针灸治疗抑郁障碍失眠的研究进展
Research Progress on Acupuncture for the Treatment of Depression-Related Insomnia
DOI: 10.12677/tcm.2025.1410604, PDF,    科研立项经费支持
作者: 刘亚敏*, 师旭亮#:河北中医药大学针灸推拿学院,河北 石家庄
关键词: 抑郁障碍失眠针灸综述Depression-Related Insomnia Acupuncture Review
摘要: 失眠是抑郁障碍的常见共病,也是抑郁障碍的诊断标准之一,不仅与患者病情预后有关,更是评估临床疗效的指标。但是关于抑郁障碍失眠(Depression-Related Insomnia, DRI)的研究较少。目前一线抗抑郁药和镇静催眠药具有不良反应,临床试验发现针灸具有抗抑郁失眠作用,本文将综述抑郁障碍失眠的研究进展,以期为临床实践提供依据。
Abstract: Insomnia is a highly prevalent comorbidity in individuals with depressive disorder and is recognized as one of its core diagnostic criteria. It is not only closely associated with disease prognosis but also serves as a critical indicator for evaluating clinical treatment outcomes. Nevertheless, research specifically focused on depression-related insomnia (DRI) remains limited. First-line antidepressant and hypnotic medications are often associated with adverse effects, whereas clinical studies have indicated that acupuncture may offer both antidepressant and hypnotic benefits. This paper aims to review recent advances in the understanding and management of insomnia related to depressive disorder, with the goal of supporting evidence-based clinical decision-making.
文章引用:刘亚敏, 师旭亮. 针灸治疗抑郁障碍失眠的研究进展[J]. 中医学, 2025, 14(10): 4164-4169. https://doi.org/10.12677/tcm.2025.1410604

参考文献

[1] Ford, D.E. and Kamerow, D. (1989) Epidemiologic Study of Sleep Disturbances and Psychiatric Disorders. JAMA, 262, 1479-1484. [Google Scholar] [CrossRef] [PubMed]
[2] Emslie, G.J., Kennard, B.D., Mayes, T.L., Nakonezny, P.A., Zhu, L., Tao, R., et al. (2012) Insomnia Moderates Outcome of Serotonin-Selective Reuptake Inhibitor Treatment in Depressed Youth. Journal of Child and Adolescent Psychopharmacology, 22, 21-28. [Google Scholar] [CrossRef] [PubMed]
[3] Hamilton, M. (1989) Frequency of Symptoms in Melancholia (Depressive Illness). British Journal of Psychiatry, 154, 201-206. [Google Scholar] [CrossRef] [PubMed]
[4] Soehner, A.M., Kaplan, K.A. and Harvey, A.G. (2014) Prevalence and Clinical Correlates of Co-Occurring Insomnia and Hypersomnia Symptoms in Depression. Journal of Affective Disorders, 167, 93-97. [Google Scholar] [CrossRef] [PubMed]
[5] Taylor, D.J., Lichstein, K.L., Durrence, H.H., Reidel, B.W. and Bush, A.J. (2005) Epidemiology of Insomnia, Depression, and Anxiety. Sleep, 28, 1457-1464. [Google Scholar] [CrossRef] [PubMed]
[6] Nierenberg, A.A., Husain, M.M., Trivedi, M.H., Fava, M., Warden, D., Wisniewski, S.R., et al. (2010) Residual Symptoms after Remission of Major Depressive Disorder with Citalopram and Risk of Relapse: A STAR*D Report. Psychological Medicine, 40, 41-50. [Google Scholar] [CrossRef] [PubMed]
[7] Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., et al. (2011) Insomnia as a Predictor of Depression: A Meta-Analytic Evaluation of Longitudinal Epidemiological Studies. Journal of Affective Disorders, 135, 10-19. [Google Scholar] [CrossRef] [PubMed]
[8] Daghlas, I., Lane, J.M., Saxena, R. and Vetter, C. (2021) Genetically Proxied Diurnal Preference, Sleep Timing, and Risk of Major Depressive Disorder. JAMA Psychiatry, 78, 903-910. [Google Scholar] [CrossRef] [PubMed]
[9] Otto, M.W., Birk, J.L., Fitzgerald, H.E., Chauvin, G.V., Gold, A.K. and Carl, J.R. (2022) Stage Models for Major Depression: Cognitive Behavior Therapy, Mechanistic Treatment Targets, and the Prevention of Stage Transition. Clinical Psychology Review, 95, Article 102172. [Google Scholar] [CrossRef] [PubMed]
[10] Benasi, G., Guidi, J., Offidani, E., Balon, R., Rickels, K. and Fava, G.A. (2018) Benzodiazepines as a Monotherapy in Depressive Disorders: A Systematic Review. Psychotherapy and Psychosomatics, 87, 65-74. [Google Scholar] [CrossRef] [PubMed]
[11] Wilson, S., Anderson, K., Baldwin, D., Dijk, D., Espie, A., Espie, C., et al. (2019) British Association for Psychopharmacology Consensus Statement on Evidence-Based Treatment of Insomnia, Parasomnias and Circadian Rhythm Disorders: An Update. Journal of Psychopharmacology, 33, 923-947. [Google Scholar] [CrossRef] [PubMed]
[12] Fava, M., Hoog, S.L., Judge, R.A., Kopp, J.B., Nilsson, M.E. and Gonzales, J.S. (2002) Acute Efficacy of Fluoxetine versus Sertraline and Paroxetine in Major Depressive Disorder Including Effects of Baseline Insomnia. Journal of Clinical Psychopharmacology, 22, 137-147. [Google Scholar] [CrossRef] [PubMed]
[13] De Crescenzo, F., D’Alò, G.L., Ostinelli, E.G., Ciabattini, M., Di Franco, V., Watanabe, N., et al. (2022) Comparative Effects of Pharmacological Interventions for the Acute and Long-Term Management of Insomnia Disorder in Adults: A Systematic Review and Network Meta-Analysis. The Lancet, 400, 170-184. [Google Scholar] [CrossRef] [PubMed]
[14] Carney, C.E., Edinger, J.D., Kuchibhatla, M., Lachowski, A.M., Bogouslavsky, O., Krystal, A.D., et al. (2017) Cognitive Behavioral Insomnia Therapy for Those with Insomnia and Depression: A Randomized Controlled Clinical Trial. Sleep, 40, zsx019. [Google Scholar] [CrossRef] [PubMed]
[15] Asarnow, L.D. and Manber, R. (2019) Cognitive Behavioral Therapy for Insomnia in Depression. Sleep Medicine Clinics, 14, 177-184. [Google Scholar] [CrossRef] [PubMed]
[16] Müller-Popkes, K. and Hajak, G. (1996) Interpersonal Psychotherapy in Treatment of Patients with Primary Insomnia—Preliminary Data of Polysomnographic Macro-Analysis. Wiener Medizinische Wochenschrift, 146, 303-305.
[17] Lefaucheur, J., Aleman, A., Baeken, C., Benninger, D.H., Brunelin, J., Di Lazzaro, V., et al. (2020) Evidence-Based Guidelines on the Therapeutic Use of Repetitive Transcranial Magnetic Stimulation (rTMS): An Update (2014-2018). Clinical Neurophysiology, 131, 474-528. [Google Scholar] [CrossRef] [PubMed]
[18] Norred, M.A., Haselden, L.C., Sahlem, G.L., Wilkerson, A.K., Short, E.B., McTeague, L.M., et al. (2021) TMS and CBT-I for Comorbid Depression and Insomnia. Exploring Feasibility and Tolerability of Transcranial Magnetic Stimulation (TMS) and Cognitive Behavioral Therapy for Insomnia (CBT-I) for Comorbid Major Depressive Disorder and Insomnia during the COVID-19 Pandemic. Brain Stimulation, 14, 1508-1510. [Google Scholar] [CrossRef] [PubMed]
[19] Yeung, W., Chung, K., Zhang, Z., Chan, W., Zhang, S., Ng, R.M., et al. (2017) Electroacupuncture for Tapering off Long-Term Benzodiazepine Use: Study Protocol of Randomized Controlled Trial. BMC Complementary and Alternative Medicine, 17, Article No. 183. [Google Scholar] [CrossRef] [PubMed]
[20] 穆薪竹. 针灸治疗抑郁相关失眠的应用与疗效分析[J]. 中国医药指南, 2022, 20(19): 116-119.
[21] 温静. 温针灸联合耳穴压丸治疗抑郁性失眠临床观察[J]. 光明中医, 2021, 36(10): 1666-1668.
[22] 徐畅. 针灸治疗失眠合并抑郁焦虑疗效的临床观察[J]. 航空航天医学杂志, 2021, 32(2): 210-211.
[23] 杨晨曦, 陈赟, 杨义萍, 等. 针灸治疗抑郁性失眠临床选穴规律分析[J]. 中医药通报, 2021, 20(2): 42-46.
[24] 韩兴军, 郑雅峰, 王璇, 等. 灸神阙、针刺组穴对抑郁型大鼠不同脑区神经递质影响[J]. 辽宁中医药大学学报, 2018, 20(8): 154-158.
[25] 邹天雨, 赵宇, 马莉等. 电针百会及神庭穴对抑郁小鼠行为学及不同脑区单胺类神经递质含量的影响[J]. 中医药信息, 2020, 37(3): 59-62.
[26] 刘星, 包金风. 神经发生在抑郁症发生发展中的作用[J]. 中国细胞生物学学报, 2019, 41(6): 1184-1192.