温阳化饮中药治疗抑郁症与肥胖症共病机制研究进展*

作者：尹赛琼1，苏 丹1，许 强2，王久源1，刘平安1，孙贵香1

单位：1.湖南中医药大学中医学院，湖南 长沙 410208； 2.广西中医药大学，广西 南宁 530200

引用：引用：尹赛琼，苏丹，许强，王久源，刘平安，孙贵香.温阳化饮中药治疗抑郁症与肥胖症共病机制研究进展[J].中医药导报,2026,32(3):132-139.

DOI：10.13862/j.cn43-1446/r.2026.03.021

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摘要：抑郁症（MDD）与肥胖症（OB）均为临床高发疾病，二者共病率高且相互影响，其核心病机均以阳虚为本、痰饮为标，现代医学层面则存在遗传基因、代谢通路等多方面关联。本文系统梳理温阳化饮中药治疗二者共病的作用机制，发现该类中药可通过调节线粒体功能提升机体动力，改善脂代谢、抑制炎症反应、调节下丘脑-垂体-肾上腺轴功能、改善胰岛素抵抗及调控肠道菌群等途径优化人体代谢，多靶点、多途径同步改善抑郁与肥胖的病理状态。同时，从中医理论与遗传机制（如MC4R、SLC6A4、BDNF、FTO等基因）层面，阐明了MDD与OB的共病关联性，为“异病同治”提供了理论支撑。温阳化饮中药凭借高效低毒、协同调理的优势，在临床治疗中展现出独特价值。

关键词：抑郁症；肥胖症；温阳化饮中药；胰岛素抵抗；脂代谢；炎症反应；肠道菌群；综述

Abstract：Both major depressive disorder (MDD) and obesity (OB) are clinically prevalent conditions with a high comorbidity rate and mutual influence. Their core pathogenesis is rooted in yang deficiency as the root cause and phlegm-fluid retention as the manifestation. At the modern medical level, they share associations in genetics, metabolic pathways, and other aspects. This paper systematically reviews the mechanisms of action of traditional Chinese medicine (TCM) for warming yang and resolving fluid retention in treating this comorbidity. It finds that these TCM interventions can enhance the body's energy metabolism by regulating mitochondrial function, improving lipid metabolism, inhibiting inflammatory responses, regulating the hypothalamic-pituitary-adrenal (HPA) axis, improving insulin resistance, and modulating the gut microbiota. They simultaneously improve the pathological states of both depression and obesity through multi-target and multi-pathway effects. Furthermore, it elucidates the comorbidity association between MDD and OB from the perspectives of TCM theory and genetic mechanisms (e.g., MC4R, SLC6A4, BDNF, FTO genes), providing theoretical support for the principle of "treating different diseases with the same method". With advantages such as high efficiency, low toxicity, and synergistic regulation, TCM for warming yang and resolving fluid retention demonstrates unique value in clinical treatment.

Key words：major depressive disorder; obesity; traditional Chinese medicine for warming yang and resolving fluid retention; insulin resistance; lipid metabolism; inflammatory response; gut microbiota; review

发布时间：2026-03-28

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