失眠作为一种常见的睡眠障碍，其发病率逐年上升，发病机制与肠道菌群紊乱密切相关。目前临床治疗失眠的方法多存在局限性及不良反应，通过总结近国内外文献发现，莲子心Nelumbinis Plumula具有多成分、多途径、多靶点的特点，通过调控肠道菌群，影响肠道屏障功能、微生物组成及其代谢产物，并抑制炎症反应及调节免疫，从而发挥镇静催眠作用，但其具体分子机制网络尚未完全阐明。阐述肠道菌群在失眠发生发展中的作用机制及莲子心的调节作用，建立“莲子心-肠道菌群-失眠”轴的系统性解析，为莲子心治疗失眠和菌群靶向药的开发提供参考和理论支持，推动中西医协同防治失眠从基础研究向临床精准治疗的跨越。

Insomnia, as a common sleep disorder, exhibits a rising incidence rate annually, with its pathogenesis closely linked to gut microbiota dysbiosis. Currently, most of the clinical methods for the treatment of insomnia have limitations and adverse reactions. A review of recent domestic and international literature indicates that Lianzixin (Nelumbinis Plumula) possesses multi-component, multi-pathway, and multi-target characteristics. It exerts sedative and hypnotic effects by regulating the gut microbiota composition, influencing intestinal barrier function, microbial composition, and their metabolites, while also suppressing inflammatory responses and modulating immune homeostasis. However, its specific molecular mechanism network has not yet been fully elucidated. This review elaborates on mechanism of gut microbiota in occurrence and development of insomnia and the regulatory effects of Nelumbinis Plumula, establishes a systematic analysis of “Nelumbinis Plumula-gut microbiota-insomnia” axis, and provides theoretical support and reference for developing Nelumbinis Plumula-based insomnia treatments and microbiota-targeted drugs, advancing the collaborative prevention and treatment of insomnia through traditional Chinese medicine and Western medicine from basic research to precision clinical therapy.

R285

第七批全国老中医药专家学术经验继承项目（国中医药人教函 [2022] 76号）；河南省中医药科学研究专项课题（2023ZXZX1057，2023ZXZX1143）；河南省自然科学基金资助项目（252300421632）；河南省病毒性疾病中医药防治重点实验室开放课题（SBDSYY2022-001）