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失眠合并抑郁的发病机制与治疗

The Pathogenesis and Treatment of Insomnia Combined with Depression.

作者信息

Chang Yifan, Liu Lu, Xu Xiaodong, Zhang Shiqiang

机构信息

Acupuncture and Moxibustion Department, Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China.

Hebei Province Key Laboratory of Integrated Traditional and Western Medicine in Neurological Rehabilitation, Hebei Province Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou, Hebei, People's Republic of China.

出版信息

Int J Gen Med. 2025 Aug 22;18:4635-4645. doi: 10.2147/IJGM.S547865. eCollection 2025.

Abstract

Under the fast pace and high pressure of modern society, many people suffer from sleep disorders such as insomnia, and then suffer from depression and anxiety. This article may lead to a better understanding of the mechanisms of insomnia combined with depression and its treatment. Vital and meaningful, these mechanisms include synaptic plasticity, neurotransmitter dysfunction, the hypothalamic-pituitary-adrenocortical (HPA) axis, and diminished brain-derived neurotrophic factor (BDNF) levels. Evidence for mechanism-guided integrated therapies is scarce. In clinical practice, pharmacological therapies, including antidepressants, Cognitive behavioural therapy(CBT), physiotherapeutics, acupuncture treatment, and mindfulness interventions, are generally utilised. A more profound comprehension of the pathophysiological mechanisms and the development of comprehensive and effective treatment strategies for insomnia co-occurring with depression can enhance neuropsychiatrists' ability to manage this comorbidity more effectively. This study bridges these gaps by delineating novel neurobiological crosslinks underlying comorbidity and establishing a targeted combined intervention protocol.

摘要

在现代社会的快节奏和高压之下,许多人患有失眠等睡眠障碍,进而患上抑郁症和焦虑症。本文可能有助于更好地理解失眠合并抑郁症的机制及其治疗方法。这些机制包括突触可塑性、神经递质功能障碍、下丘脑-垂体-肾上腺皮质(HPA)轴以及脑源性神经营养因子(BDNF)水平降低,至关重要且意义重大。关于机制导向的综合疗法的证据很少。在临床实践中,通常会采用包括抗抑郁药、认知行为疗法(CBT)、物理治疗、针灸治疗和正念干预在内的药物疗法。更深入地理解病理生理机制以及制定针对失眠合并抑郁症的全面有效治疗策略,可以提高神经精神科医生更有效管理这种共病的能力。本研究通过描绘共病背后新的神经生物学交叉联系并建立有针对性的联合干预方案,填补了这些空白。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d258/12379958/764f9bfbda33/IJGM-18-4635-g0001.jpg

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