础治疗,在抑郁症各证型分型论治过程中,当根据肾阳郁闭、肾阳不足之不同,佐以辛通肾阳与温补肾阳之法,有利于提高抑郁症的临床疗效。这一认识不仅创新了中医有关抑郁症发病机理的理论,还为临床防治抑郁症开辟了新的治疗思路,为进一步探明肾阳不足导致抑郁症的发病机理及温振肾阳法作用于抑郁症的治疗机理奠定了前期基础,有利于开发安全显效的新型抗抑郁中成药。更多还原

【Abstract】 Objective:An original view on the close relation between kidney yang deficiency based on theory of yang being charge of activity and the pathogenesis of melancholia was verified through literature and experiment research.Methods:In literature research, the concrete discourse on Yang qi, Kidney yang and depression syndrome was sorted out of various ancient books written from Qin Han Dynasty to Qing Dynasty as well as periodicals on Chinese medicine from January 1978 to December 2008; meanwhile, experimental evidence upon the relativity between kidney yang deficiency and pathogenesis of melancholia existing was notified. In experiment research, an amount of 30 qualified grown up SD rats, selected out according to the scores of open field exploration, were randomized into normal control group, depression model group, kidney yang deficiency group with 10 rats in each group. The depression model was built up by chronic unpredictable moderate stimulation, while kidney yang deficiency of rats was introduced by injection of corticosterone. The rats’weights, behavior features, glucose consume were tested once a week to observe the differences among above three groups. All data was analyzed with SPSS 13.0。Results:In literature research, with theoretical foundation and indirect experimental evidence, kidney yang deficiency based on theory of yang being charge of activity was a common pathogenesis of melancholia. In experiment research, the rats’weights, behavior features, glucose consume in the two model groups differed apparently from those in the control group (P<0.05 or P＜0.01). The close relation between kidney yang deficiency and the pathogenesis of melancholia was verified as two model groups showed similarity on all index (P>0.05)。Conclusion:As kidney yang deficiency is an key pathogenesis of melancholia, the treating principle of warming and invigorating kidney yang should be applied on various patterns through the entire treating course.Moreover, two different therapy, invigarating kidney yang or tonifying kidney yang with warm medicinals, should be employed in terms of the patient’s condition. This not only originated a theory of pathogenesis of melancholia, but also presented a new thought for clinical prevention and treatment, which laid a preceeding foundation to discover the pathogenesis of melancholia due to kidney yang deficiency, and to exposit the treating machanism of warming and invigorating kidney yang. Thus, the research and development of new safe and effective Chinese patent drugs for anti-depression would be benefited..更多还原