[1]王 云,赵 崧.基于内脏高敏感从脾阳不足论述腹泻型肠易激综合征临床症状[J].陕西中医,2022,(5):612-615,623.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.016]
 WANG Yun,ZHAO Song.IBS-D clinical symptoms from deficiency of spleen yang based on visceral hypersensitivity[J].,2022,(5):612-615,623.[doi:DOI:10.3969/j.issn.1000-7369.2022.05.016]
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基于内脏高敏感从脾阳不足论述腹泻型肠易激综合征临床症状
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2022年5期
页码:
612-615,623
栏目:
学术探讨
出版日期:
2022-05-05

文章信息/Info

Title:
IBS-D clinical symptoms from deficiency of spleen yang based on visceral hypersensitivity
作者:
王 云赵 崧
(南京中医药大学第一附属医院脾胃科,江苏 南京 210029)
Author(s):
WANG YunZHAO Song
(Department of Gastroenterology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)
关键词:
腹泻型肠易激综合征 脾阳不足 脾肾阳虚 内脏高敏感 病机
Keywords:
Diarrhea-predominant irritable bowel syndrome Deficiency of spleen yang Spleen-yang deficiency Visceral hypersensitivity Pathogenesis
分类号:
R 574
DOI:
DOI:10.3969/j.issn.1000-7369.2022.05.016
文献标志码:
A
摘要:
腹泻型肠易激综合征(IBS-D)是一类易受饮食、生活环境及心理精神影响,以腹痛或腹部不适及腹泻为主要临床表现的功能性胃肠疾病。其机制仍在探索中,但内脏敏感性增高被认为是导致IBS-D发生的核心机制,其主要体现为感觉异常或阈值下降,即低于一般刺激时患者易出现腹痛、腹部不适及腹泻的症状。目前中医上对IBS-D患者病因病机认识尚有争议,但该病本于脾虚,病久导致脾肾阳虚的病机是公认的。结合二者临床特点及相关研究,推测脾肾阳虚型IBS-D的临床表现与内脏高敏感密切相关。
Abstract:
Diarrhea-predominant irritable bowel syndrome(IBS-D)is a kind of functional gastrointestinal diseases which are easily influenced by diet,living environment and psychological spirit,and whose main clinical manifestations are abdominal pain or abdominal discomfort and diarrhea.Its mechanism is still not clear,but the increased visceral sensitivity is considered as the core factor,which is mainly manifested by abnormal sensation or lower threshold.Therefore,patients are more likely to suffer from lower stimulation than regular condition.At present, the etiology and pathogenesis of IBS-D are still controversial in traditional Chinese medicine,but it is generally recognized that long-term illness leads to spleen-kidney yang deficiency in IBS-D patients based on spleen deficiency.Combined with the clinical characteristics and related research,it is speculated that the clinical manifestations of IBS-D with spleen-yang deficiency are closely related to visceral hypersensitivity.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(81774243)
更新日期/Last Update: 2022-05-09