Journal: Frontiers of Chinese Medicine Research DOI: 10.32629/fcmr.v8i3.21813
Abstract
失眠是入睡及维持障碍,严重影响日间工作生活的常见疾病。而抑郁以持久性心境低 落为核心,伴有认知与躯体症状的情感障碍疾病。随着生活压力增大,失眠与抑郁共 病愈发普遍。二者共病率高、机制复杂,属中医学“不寐”“郁证”范畴。中医药以整体 调节、多靶点调控异病同治为特点,但机制尚待阐明。食欲素系统作为调节觉醒与情 绪的关键节点,在共病中发挥重要作用。本文围绕食欲素系统,综述其在失眠合并抑 郁中的作用及中医药干预研究进展,以期为该病的中医药治疗提供科学依据。
Keywords
食欲素；失眠合并抑郁；中医药；作用机制
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[2] Haddad M.The orexinergic system in the retina:Expression and physiological impact-A review of the literature[J].Frontiers in neuroendocrinology,2026,82.101256.
[3] Burke MH,Davis CM,Otte C.Depression and cortisol responses to psychological stress:A meta- analysis[J].Psychoneuroendocrinology,2005,30(9):846-856.
[4] Pires TGS,Cecília AGMD,Nóbrega RAD.Changes in Cortisol but Not in Brain-Derived Neurotrophic Factor Modulate the Association Between Sleep Disturbances and Major Depression[J].Frontiers in behavioral neuroscience,2020,1444.
[5] Ozaki K,Nishiide S,Shikanai H.Changes in the orexin system,hypothalamic-pituitary-adrenal axis and circadian rhythm in juvenile- stressed rats[J].Journal of Pharmacological Sciences,2026,161(3):49-63.
[6] Yaeger WDJ,John MM,Ledesma JL.Social defeat stress responses in the stress alternative model are dependent on sex and anterior basolateral amygdala orexin 2 receptors[J].Biology of sex differences,2026,17(1):87-87.
[7] GOS,Monique B,Michelle K.Dietary fibre intake and its associations with depressive symptoms in a prospective adolescent cohort[J].The British journal of nutrition,2020,31-34.
[8] Wang L,Xiong X,Wang B.Orexin dual receptor antagonist attenuates neurological deficits possibly via PI3K/Akt/mTOR pathway activation in sleep-deprived stroke rats[J].Brain research bulletin,2026,236.111762.
[9] Ahremenko E,Andreev A,Apushkin D.Glial Cells in the Early Stages of Neurodegeneration: Pathogenesis and Therapeutic Targets[J].International Journal of Molecular Sciences,2025,26(24):11995.
[10] Panda PS,Sinha S,Kesharwani A.Role of OX/OXR cascade in insomnia and sleep deprivation link Alzheimer's disease and Parkinson's disease: Therapeutic avenue of Dual OXR Antagonist(DORA)[J].Biochemical pharmacology,2025,233.116794.
[11] EBJ.The role of noradrenergic locus coeruleus neurons and neighboring cholinergic neurons of the pontomesencephalic tegmentum in sleep-wake states[J].Progress in brain research,1991,88533-43.
[12] Cristina C,Denis B.Orexin/Hypocretin and MCH Neurons: Cognitive and Motor Roles Beyond Arousal[J].Frontiers in Neuroscience,2021,15.639313.
[13] 王馨慧,王苏童,王永成,等.基于网络药理学探讨柴胡加龙骨牡蛎汤治疗冠心病合 并焦虑抑郁的机制[J].中国中医药现代远程教育,2025,23(2):147-150.
[14] 李嘉琪.基于Meta分析及网络药理学探讨柴胡加龙骨牡蛎汤治疗失眠的疗效和机制 [D].湖北中医药大学,2024.
[15] 王瑜,陈昺伃,王彦华.柴胡加龙骨牡蛎汤通过神经递质及食欲素改善失眠伴焦虑的 作用机制研究[J].辽宁中医药大学学报,2025,27(12):21-25.
[16] 吴震,边卓琼,陈爱林,等.新型助眠汤通过抑炎作用改善气虚/阴虚质老年失眠的机 制研究[J].细胞与分子免疫学杂志,2025,41(11):1007-1012.
[17] Guangyuan X,Yongxue H,Fangxian C.Abnormalities of the Default Mode Network Functional Connectivity in Patients with Insomnia Disorder[J].Contrast Media &Molecular Imaging,2022,2022 9197858.
[18] 张洪雄,高太祥,赵峰,等.药效学结合网络药理学研究酸枣仁汤对不同疾病模型的 干预作用及其作用机制[J].世界科学技术-中医药现代化,2023,25(7):2465-2478.
[19] 王嘉明,丁皙研,张栩瑞,等.中医药调节食欲素系统治疗失眠的机制进展[J/OL].中 国实验方剂学杂志,2026,6(1):1-14.
[20] 李军瑞,闫珍昆,王清娴.加味酸枣仁汤干预对焦虑症合并失眠患者焦虑水平及睡眠 质量的改善效应研究[J].深圳中西医结合杂志,2026,36(6):50-53.
[21] 吴旭芳.归脾汤联合耳穴压丸疗法治疗抑郁障碍相关性失眠心脾两虚证疗效观察[ J].黑龙江中医药,2022,51(5):42-44.
[22] 吕佳欣.加味归脾汤治疗伴抑郁状态的心脾两虚型失眠的临床观察[D].辽宁中医药 大学,2024.
[23] 张珣,刘颖慧,李玲,等.健脾养心安神方联合认知行为疗法治疗老年失眠症的临床 疗效及对血清5- 羟色胺、食欲素A水平的影响[J].广州中医药大学学报,2023,40(8):1902-1910.
[24] 杜泓瑾,娄泰伟.基于“营卫- 脑玄府”理论与食欲素系统在失眠发病中的相关性探讨[J].四川中医,2026,44(5):28- 33.
[25] 文立杨,刘鹏,薛剑,等.调神固本整合针灸治疗对慢性失眠患者睡眠质量及血清神 经递质含量的影响[J].针灸临床杂志,2026,42(6):24-29.
[26] 万书润.耳穴压丸联合逍遥散治疗肝郁脾虚型失眠伴焦虑抑郁的临床疗效观察[D] .北京中医药大学,2025.
[27] 郑茹文,王东岩,董旭,等.基于电生理特征探讨针刺改善失眠过度觉醒的神经生物 学机制研究进展[J].中华老年多器官疾病杂志,2026,25(5):392-395.
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