摘要
腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)是一种慢性反复发作性的功能性胃肠道疾病,严重影响患者工作与生活质量。其病因与发病机制较为复杂,目前仍未明确,现有研究认为肠道黏膜屏障损伤是该病发病的关键环节,屏障受损后,肠道血管通透性增加,对脂肪、蛋白质以及碳水化合物的吸收减少,导致肠腔内渗透物质增多,引起腹泻的发生。现代医学主要采用调节肠道菌群、止泻解痉、抗焦虑抑郁等方法对症治疗,其存在疗效有限、不良反应多、易复发等局限性,因此寻求新的治疗方法是防治IBS-D亟需解决的关键。近年来,随着对中医药研究的不断深入,越来越多的研究表明中医药在防治IBS-D方面有其独特的优势。中药单体及复方可以通过多层次、多路径、多靶点系统调节肠道黏膜屏障进而干预IBS-D的发生、发展,已逐渐成为IBS-D防治研究的热点。该文在阐释肠道黏膜屏障受损与IBS-D相关性的基础上,从调节肠道菌群、调控肠道化学屏障、增强肠道机械屏障及抑制炎症反应4个方面系统总结中医药干预肠道黏膜屏障,防治IBS-D的作用机制,以期为中医药治疗腹泻型肠易激综合征提供新思路。
Diarrhea-predominant irritable bowel syndrome(IBS-D)is a chronic recurrent functional gastrointestinal disease that seriously affects the quality of work and life of patients.The etiology and pathogenesis of this disease are relatively complex and currently unclear.Existing research suggests that damage to the intestinal mucosal barrier is a key link in the pathogenesis of this disease.After the barrier is damaged,the permeability of intestinal blood vessels increases,and the absorption of fat,protein,and carbohydrates decreases,leading to an increase in intestinal permeability and the occurrence of diarrhea.Modern medicine mainly adopts symptomatic treatment methods such as regulating intestinal microbiota,relieving diarrhea and spasms,and combating anxiety and depression.However,it has limitations such as limited efficacy,multiple side effects,and easy recurrence.Therefore,seeking new treatment methods is the key to urgently solve the prevention and treatment of IBS-D.In recent years,with the continuous deepening of research on traditional Chinese medicine,more and more studies have shown that traditional Chinese medicine has its unique advantages in preventing and treating IBS-D.Traditional Chinese medicine formulas and monomers can intervene in the occurrence and development of IBS-D through multi-level,multi-path,multi-target,and systematic regulation of intestinal microbiota,and have gradually become a hot research topic in the prevention and treatment of IBS-D.On the basis of explaining the correlation between impaired intestinal mucosal barrier and IBS-D,this article systematically summarizes the mechanism of traditional Chinese medicine intervention in the prevention and treatment of IBS-D from four aspects:regulating intestinal microbiota,regulating intestinal chemical barrier,enhancing intestinal mechanical barrier,and inhibiting inflammatory response,in order to provide new ideas for the treatment of IBS-D with traditional Chinese medicine.
作者
何志辉
陈雅璐
陈俊杰
李春夏
潘梓华
黄丽华
王道刚
HE Zhihui;CHEN Yalu;CHEN Junjie;LI Chunxia;PAN Zihua;HUANG Lihua;WANG Daogang(Guangxi University of Traditional Chinese Medicine,Nanning 530200,Guangxi,China;The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,Guangxi,China)
出处
《辽宁中医药大学学报》
CAS
2024年第12期113-116,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
国家中医临床研究基地建设项目(国中医药科技函﹝2018﹞131号)
国家中医药传承创新中心项目(发改办社会﹝2022﹞366号)
广西中医药适宜技术开发与推广项目(GZSY23-21)
广西壮族自治区医疗卫生重点学科和重点教育学科项目(桂卫教科发﹝2023﹞1号)
广西中医药大学面上项目(2019MS016)。
关键词
中医药
肠道黏膜屏障
腹泻型肠易激综合征
机制
综述
traditional Chinese medicine
intestinal mucosal barrier
diarrhea type irritable bowel syndrome
mechanism
summarize
作者简介
何志辉(2000-),男,湖南耒阳人,硕士在读,研究方向:中医脾胃病临床与基础研究;通讯作者:王道刚(1984-),男,山东济宁人,副主任医师,硕士,研究方向:中医脾胃病临床与基础研究。
