[1]熊 啸,徐天舒.基于脑肠互动探析中医药改善功能性消化不良的作用机制[J].陕西中医,2023,(2):224-228.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.020]
 XIONG Xiao,XU Tianshu.Exploring the mechanism of traditional Chinese medicine to improve functional dyspepsia based on brain-gut interaction[J].,2023,(2):224-228.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.020]
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基于脑肠互动探析中医药改善功能性消化不良的作用机制
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年2期
页码:
224-228
栏目:
学术探讨
出版日期:
2023-02-05

文章信息/Info

Title:
Exploring the mechanism of traditional Chinese medicine to improve functional dyspepsia based on brain-gut interaction
作者:
熊 啸1徐天舒2
(1.南京中医药大学中西医结合鼓楼临床医学院,江苏 南京210046; 2.南京鼓楼医院中医科,江苏 南京210008)
Author(s):
XIONG XiaoXU Tianshu
(Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210046,China)
关键词:
功能性消化不良 脑肠轴 脑肠肽 肠道菌群 神经递质
Keywords:
Functional dyspepsia Brain-gut axis Brain gut peptide Intestinal flora Neurotransmitter
分类号:
R 714.255
DOI:
DOI:10.3969/j.issn.1000-7369.2023.02.020
文献标志码:
A
摘要:
功能性消化不良(FD)是临床上常见的功能性胃肠道疾病,发病率高,其发病机制尚未完全明确,多项研究显示脑肠轴功能紊乱是FD发病的重要机制,贯穿疾病始终。脑肠轴通过神经传导、内分泌免疫因子的释放等方式连接脑、肠,形成双向调节的通路; 脑肠轴功能紊乱同样参与其他发病机制作用的过程。中医理论认为脑与胃肠之间同样存在着广泛的联系,生理功能上相互调节,病理上相互影响。中医药可以通过脑肠轴对脑肠肽等神经递质或激素的释放及肠道菌群等产生相应影响,从而改善FD患者胃肠动力障碍、肠道菌群失调及焦虑抑郁的精神心理状态等临床症状。现论述了中医药通过脑肠轴对FD的调节作用及其可能机制,为后续中医药治疗FD的研究提供参考。
Abstract:
Functional dyspepsia(FD)is a common clinical functional gastrointestinal disease with a high incidence rate and its pathogenesis is not yet fully understood.Several studies have shown that disturbance of brain-gut interaction is a major pathogenesis of FD throughout the disease.The brain-gut axis enables bidirectional regulation and mutual influence between brain and gut through nerve conduction and release of endocrine immune factors.Traditional Chinese Medicine(TCM)theory also suggests that there is an extensive connection between brain and gastrointestinal,with mutual regulation in physiological function and mutual influence in pathology.TCM can improve the clinical symptoms of FD patients such as gastrointestinal motility disorder,intestinal flora dysbiosis,and anxiety depression,through the brain-gut axis on the release of brain-gut peptides and the effect of intestinal flora.This paper reviews the regulatory effects of TCM on FD through the brain-gut axis and its possible mechanisms,and provides a reference for the subsequent research on TCM treatment of FD.

参考文献/References:

[1] Drossman DA,Hasler WL.Rome Ⅳ-functional gi disorders:Disorders of gut-brain interaction[J].Gastroenterology,2016,150(6):1257-1261.
[2] Walker MM,Potter MD,Talley NJ.Tangible pathologies in functional dyspepsia[J].Best Pract Res Clin Gastroenterol,2019,40:101650.
[3] 汪龙德,毛兰芳,杜晓娟,等.功能性消化不良的相关研究进展[J].世界华人消化杂志,2017,25(1):84-90.
[4] 张声生,赵鲁卿.功能性消化不良中医诊疗专家共识意见(2017)[J].中华中医药杂志,2017,32(6):2595-2598.
[5] 展立芬,邢博文,覃思敏,等.心胃相关理论在功能性消化不良中的运用及机制探析[J].陕西中医,2021,42(8):1103-1107.
[6] Dabrowski W,Siwicka GD,Kotfis K,et al.The brain-gut axis-where are we now and how can we modulate these connections?[J].Curr Neuropharmacol,2021,19(8):1164-1177.
[7] Furness JB.The enteric nervous system and neurogastroenterology[J].Nat Rev Gastroenterol Hepatol,2012,9(5):286-294.
[8] Wiley JW,Chang L.Functional bowel disorders[J].Gastroenterology,2018,155(1):1-4.
[9] Hu ML,Rayner CK,Wu KL,et al.Effect of ginger on gastric motility and symptoms of functional dyspepsia[J].World J Gastroenterol,2011,17(1):105-110.
[10] Simren M,Tornblom H,Palsson OS,et al.Visceral hypersensitivity is associated with GI symptom severity in functional GI disorders:Consistent findings from five different patient cohorts[J].Gut,2018,67(2):255-262.
[11] Kano M,Dupont P,Aziz Q,et al.Understanding neurogastroenterology from neuroimaging perspective:A comprehensive review of functional and structural brain imaging in functional gastrointestinal disorders[J].J Neurogastroenterol Motil,2018,24(4):512-527.
[12] Osadchiy V,Martin CR,Mayer EA.The gut-brain axis and the microbiome:Mechanisms and clinical implications[J].Clin Gastroenterol Hepatol,2019,17(2):322-332.
[13] 何 勇,冯爱民,张 卉,等.生命早期肠道菌群与孤独症谱系障碍研究进展[J].陕西医学杂志,2020,49(3):381-385.
[14] Du L,Chen B,Kim JJ,et al.Micro-inflammation in functional dyspepsia:A systematic review and meta-analysis[J].Neurogastroenterol Motil,2018,30(4):13304.
[15] 柯美云,张艳丽.重视心理因素与功能性胃肠疾病关系的研究[J].诊断学理论与实践,2006,15(1):1-2.
[16] Zeng F,Qin W,Yang Y,et al.Regional brain structural abnormality in meal-related functional dyspepsia patients:A voxel-based morphometry study[J].PLoS One,2013,8(7):68383.
[17] 潘雨烟,毛心勇,刘 倩,等.基于“脑肠同调”治疗腹泻型肠易激综合征[J].中医杂志,2021,62(13):1130-1133.
[18] 范明明,林 伟,韩海瑞,等.柴术理胃饮对肝郁脾虚型功能性消化不良大鼠血清MTL、GAS的影响[J].中医药信息,2021,38(10):18-22.
[19] 林柳兵,沈艳婷,阙任烨,等.疏肝健脾养心法对功能性消化不良伴焦虑抑郁状态患者血清5-HT、SP、VIP、NPY的影响[J].世界中西医结合杂志,2019,14(7):966-969.
[20] 张 鑫,刘 阳,姜 巍,等.和胃理气方对肝郁型功能性消化不良大鼠Ghrelin表达的影响[J].云南中医中药杂志,2021,42(4):63-66.
[21] 何青鋆,戴 宁,马 捷,等.脾虚1号方对功能性消化不良大鼠CGRP、CCK和VIP的影响[J].时珍国医国药,2021,32(2):298-301.
[22] 单国顺,赵启苗,臧彬如,等.生、制白术制枳术丸对功能性消化不良大鼠“脑-肠”轴功能影响的研究[J].中华中医药学刊,2022,40(3):44-47.
[23] 程华尧,江雪梅,徐藴杰,等.逍遥散联合西药治疗肝郁脾虚型功能性消化不良及对胃肠激素和炎症因子的影响[J].中药新药与临床药理,2021,32(9):1380-1385.
[24] 李明珠,邢 颖,岳滢滢,等.从抑郁症与功能性消化不良发生机制的相关性探讨肝胃不和证的研究思路[J].湖北中医药大学学报,2013,15(6):36-38.
[25] 肖靓宜,王凌燕,周魁明,等.隔药饼灸对功能性消化不良肝郁脾虚模型大鼠HPA轴中枢相关受体及激素的影响[J].中华中医药杂志,2017,32(1):238-241.
[26] 刘玥芸.肝郁脾虚证模型大鼠下丘脑-垂体-肾上腺轴的变化及逍遥散的调整作用[D].北京:北京中医药大学,2010.
[27] 王士萌,陈 璐,冯晓玲.肾虚血瘀型复发性流产与肠道菌群相关性研究进展[J].陕西中医,2022,43(2):261-264.
[28] 李正民,李江静,庄莹莹,等.益生菌对脂多糖诱发大鼠脑内神经炎症及认知功能障碍保护作用的实验研究[J].陕西医学杂志,2021,50(7):771-775.
[29] Liu Y,Liao W,Liu X,et al.Digestive promoting effect and mechanism of Jiao Sanxian in rats[J].J Ethnopharmacol,2021(278):114334.
[30] 陈亚琳,余丹丹,潘 研,等.肠道菌群失调的中医药治疗[J].世界中西医结合杂志,2018,13(6):879-882.
[31] 武妍琳,刘喜平,贾育新,等.参苓白术散对肠道菌群失调幼鼠肺部免疫炎症反应的影响[J].中国中医药信息杂志,2022,29(11):79-85.
[32] 欧阳庆武,费 雁,魏运姣,等.四君子汤对结肠癌小鼠肠道菌群及免疫功能的调节作用[J].中国老年学杂志,2021,41(21):4819-4823.
[33] 毛梦琳,林 萍,熊林林,等.参苓白术散和理中汤对AAD动物模型肠道产丁酸菌群多样性变化的影响[J].中国实验方剂学杂志,2021,27(22):23-30.
[34] 章斐然,谢澳斯,张金海,等.四君子汤对大肠癌术后化疗患者肠道菌群及免疫功能影响的临床研究[J].汕头大学医学院学报,2020,33(4):206-208.
[35] Zhang S,Lin L,Liu W,et al.Shen Ling Bai Zhu San alleviates functional dyspepsia in rats and modulates the composition of the gut microbiota[J].Nutr Res,2019(71):89-99.
[36] Gunn BG,Cunningham L,Mitchell SG,et al.GABAA receptor-acting neurosteroids:A role in the development and regulation of the stress response[J].Front Neuroendocrinol,2015,36:28-48.
[37] 穆道周.芍药苷抗抑郁促动力作用的实验研究[D].南京:南京中医药大学,2016.
[38] 李传朋,刘 玉,魏品球,等.逍遥散及其类方与有效成分抗抑郁作用机制研究进展[J].中国实验方剂学杂志,2020,26(6):243-250.

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备注/Memo

备注/Memo:
基金项目:南京市卫生科技发展专项资金资助项目(ZKX21020)
更新日期/Last Update: 2023-02-08