Wang Xiao, Yan Lijuan, Zhang Xiaodong, Liu Xiang, Yang Bin
Department of Ultrasound, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Department of Anesthesiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Front Psychiatry. 2025 Jul 18;16:1613408. doi: 10.3389/fpsyt.2025.1613408. eCollection 2025.
Insomnia, affecting up to 30% of adults (typically 18-65 years), is characterized by GABAergic dysfunction and hyperarousal. This mini-review establishes three pivotal advances in insomnia therapeutics: Firstly, it is demonstrated that microbiota-gut-brain axis (MGBA) dysregulation is mechanistically central to insomnia, directly linking gut dysbiosis to vagal, hypothalamic-pituitary-adrenal (HPA), and γ-aminobutyric acid (GABA) axis dysfunction and neuroinflammation. Secondly, the present study documents the unique multitarget effects of electroacupuncture (EA), which have been shown to simultaneously normalize HPA axis activity, enrich GABA-producing microbiota, improve the vagal tone, and suppress neuroimmune activation. The aforementioned effects collectively resolve insomnia's multifactorial etiology. Thirdly, clinical evidence confirms the sustained efficacy of EA to be comparable to that of hypnotics, yet with superior safety and durability. EA redefines therapeutic frameworks by integrating biological and neural interventions that are inaccessible to single-target approaches.
失眠影响着高达30%的成年人（通常为18 - 65岁），其特征为γ-氨基丁酸能功能障碍和过度觉醒。本综述阐述了失眠治疗领域的三项关键进展：首先，研究表明微生物群-肠-脑轴（MGBA）失调在失眠机制中起核心作用，直接将肠道菌群失调与迷走神经、下丘脑-垂体-肾上腺（HPA）轴及γ-氨基丁酸（GABA）轴功能障碍和神经炎症联系起来。其次，本研究记录了电针（EA）独特的多靶点效应，电针已被证明能同时使HPA轴活动正常化、富集产生GABA的微生物群、改善迷走神经张力并抑制神经免疫激活。上述效应共同解决了失眠的多因素病因。第三，临床证据证实电针的持续疗效与催眠药相当，但安全性和持久性更佳。电针通过整合单靶点方法无法实现的生物和神经干预，重新定义了治疗框架。
