摘要
放射性肠炎是腹腔、盆腔及腹膜后恶性肿瘤经放射治疗出现的常见并发症,临床以大便次数增多、腹泻、便血、里急后重等为表现,属于中医“肠澼”“泄泻”“便血”等范畴。因放疗技术的广泛应用,其发病率呈现逐年递增的趋势,严重影响患者的生活质量。目前尚无有效手段来防治放射性肠炎。越来越多的研究表明,放射性肠炎患者普遍存在肠道菌群失衡情况,表现为菌群的结构、多样性及丰度发生较大变化,有益菌如双歧杆菌、乳酸杆菌等减少,而有害菌如放线菌、变形杆菌增加。同时,肠道菌群失衡在放射性肠炎发生、发展过程中起着重要作用。无论是动物实验还是临床试验,均发现放疗引起的肠道菌群紊乱会加重肠道炎症反应,而以肠道菌群为靶点治疗放射性肠炎的有效性已得到证实。众多研究也表明,黄芩、黄连、枸杞、白头翁汤、葛根芩连汤、参苓白术散、乌梅丸等中药及方剂具有调节菌群构成及丰度,促进肠道有益菌群生长,调节菌群代谢产物等作用,能有效缓解放射性肠炎症状,改善患者的生活质量。研究基于肠道菌群的角度,探讨中医药防治放射性肠炎的积极作用,为进一步研究中医药治疗放射性肠炎提供一定参考。
Radiation induced enteritis is a common complication of radiation therapy for malignant tumors in the abdomen,Rpelvic cavity,and retroperitoneum.Clinical manifestations include increased frequency of bowel movements,diarrhea,bloody stools,tenesmus,and it belongs to the categories of traditional Chinese medicine such as intestinal obstruction,diarrhea,and bloody stools.Due to the extensive application of radiotherapy technology,its incidence rate is increasing year by year,which seriously affects the quality of life of patients.At present,there is no effective method to prevent and treat radiation induced enteritis.An increasing number of studies have shown that patients with radiation induced enteritis generally experience imbalanced gut microbiota,characterized by significant changes in the structure,diversity,and abundance of the microbiota.Beneficial bacteria such as Bifidobacterium and Lactobacillus decrease,while harmful bacteria such as Actinobacteria and Proteus increase.Meanwhile,the imbalance of gut microbiota plays an important role in the occurrence and development of radiation induced enteritis.Both animal experiments and clinical trials have found that radiation therapy induced disruption of gut microbiota can exacerbate intestinal inflammatory response,and the effectiveness of targeting gut microbiota in treating radiation induced enteritis has been confirmed.Numerous studies have also shown that Chinese medicines and formulas such as Huangqin(Scutellaria baicalensis),Huanglian(Coptis chinensis),Gouqi(Fructus lycii),the Baitouweng decoction(白头翁汤),the Gegen Qinlian decoction(葛根芩连汤),Shenling Baizhu San(参苓白术散),Wumei wan(乌梅丸),etc.have the ability to regulate the composition and abundance of microbial communities,promote the growth of beneficial gut microbiota,regulate microbial metabolites,and effectively alleviate symptoms of radiation induced intestinal inflammation and improve quality of life.Therefore,based on the perspective of gut microbiota,this article explores the positive role of traditional Chinese medicine in the prevention and treatment of radiation induced enteritis,providing a certain reference for further research on the treatment of radiation induced enteritis in traditional Chinese medicine.
出处
《中医临床研究》
2024年第19期123-128,共6页
Clinical Journal Of Chinese Medicine
基金
辽宁省科技重大专项项目课题(2021JH1/10400051)。
关键词
放射性肠炎
肠道菌群
中医药治疗
综述
Radiation induced enteritis
Intestinal flora
Traditional Chinese medicine treatment
Review
作者简介
衡芳(1997-),四川遂宁人,2021级在读研究生,研究方向为中西医结合临床肿瘤学。
