基于肠道菌群探讨脾阳虚型老年性失眠的机制

Mechanism Exploration of Geriatric Insomnia of Spleen-Yang Deficiency Based on Gut Microbiota

摘要: 老年性失眠是一种常见的健康问题，中医上病因复杂，而在老年生理中尤其重视脾胃。近年来，肠道菌群(GM)与失眠的关系成为研究热点，菌群–肠–脑轴(BGM)的提出为理解这一复杂机制提供了新视角。本文从脾阳虚角度探讨老年性失眠与肠道菌群的相互作用，揭示脾阳虚患者肠道菌群失调如何通过影响短链脂肪酸(SCFA)、神经递质(如GABA、5-HT)及炎症因子(如IL-6)的分泌，进而扰乱睡眠–觉醒周期。同时，本文结合中医理论，提出脾阳虚导致脾胃功能失调，进一步加剧肠道菌群失衡，形成恶性循环。通过分析中药(如黄芪、茯苓、白术等)调节肠道菌群、改善脾阳虚型失眠的作用机制，为老年性失眠的治疗提供了新的理论依据和潜在干预策略。

Abstract: Senile insomnia is a common health problem. In traditional Chinese medicine, the causes are complex, but in elderly physiology, particular attention is given to the spleen and stomach. In recent years, the relationship between gut microbiota and insomnia has become a research hotspot, and the proposal of the Microbiome-Gut-Brain Axis provides a new perspective for understanding this complex mechanism. This paper explores the interaction between senile insomnia and gut microbiota from the perspective of spleen-yang deficiency, revealing how intestinal flora dysregulation in patients with spleen-yang deficiency disrupts the sleep-wake cycle by affecting the secretion of short-chain fatty acids, neurotransmitters and inflammatory factors. Meanwhile, combining with Chinese medicine theories, this paper proposes that spleen-yang deficiency leads to dysfunction of the spleen and stomach, which further exacerbates the imbalance of gut microbiota, forming a vicious cycle. By analyzing the mechanism of action of traditional Chinese medicine (e.g., Astragalus, Poria, Atractylodes macrocephala) in regulating the gut microbiota and improving the insomnia of the spleen-yang deficiency type, it provides a new theoretical basis and potential intervention strategy for the treatment of senile insomnia.