高原睡眠障碍是一种由高原环境引起的常见生理紊乱，主要表现为失眠、睡眠呼吸暂停和睡眠片段化，其发生病因涉及低氧诱导因子、氧化应激、神经内分泌失调等方面，严重时可诱导发生不可逆性神经损伤。脑-肠轴作为连接中枢神经系统与肠道功能的双向调节通路，在高原睡眠障碍的发生和发展中展现出重要作用，肠道菌群作为连接肠和脑的关键枢纽，可能通过调节神经递质、生成短链脂肪酸、影响激素生成等途径影响睡眠障碍。中藏医药在高原睡眠障碍的调控方面具有独特优势，中医理论认为“胃不和则卧不安”，藏医理论认为“三因失调”则失眠，均可以通过调节脾胃功能来改善睡眠质量，与现代脑-肠轴理论保持一致。通过阐述中藏药对高原睡眠障碍的防治理论，梳理防治高原睡眠障碍的中藏药相关经典方剂、单味药及活性成分和新制剂，探讨中藏药通过调节脑-肠轴改善高原睡眠障碍的药效作用及机制，为进入高原人群提供安全有效的高原睡眠障碍防治策略。

High-altitude sleep disturbance (HASD), a common physiological disorder caused by hypobaric hypoxia, clinically manifests as insomnia, sleep apnea, and sleep fragmentation. Its pathogenesis involves hypoxia-inducible factor activation, oxidative stress, and neuroendocrine dysregulation, with severe cases potentially leading to irreversible neurological damage. The gut-brain axis, a bidirectional communication network between the central nervous system and the gastrointestinal tract, plays a key role in HASD progression. Gut microbiota, as a critical interface between intestinal and cerebral functions, may modulate sleep disorders through neurotransmitter regulation, short-chain fatty acid production, and hormonal pathway modulation. Traditional Chinese medicine (TCM) and traditional Tibetan medicine (TTM) offer unique therapeutic advantages for HASD management. TCM theory suggests that “gastric imbalance disrupts sleep”, while TTM attributes insomnia to “tri-humoral dysregulation”. Both systems align with the modern gut-brain axis theory, emphasizing sleep quality improvement through spleen-stomach system regulation. This study examines the theoretical foundations of TCM and TTM for preventing and treating HASD, summarizing relevant classical prescriptions, monomeric drugs, active ingredients, and novel formulations. Additionally, it explores the pharmacological mechanisms by which TCM and TTM improve HASD by regulating the gut-brain axis, providing safe and effective strategies for individuals entering high-altitude regions.

R285

西南民族大学青藏高原研究科技创新团队(2024CXTD23);西南民族大学科研启动金资助项目(RQD2024020);国家自然科学基金资助项目(82404877);四川省自然科学基金项目(2024NSFSC1685)