[1]许月月,陈 敏,谢 欣,等.从“脾为之卫”浅析腹泻型肠易激综合征肠黏膜机械屏障损伤机制[J].陕西中医,2021,(8):1096-1099.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.027]
　XU Yueyue,CHEN Min,XIE Xin,et al.The pathogenesis of mechanical barrier of intestinal mucosa based on the theory of spleen for defend[J].,2021,(8):1096-1099.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.027]
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从“脾为之卫”浅析腹泻型肠易激综合征肠黏膜机械屏障损伤机制
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2021年8期
页码:
1096-1099
栏目:
学术探讨
出版日期:
2021-08-05

文章信息/Info

Title:
The pathogenesis of mechanical barrier of intestinal mucosa based on the theory of spleen for defend
作者:
许月月1; 陈 敏2; 谢 欣1; 王 瑞1; 彭昌蓝1; 果姗姗1
(1.成都中医药大学,四川 成都 610075; 2.成都中医药大学附属医院,四川 成都 610072)
Author(s):
XU Yueyue; CHEN Min; XIE Xin; WANG Rui; PENG Changlan; GUO Shanshan
(Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)
关键词:
腹泻型肠易激综合征;  脾为之卫;  肠黏膜机械屏障;  脾主运化;  健脾益气;  免疫功能
Keywords:
IBS-D;  Spleen for defend;  Mechanical barrier of intestinal mucosa;  Spleen controlling digestion;  Invigorating spleen and invigorating qi;  Immune function
分类号:
R 574
DOI:
DOI:10.3969/j.issn.1000-7369.2020.08.027
文献标志码:
A
摘要:
肠黏膜机械屏障受损是腹泻型肠易激综合征(IBS-D)的重要病理生理基础,是目前的研究热点及新方向。“脾为之卫”是指脾具有抗御外邪、保护机体的作用,主要依托于“脾主运化”“脾主升清”而产生,“正气存内,邪不可干”是“脾为之卫”的主要内涵。从现代医学角度阐述,“脾为之卫”理论与肠黏膜机械屏障相通,是对于人体抵御外界有害物质侵袭功能的描述。脾气亏虚,正气不足,抗邪无力,湿邪内侵而致泄泻。脾气虚弱,肠黏膜机械屏障受损,有害物质通过肠黏膜直接作用于肠道而致腹痛、腹泻。现以“脾为之卫”为切入点,探讨脾虚型腹泻型肠易激综合征(IBS-D)肠黏膜机械屏障的损伤机制,为健脾益气法治疗IBS-D夯实理论基础,且为从“肠黏膜屏障”的角度治疗IBS-D提供理论依据。
Abstract:
It is necessary to know that the damage of intestinal mucosal mechanical barrier is an important pathophysiological basis of diarrhea-predominant irritable bowel syndrome(IBS-D),which is the current research hotspot and new direction.“The spleen for defend” means that the spleen has the function of resisting external evils and protecting the body.It is mainly produced by “The spleen controlling digestion” and “The spleen transporting nutrients upwards”.“The spleen for defend” main connotation is “Righteousnessexists,evil cannot do”.From the perspective of modern medicine,the theory of “The spleen for defend” is connected to the mechanical barrier of the intestinal mucosa,which is a description of the human body's ability to resist the invasion of harmful substances from the outside world.Deficiency of temper is empty,can bring about healthy Qi to reduce,the body does not have enough strength to resist damp evil and bring about diarrhea.Temper is weak,intestinal mucosal mechanical barrier is damaged,harmful substances directly act on the intestinal tract through intestinal mucosa and cause abdominal pain,diarrhea.In this paper,the author takes the “The spleen for defend” as the break through point to discuss the mechanism of intestinal mucosal mechanical barrier injury by in IBS-D with spleen deficiency,so as to lay a solid theoretical foundation for the treatment of IBS-D by “invigorating spleen and invigorating Qi”,and provide theoretical basis for the treatment of IBS-D from the perspective of “intestinal mucosal barrier”.

参考文献/References:

[1] 赵晓丹,王继东,谭海成,等.升清健脾固肠方治疗腹泻型肠易激综合征肝郁脾虚证临床研究[J].陕西中医,2020,41(9):1126-1128.
[2] 马 岚,张正晶,刘 晗,等.难治性肠易激综合征-腹泻型诱发的相关影响因素分析[J].陕西医学杂志,2015,44(12):1691-1692.
[3] Simren M,Palsson OS,Whitehead WE.Update on rome Ⅳ criteria for colorectal disorders:Implications for clinical practice current gastroenterology reports[J].Current Gastroenterology Reports,2017,19(4):15.
[4] 江 晟,陆 敏.肠康方治疗腹泻型肠易激综合征临床研究[J].陕西中医,2019,40(3),331-334.
[5] 张声生,汪红兵,李振华,等.中医药辨证治疗腹泻型肠易激综合征多中心随机对照研究[J].中国中西医结合杂志,2010,30(1):9-13.
[6] 孔 静,王 猛,张玉华,等.肠黏膜机械屏障的中西医结合研究进展[J].中国中西医结合外科杂志,2020,26(5):1001-1004.
[7] 张 新,马烈光.黄帝内经?灵枢[M].成都:四川科技出版社,2008:398.
[8] 刘杰民,蔺晓源,王 敏,等.基于肠黏膜膜免疫的“脾为之卫”理论探讨[J].中国中医基础医学杂志,2013,19(4):464-467.
[9] 熊 斌,钱会南.中医脾虚证与免疫功能关系研究进展[J].湖北中医杂志,2013,35(6):76-78.
[10] 肖定洪,王庆其.王庆其“脾主黏膜”学术观点及其在胃肠疾病治疗中的应用[J].中医杂志,2017,58(15):1278-1282.
[11] 田永超.脓毒症肠黏膜屏障功能障碍防治研究进展[J].陕西医学杂志,2020,49(4):510-513.
[12] 刘 涛,刘 霞,张 弛,等.肠黏膜机械屏障与肠易激综合征的关系[J].中国中医药现代远程教育,2018,16(11):141-144.
[13] 马明和,刘永萍,刘 萍,等.攻下清热活血方对重症急性胰腺炎大鼠血清相关炎性因子及肠黏膜屏障功能的影响研究[J].陕西中医,2020,41(8):1051-1054.
[14] 邹 维,毛靓瑶,刘 敏,等.温针灸治疗脾胃虚弱证腹泻型肠易激综合征临床研究[J].陕西中医,2019,40(12):1786-1788.
[15] 吴少祯.沈氏尊生书[M].北京:中国医药科技出版社,2011:398.
[16] 左 戎,王巧民,张 旭,等.感染后肠易激综合征患者结肠黏膜超微结构的变化与肠黏膜屏障功能障碍的关系[J].蚌埠医学院学报,2012,37(2):171-172,175.
[17] 张 博.脾虚大鼠肠黏膜屏障功能变化及四君子汤对其影响的研究[D].沈阳:辽宁中医药大学,2014.
[18] 张伟戈,廖玉婷,孟 捷,等.肠黏膜通透性增高与IBD、IBS发病机制和脾气虚关系探讨[J].辽宁中医药大学,2017,19(1):187-189.
[19] 刘杰民,黄贵华,纪云西,等.“脾为之卫”的理论内涵与免疫学外延探讨[J].新中医,2011,43(5):3-5.
[20] 秦越人.难经[M].北京:中国医药科技出版社,2017:323.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(81774321); 国家重点研发计划项目(2019YFC1709004)
更新日期/Last Update: 2021-08-09