基于"重阳"理论探讨老年失眠线粒体功能障碍的机制及治疗思路OA

Senile insomnia is a common clinical disorder.Traditional Chinese medicine(TCM)primarily attributes the pathogenesis of insomnia to Yang failing to enter Yin aspect and disharmony between Yin and Yang.However,the discussion on insomnia caused by Yang Qi deficiency in elderly patients remains insufficient.According to the theory of extreme Yang in the Huang Di Nei Jing,this paper systematically elucidates the central role of Yang Qi in maintaining mental tranquility and regulating the sleep-wake cycle.It posits that the natural decline of Yang Qi with aging leads to Yang failing to enter Yin aspect or deficient Yang floating upward,which constitutes a key pathogenesis of senile insomnia.From a modern medical perspective,mitochondrial energy metabolism dysfunction is identified as a crucial biological basis.Mitochondrial functional declines result in insufficient adenosine triphosphate(ATP)production and reactive oxygen species(ROS)accumulation,which disrupts the synthesis of sleep-related neurotransmitters and the expression of circadian clock genes,ultimately leading to sleep disturbances.Furthermore,this sutdy explores the intrinsic connection between Yang Qi deficiency and mitochondrial dysfunction,arguing for a high degree of correspondence in their functional and pathological manifestations.Accordingly,the therapeutic principle of warming and tonifying Yang Qi,nourishing the heart and tranquilizing the mild is proposed.This approach employs Yang-warming formulas and acupuncture to regulate the mitochondrial function through multiple targets.Specific mechanisms include enhancing the activity of respiratory chain complexes,activating the mitochondrial autophagy,and mitigating oxidative stress,thereby restoring energy metabolic homeostasis and improving sleep in the elderly.This study provides a new theoretical foundation and a therapeutic strategy for integrating TCM and Western medicine in preventing and treating senile insomnia.