Suanzaoren Tang and Its Modified Formulas on Prevention and Treatment of Anxiety Disorders： A Review / 中国实验方剂学杂志

ABSTRACT

Suanzaoren Tang， as documented in the Synopsis of the Golden Chamber （《金匮要略》），consists of Ziziphi Spinosae Semen， Poria， Anemarrhenae Rhizoma， Chuanxiong Rhizoma， and Glycyrrhizae Radix et Rhizoma， and is indicated for dysphoria， consumptive disease， and insomnia. In modern clinical practice，in addition to sleep disorders，Suanzaoren Tang and its modified formulas can also be used to treat anxiety disorders， as well as insomnia，cardiac intervention，myocardial infarction， and other diseases combined with anxiety. It is also used in combination with other Chinese medicinal formulas （such as Zhizichi Tang，Ganmai Dazaotang，Baihe Zhimu Dihuangtang，and Jinlingzi San），western medicines （such as paroxetine，zopiclone，enalapril，amlodipine，metformin，and sertraline hydrochloride）， acupuncture， and acupoint application to treat anxiety， as well as cardiovascular neurosis，cancer，hypertension，type 2 diabetes， and other diseases combined with anxiety. As revealed by clinical treatment results， Suanzaoren Tang and its modified formulas can significantly reduce anxiety scores such as Hamilton Anxiety Rating Scale（HAMA） and Self-rating Anxiety Scale（SAS），and improve anxiety symptoms with significant efficacy and few side effects. As reported by experimental pharmacological studies， Suanzaoren Tang can regulate the content of neurotransmitters such as dopamine（DA），homovanillic acid（HVA），γ-aminobutyric acid（GABA），noradrenaline （NE），5-hydroxyindoleacetic acid （5-HIAA），glutamic acid（Glu），β-endorphin（β-EP），5-hydroxytryptamine（5-HT）， and nitric oxide （NO）in the brain， and mediate immune function by reducing the levels of inflammatory cytokines such as interleukin-1β（IL-1β）and tumor necrosis factor-α（TNF-α），enhancing the proliferation of B lymphocytes，phagocytosis of peritoneal macrophages， and down-regulating the proliferation of T lymphocytes. Besides， it can also regulate the endocrine level to allow the homeostasis of nervous system， endocrine system， and immune system by increasing adrenocorticotropic hormone（ACTH）and corticosterone（CORT）levels and up-regulating glucocorticoid receptor（GR）expression， finally achieving the effect of anxiety prevention and treatment. The present study systematically reviewed the clinical and basic research progress on the prevention and treatment of anxiety with Suanzaoren Tang to provide references for the research on the mechanism and material basis of Suanzaoren Tang and the development of new drugs for anxiety.