睡眠障碍是机体功能受损、发展为其他躯体和精神疾病以及增加医疗保健费用的重要危险因素，其病因 和病理生理学机制涉及遗传、环境、行为、心理和生理等多方面因素。失眠是一种常见的睡眠障碍类临床疾 病，其特征是频繁而持续的难以开始或维持睡眠，并伴有清醒时烦躁或疲劳等症状，而长期的睡眠问题将会伴 发多系统疾病。在治疗上，非苯二氮类、苯二氮类等药物存在日间残留效应、认知和运动障碍、药物成瘾等不 良反应；非药物治疗则有着起效滞后、费用昂贵、治疗依从性差等局限性，使得患者在现代医学治疗中获益率 较低，临床上解决睡眠障碍问题难度较大。中医药治疗失眠具有毒副作用小，疗效确切等独特优势。药对体现 了中药七情配伍中的“相须”为用，更加体现了中医辨治的针对性与灵活性。该文通过对酸枣仁-茯苓药对物 质基础及药理活性现代研究现状与进展方面进行综述，分析二者联合使用通过调控下丘脑-垂体-肾上腺轴功 能、调节中枢神经递质水平、调控睡眠-觉醒周期及昼夜节律、调节细胞因子及肠道菌群多种方式改善睡眠， 为揭示酸枣仁-茯苓药对配伍的科学性以及临床应用中药防治睡眠障碍相关方面提供参考。

Sleep disorder is an important risk factor for impaired body function， development of other physical and mental diseases，and increased healthcare costs. Its etiology and pathophysiological mechanisms involve multiple factors including genetics， environment， behavior， psychology and physiology. Insomnia is a common clinical diseases of sleep disorder， which is characterized by frequent and persistent difficulty in initiating or maintaining sleep with symptoms such as daytime irritability or fatigue，long-term sleep problems will be associated with multisystem diseases. Non-benzodiazepines and benzodiazepines have adverse reactions in the treatment of insomnia， such as daytime residual effect，cognitive and movement disorders，and drug addiction，while non-drug therapy showed limitation in the delayed onset of action，expensive costs and poor treatment compliance，which make patients in modern medical treatment have less benefit rate. It is difficult to solve the problem of sleep disorders in clinic. The treatment of insomnia with traditional Chinese medicine has unique advantages such as small toxic and side effects and definite curative effect. The herb pair reflects the use of "mutual promotion" in the compatibility of the seven emotions of traditional Chinese medicine. Furthermore， it reflects the pertinence and flexibility of traditional Chinese medicine differentiation and treatment. This paper reviews the current status and research progress of the material basis and pharmacological activity of Ziziphi spinosae Semen-Poria， and analyzes a combination of the two to improve sleep through regulating the hypothalamus-pituitary-adrenal axis function，the level of central neurotransmitters，sleep-wake cycle and circadian rhythm，cytokines and intestinal flora in multiple ways. Our aim in this study is to reveal the rational of Ziziphi spinosae Semen-Poria，and to provide reference for clinical application of traditional Chinese medicine in prevention and control of sleep disorders.

R285. 5

国家中医药管理局第六批全国老中医药专家学术经验继承项目（国中医药人教发[2017]29 号）；王宝亮全国名老中医药专家传承 工作室建设项目（国中医药人教函[2022]75号）；河南省卫生健康委中医药科学研究专项课题（2023ZY2040）