抑郁症与认知功能障碍共病现象在临床中日益普遍，尤其在老年群体中具有较高的发病风险。鉴于当前共病态势的严峻性及中医异病同治理论的指导意义，系统探讨其共病机制，并深入分析中医药多靶点干预策略。中医认为其共病的病机核心在于脏腑亏虚、气血不荣与痰浊蒙窍扰神，共同导致神机失用；现代医学研究则表明，血管性病变、脑源性神经营养因子降低、下丘脑-垂体-肾上腺轴功能亢进、神经炎症及肠道菌群紊乱等多系统机制的交互作用，共同构成共病的病理基础。中医药通过多靶点调控神经递质、抑制神经炎症、增强神经可塑性及调节脑-肠轴等途径，展现出整体干预的独特优势。通过系统综述抑郁症与认知功能障碍共病的机制及中医药多靶点干预研究进展，为该领域的科学研究和临床实践提供新的思路与参考。

The comorbidity of depression and cognitive impairment is increasingly prevalent in clinical practice, particularly among the elderly population, which faces a higher risk of onset. Given the severity of the current comorbidity situation and the guiding significance of the traditional Chinese medicine (TCM) theory of “treating different diseases with the same method,” it is essential to systematically explore the underlying mechanisms of this comorbidity and conduct an in-depth analysis of TCM’s multi-target intervention strategies. According to TCM theory, the core pathogenesis of this comorbidity involves visceral deficiency, insufficiency of qi and blood, and phlegm turbidity clouding the orifices and disturbing the spirit, collectively leading to impaired mental functioning. Modern medical research, on the other hand, indicates that the pathological basis of this comorbidity arises from the interplay of multiple systemic mechanisms, including vascular pathologies, reduced brain-derived neurotrophic factor, hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, neuroinflammation, and gut microbiota dysbiosis. TCM demonstrates unique advantages in holistic intervention by multi-target regulation of neurotransmitters, suppression of neuroinflammation, enhancement of neuroplasticity, and modulation of the gut-brain axis. Through a systematic review of the mechanisms underlying the comorbidity of depression and cognitive impairment and the progress in multi-target intervention research in TCM, this study aims to provide new insights and references for scientific research and clinical practice in this field.

R285

国家自然科学基金资助项目(82405203);江西省自然科学基金资助项目(20242BAB20451);中央级公益性科研院所基本科研业务费专项资金资助项目(ZZ17-ND-12,ZZ17-YQ-054)