背景:失眠和抑郁障碍是临床实践中存在相互因果关系的两种常见症状,通常以合并症的形式表现出来。几种药物已广泛用于治疗失眠和抑郁症,但是这些药物中的大多数都显示出不可忽视的副作用。目前,许多治疗方法适用于失眠和抑郁症状,包括中草药,如天麻(G.elata),在临床和动物研究中具有出色的镇静催眠和抗抑郁作用。
目的:总结失眠症和抑郁症的发病机制以及G.elata缓解这些症状的构效机制。特别是下丘脑-垂体-肾上腺(HPA)轴和肠道菌群,旨在发现治疗失眠和抑郁症的新方法。
方法:从2023年11月开始搜索以下电子数据库:PubMed,WebofScience,谷歌学者,万方数据库,和CNKI。G.elata的以下关键字与其他相关主题术语一起被截断,比如抑郁症,失眠,抗抑郁药,镇静催眠药,神经保护,应用程序,安全,和毒性。
结果:来自G.elata的天然化合物可以缓解失眠和抑郁症,涉及单胺类神经递质,炎症反应,氧化应激,和肠道微生物,等。多项临床试验表明,治疗抑郁症和失眠的G.elata衍生的天然化合物具有显著和安全的治疗作用,但需要进一步精心设计的临床和毒理学研究。
结论:G.elata由于其多靶向特性和较少的副作用,在治疗抑郁症和失眠方面发挥着关键作用。然而,应进行更多的临床和毒理学研究,以进一步探索G.elata的镇静催眠和抗抑郁机制,并为其临床应用提供更多的证据和建议。我们的综述概述了G.elata治疗失眠伴抑郁症的研究方向。
BACKGROUND: Insomnia and depressive disorder are two common symptoms with a reciprocal causal relationship in clinical practice, which are usually manifested in comorbid form. Several medications have been widely used in the treatment of insomnia and depression, but most of these drugs show non-negligible side effects. Currently, many treatments are indicated for insomnia and depressive symptom, including Chinese herbal medicine such as Gastrodia elata Blume (G. elata), which has excellent sedative-hypnotic and antidepressant effects in clinical and animal studies.
OBJECTIVE: To summarize the mechanisms of insomnia and depression and the structure-activity mechanism for G. elata to alleviate these symptoms, particularly by hypothalamic-pituitary-adrenal (HPA) axis and intestinal flora, aiming to discover new approaches for the treatment of insomnia and depression.
METHODS: The following electronic databases were searched from the beginning to November 2023: PubMed, Web of Science, Google Scholar, Wanfang Database, and CNKI. The following keywords of G. elata were used truncated with other relevant topic terms, such as depression, insomnia, antidepressant, sedative-hypnotic, neuroprotection, application, safety, and toxicity.
RESULTS: Natural compounds derived from G. elata could alleviate insomnia and depressive disorder, which is involved in monoamine neurotransmitters, inflammatory response, oxidative stress, and gut microbes, etc. Several clinical trials showed that G. elata-derived natural compounds that treat depression and insomnia have significant and safe therapeutic effects, but further well-designed clinical and toxicological studies are needed.
CONCLUSIONS: G. elata exerts a critical role in treating depression and insomnia due to its multi-targeting properties and fewer side effects. However, more clinical and toxicological studies should be performed to further explore the sedative-hypnotic and antidepressant mechanisms of G. elata and provide more evidence and recommendations for its clinical application. Our
review provides an overview of G. elata treating insomnia with depression for future research direction.