抑郁症是一种严重威胁人类健康的精神障碍疾病，在中医范畴中属于“郁证”。抑郁症的发病机制复杂，现有的抗抑郁药物普遍存在不可忽视的问题，如治疗效果欠佳、成瘾性高及不良反应严重等。目前，抑郁症的治疗方法多样，其中名贵中药材天麻Gastrodia elata在临床和动物研究中均显示出良好的抗抑郁效果。天麻及其活性成分可通过调节单胺类神经递质、神经营养因子、下丘脑-垂体-肾上腺轴、炎症反应、神经可塑性、肠道菌群、氧化应激以及抑制神经元过度凋亡等机制缓解抑郁症状。通过总结抑郁症的致病机制、天麻中作用于中枢神经系统的活性成分、天麻及其活性成分的抗抑郁机制，以及天麻相关药物在抑郁症治疗中的临床应用，探讨其面临的挑战和未来发展前景，为天麻抗抑郁的进一步研究提供理论依据和新方向。

Depression is a mental disorder that poses a serious threat to human health. In traditional Chinese medicine, it falls within the realm of “depression syndrome”. The pathogenesis of depression is intricate. The existing antidepressant drugs typically have side effects that cannot be disregarded, such as low therapeutic efficacy, high addiction potential, and severe adverse reactions. At present, there are numerous approaches for treating depression, among which the precious traditional Chinese medicinal material Gastrodia elata has demonstrated favorable antidepressant effects in both clinical and animal studies. G. elata and its active components can alleviate depressive disorders through mechanisms involving monoamine neurotransmitters, neurotrophic factors, the hypothalamic-pituitary-adrenal (HPA) axis, inflammatory responses, neuroplasticity, gut microbiota, oxidative stress, and excessive neuronal apoptosis, etc. In this review, we summarized the pathological mechanisms of depression, active ingredients that act on central nervous system in G. elata, antidepressant mechanisms of G. elata and its active ingredients, as well as the clinical application of G. elata related drugs in the treatment of depression and then discussed the challenges and prospects of it, thereby providing a basis and new directions for future research on antidepressant effects of G. elata.

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云南省基础研究计划项目（202501AU070176）；云南省教育厅科学研究基金项目（2025J1041）；云南省地方高校基础研究联合专项项目（202301BA070001-096）