睡眠相关神经递质与阴阳变化的相关性探讨
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摘要
探讨睡眠相关中枢神经递质水平与阴阳变化在生理病理表现的相关性。认为参与睡眠—觉醒节律调控的众多神经递质,根据其作用和功能可分属不同的阴阳属性,即有抑制作用、促眠功能的为阴属类递质,有兴奋作用、促醒功能的为阳属类递质;神经递质含量的变化是阴阳消长转化的物质基础,且当递质含量的变化超出生理范围时,就会诱发病变,出现系列阴阳消长失调的临床症状;而阴阳失调是递质异常活动的结果,是疾病症状的外在表现。探讨睡眠相关中枢神经递质水平与阴阳变化在生理病理表现的相关性,将有助于寻找更安全有效的方法以提高临床治疗失眠的疗效。
The physiopathological correlation of the levels of sleep-associated neurotransmitters with Yin-yang alternation was discussed. It is indicated that the multiple sleep-awakening-rhythm associated neurotransmitters can be classified into Yin or Yang according to their action and function, i.e., the neurotransmitters with the inhibitory action and sleep-promoting function can be classified into Yin,and those with the excitatory action and awakening-promoting function can be classified into Yang. The changes in the contents of neurotransmitters result into the wax-wane and transformation of Yin and Yang, and clinical symptoms of disorder of Yin-yang transformation will appear if the levels of neurotransmitters are not in their normal range;the disorder of Yin and Yang is the result of the changes of neurotransmitter levels,and is the manifestation of the disease. The exploration of correlation of the levels of sleep-associated neurotransmitters with Yin-yang alternation will be helpful to find out a more effective and safer therapy for enhancing the therapeutic effect on insomnia treated with western medicine and Chinese medicine.
The physiopathological correlation of the levels of sleep-associated neurotransmitters with Yin-yang alternation was discussed. It is indicated that the multiple sleep-awakening-rhythm associated neurotransmitters can be classified into Yin or Yang according to their action and function, i.e., the neurotransmitters with the inhibitory action and sleep-promoting function can be classified into Yin,and those with the excitatory action and awakening-promoting function can be classified into Yang. The changes in the contents of neurotransmitters result into the wax-wane and transformation of Yin and Yang, and clinical symptoms of disorder of Yin-yang transformation will appear if the levels of neurotransmitters are not in their normal range;the disorder of Yin and Yang is the result of the changes of neurotransmitter levels,and is the manifestation of the disease. The exploration of correlation of the levels of sleep-associated neurotransmitters with Yin-yang alternation will be helpful to find out a more effective and safer therapy for enhancing the therapeutic effect on insomnia treated with western medicine and Chinese medicine.
引文
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[23]张福利,马伯艳,白妍,等.温胆汤对失眠大鼠下丘脑内单胺类递质影响的研究[J].中医药信息,2005,22(2):48.
[24]孔梅,邢长永,舒晓春.逍遥散干预抑郁症睡眠障碍模型大鼠海马5-HT1A受体,5-HT2A受体的变化[J].中国实验方剂学杂志,2010,16(14):1157.
[25]刘珂欣,史恒军. 1978—2002年中医药治疗失眠症文献的再分析[J].中国中医基础医学杂志,2005,11(5):377.
[26] Bergdahl L,Broman J E,Berman A H,et al. Auricular acupuncture and cognitive behavioural therapy for insomnia:a randomised controlled study[J/OL]. Sleep Disord, 2016, 2016:7057282.
[2]汪咏秋,张克翰,章向明.思诺思致短暂精神异常6例报告[J].中国神经精神疾病杂志,2004,30(1):71.
[3] Sanford L D,Parris B,Tang X. GABAergic regulation of the central nucleus of the amygdala:implications for sleep control[J].Brain Res,2002,956(2):276.
[4] Eban-Rothschild A,Rothschild G,Giardino W J,et al. VTA dopaminergic neurons regulate ethologically relevant sleep–wake behaviors[J]. Nat Neurosci,2016, 19(10):1356.
[5]李绍旦,杨明会,王振福,等.亚健康失眠人群脑内神经递质水平分析[J].中国全科医学,2008,11(1A):24.
[6] Hunsley M S, Palmiter R D. Altered sleep latency and arousal regulation in mice lacking norepinephrine[J]. Pharmacol Biochem Behav,2004,78(4):765.
[7] Chastrette N, Cespuglio R, Jouvet M. Proopiomelanocortin(POMC)-derived peptides and sleep in the rat. Part1. Hypogenic porperties of ACTH derivatives[J]. Neuropeptides, 1990, 15(2):61.
[8]叶惟泠.哺乳动物中枢单胺类递质的昼夜节律性变化[J].生理科学进展,1984,15(4):316.
[9] Sheving L E,Harrison W H,Gordon P,et al. Daily fluctuation(circadian and ultradian)in biogenic amines of the rat brain[J].Am J Physiol,1968,214(1):166.
[10]蒋晓江,许志强,刘娟.内因性失眠症患者中枢抑制源GABA震荡的脑电涨落变化[J].中国临床神经科学,2005,13(3):236.
[11]曾远明,李长清,胡长林.慢性失眠病人脑内神经递质活动的超慢涨落图表现[J].临床神经电生理学杂志,2005,14(2):85.
[12]骆晓林,龙浩文.失眠症患者脑电超慢涨落图特征研究[J].现代生物医学进展,2010,10(10):1895.
[13]李建国,赵博.中医药对抑郁症单胺类神经递质影响的研究进展[J].贵阳中医学院学报,2011,4(33):129.
[14]谢健,高力舒.焦虑症患者去甲肾上腺素、总皮质醇及白介素-2测定[J].浙江临床医学,2006,8(8):798.
[15]全世建,林杏娥,刘妮. PCPA大鼠失眠模型的证候属性研究[J].中医药学刊,2006,24(3):450.
[16]张舜波,王平,田代志,等.酸枣仁总皂苷对失眠老年大鼠脑氨基酸类神经递质及受体表达的影响[J].中国实验方剂学杂志,2014,20(4):124.
[17]吴文哲,李跃华,赵翠萍,等. 60例心肾不交型原发性抑郁症患者脑电超慢涨落图的特征研究[J].中西医结合心脑血管病杂志,2012,13(6):739.
[18]游秋云,王平,孔明望,等.酸枣仁汤对老年血亏阴虚失眠证候模型大鼠脑组织谷氨酸、γ-氨基丁酸及γ-氨基丁酸A受体表达的影响[J].中国实验方剂学杂志,2010,16(14):119.
[19]吴立明,郝芬兰.加味酸枣仁汤治疗慢性重度失眠70例疗效观察[C]//中华中医药学会中医方证基础研究与临床应用学术研讨会论文汇编. 2006:149-151.
[20]胡文婷,李廷利,朱蕾,等.刺五加与五味子合用对小鼠镇静催眠作用的研究[J].中药药理与临床,2012,27(6):66.
[21]刘敬霞,李建生.苦参及其有效成分治疗失眠症研究进展[J].中国实验方剂学杂志,2012,18(11):284.
[22]张欣,刘明军.抓痧调神法推拿对失眠大鼠脑内单胺类神经递质的影响观察[J].时珍国医国药,2011,22(2):490.
[23]张福利,马伯艳,白妍,等.温胆汤对失眠大鼠下丘脑内单胺类递质影响的研究[J].中医药信息,2005,22(2):48.
[24]孔梅,邢长永,舒晓春.逍遥散干预抑郁症睡眠障碍模型大鼠海马5-HT1A受体,5-HT2A受体的变化[J].中国实验方剂学杂志,2010,16(14):1157.
[25]刘珂欣,史恒军. 1978—2002年中医药治疗失眠症文献的再分析[J].中国中医基础医学杂志,2005,11(5):377.
[26] Bergdahl L,Broman J E,Berman A H,et al. Auricular acupuncture and cognitive behavioural therapy for insomnia:a randomised controlled study[J/OL]. Sleep Disord, 2016, 2016:7057282.