肺系疾病与抑郁症共病现象呈现双向病理联系，形成难以破解的恶性循环，构成临床治疗的一大挑战。该共病机制既涉及现代医学所提出的“神经-免疫-微生态”失衡理论，又与中医“脏腑相关”整体观念高度吻合。一方面，肺源性炎症因子风暴、低氧应激及下丘脑-垂体-肾上腺轴异常活化等因素，可导致神经递质及神经源性因子表达异常，通过“肺-脑轴”介导炎症级联反应，从而诱发或加重抑郁状态；另一方面，抑郁症伴随的自主神经功能紊乱又可进一步损害肺功能，形成病情加重回路。此外，共病状态引发的微生态失衡通过“肺-脑轴”“肺-脑-肠轴”等多脏腑互扰，促成跨器官病理信号网络的扩散，出现“因病致郁”与“因郁致病”相互交织的复杂局面，使疾病迁延难愈。在治疗方面，化学药虽靶点明确但不良反应较明显；中药则注重整体调节和多靶点干预。二者联用优势互补、协同增效，在该共病治疗中显示出广阔前景。未来应构建跨学科整合研究范式，融合多维度生物信息以建立个体化精准诊疗体系，并借助动态建模方法持续优化治疗路径，从而最终实现临床疗效与患者生存质量的全面提升。

The comorbidity of pulmonary diseases and depression exhibits a bidirectional pathological relationship, forming a vicious cycle that is difficult to break and posing a significant challenge in clinical treatment. The mechanisms underlying this comorbidity not only align with the “neuro-immune-microecological” imbalance theory proposed by modern medicine but also are highly correspond with the holistic concept of “Zang-Fu correlation” in traditional Chinese medicine (TCM). On one hand, factors such as pulmonary-derived inflammatory cytokine storms, hypoxic stress, and abnormal activation of the hypothalamic-pituitary-adrenal axis can lead to dysregulated expression of neurotransmitters and neurogenic factors, mediating inflammatory cascades via the “lung-brain axis” and thereby inducing or exacerbating depressive states. On the other hand, autonomic dysfunction associated with depression can further impair pulmonary function, creating a feedback loop that aggravates the condition. Additionally, microecological imbalances triggered by the comorbid state facilitate the spread of pathological signaling networks across organs through multi-visceral interactions such as the “lung-brain axis” and “lung-brain-gut axis”, resulting in a complex interplay between “disease-induced depression” and “depression-induced disease”, which contributes to disease chronicity and treatment resistance. In terms of treatment, Western medicine, while target-specific, often presents notable side effects, whereas TCM emphasizes holistic regulation and multi-target intervention. The combination of both approaches leverages their complementary advantages and synergistic effects, demonstrating broad prospects in the management of this comorbidity. Future efforts should focus on establishing an interdisciplinary integrated research paradigm, incorporating multi-dimensional biological information to develop personalized precision diagnosis and treatment systems, and employing dynamic modeling methods to continuously optimize therapeutic pathways, ultimately achieving comprehensive improvements in clinical efficacy and patient quality of life.

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国家自然科学基金资助项目（82274360）；山西省中医药管理局资助项目（2024ZYY2A032）；山西省中医药创新团队（zyytd2024020）