[1]聂姝常,王妙苗,程彬彬.肝硬化合并肠道功能失调的中西医结合治疗研究进展[J].陕西中医杂志,2023,(2):259-261,266.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.028]
　NIE Shuchang,WANG Miaomiao,CHENG Binbin.Research progress of traditional Chinese and western medicine for treating intestinal dysfunction in liver cirrhosis[J].,2023,(2):259-261,266.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.028]
点击复制

肝硬化合并肠道功能失调的中西医结合治疗研究进展
分享到：

《陕西中医》杂志[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年2期
页码:
259-261,266
栏目:
综 述
出版日期:
2023-02-05

文章信息/Info

Title:
Research progress of traditional Chinese and western medicine for treating intestinal dysfunction in liver cirrhosis
作者:
聂姝常1; 2; 王妙苗3; 程彬彬1; 2
(1.海军军医大学中医系,上海 200433; 2.海军军医大学附属长海医院中医肿瘤科,上海 200433; 3.海军军医大学第二附属医院肿瘤科,上海 200003)
Author(s):
NIE Shuchang; WANG Miaomiao; CHENG Binbin
(Department of Traditional Chinese Medicine,Naval Medical University,Shanghai 200433,China)
关键词:
肝硬化;  肠道功能失调;  腹胀;  腹泻;  肠道菌群
Keywords:
Cirrhosis;  Intestinal dysfunction;  Bloating;  Diarrhea;  Intestinal flora
分类号:
R 657.31
DOI:
DOI:10.3969/j.issn.1000-7369.2023.02.028
文献标志码:
A
摘要:
肝硬化患者肠道功能失调的发病率高且常反复发作,病程长且难以治愈。肠道功能失调主要表现为腹泻或腹胀,其症状严重时甚至会加重本身肝病病情。肝硬化合并肠道功能失调病因繁多,发病机制复杂,多由于肝硬化通过肝肠轴导致肠道菌群紊乱或肠黏膜屏障功能损伤,目前尚无特效疗法。西医临床常采用对症治疗或联合调节肠道菌群治疗,具有一定疗效,而中医则以辨证论治为原则,多以培土抑木法贯穿始终,具有多靶点和多方式的优点,从而使患者获得更好的生活质量。现分别从西医及中医病机及治疗等几个方面对该疾病进行综述,旨在提高临床医生对肝硬化合并肠道菌群失调的认识,并为中西医治疗该疾病提供依据与方法。
Abstract:
The incidence of intestinal dysfunction in patients with liver cirrhosis is high.The disease which often recurs has a long course and is difficult to cure.The main symptoms are diarrhea or bloating,which can aggravate the liver disease.The etiology of the intestinal dysfunction in cirrhosis is various and the pathogenesis is complex.The intestinal dysfunction is mostly caused by liver cirrhosis through the liver-gut axis leading to intestinal flora disorder or intestinal mucosal barrier function damage.No specific treatment has been discovered currently.Western medicine usually adopts symptomatic treatment or regulation of intestinal flora treatment,while traditional Chinese medicine mostly adopts the treatment of reinforcing the spleen to control the liver based on syndrome differentiation.Traditional Chinese medicine has the advantages of multiple targets and multiple methods,so that patients can obtain a better quality of life.This article will review the disease from four aspects of western medicine and traditional Chinese medicine in both pathogenesis and treatment,aiming to improve clinical' understanding of cirrhosis with intestinal dysfunction,and provide evidence and methods for traditional Chinese and western medicine to treat cirrhosis with intestinal dysfunction.

参考文献/References:

[1] 于兴华,马晓莹,张 鹏,等.酪酸梭菌与胃肠道及肝脏疾病的研究进展[J].中国微生态学杂志,2020,32(4):472-476,497.
[2] 张莉娟,江 勇,刘炳华,等.成年人慢性腹泻病因的研究进展[J].中国全科医学,2019,22(22):2760-2765.
[3] 庄 莹,林志辉.食物不耐受与肝源性腹泻的相关性分析[J].福建医药杂志,2019,41(6):8-11.
[4] Milosevic I,Vujovic A,Barac A,et al.Gut-liver axis,gut microbiota,and its modulation in the management of liver diseases:A review of the literature[J].Int J Mol Sci,2019,20(2):395.
[5] 李京涛,焦俊喆,魏海梁,等.茵陈蒿汤对急性肝内胆汁淤积大鼠肠道黏膜屏障和NF-κB的影响[J].陕西中医,2019,40(5):547-549.
[6] Qin N,Yang F,Li A,et al.Alterations of the human gut microbiome in liver cirrhosis[J].Nature,2014,513(7516):59-64.
[7] Sarangi AN,Goel A,Singh A,et al.Faecal bacterial microbiota in patients with cirrhosis and the effect of lactulose administration[J].BMC Gastroenterol,2017,17(1):125.
[8] Miura K,Ohnishi H.Role of gut microbiota and Toll-like receptors in nonalcoholic fatty liver disease[J].World J Gastroenterol,2014,20(23):7381-7391.
[9] Chopyk DM,Grakoui A.Contribution of the intestinal microbiome and gut barrier to hepatic disorders[J].Gastroenterology,2020,159(3):849-863.
[10] Palmer LB,Kuftinec G,Pearlman M,et al.Nutrition in cirrhosis[J].Curr Gastroenterol Rep,2019,21(8):38.
[11] 刘璨宇,韩际奥,王会敏,等.低FODMAP饮食对肝硬化患者胃肠道症状的影响[J].胃肠病学和肝病学杂志,2021,30(6):682-687.
[12] Munck TJ,Xu P,Verwijs HJ,et al.Intestinal permeability in human nonalcoholic fatty liver disease:A systematic review and meta-analysis[J].Liver Int,2020,40(12):2906-2916.
[13] 鲍素霞,孙长宇,周 言,等.肝源性腹泻62例诊治分析[J].临床肝胆病杂志,2014,30(6):560-562.
[14] Ciocan D,Voican CS,Wrzosek L,et al.Bile acid homeostasis and intestinal dysbiosis in alcoholic hepatitis[J].Aliment Pharmacol Ther,2018,48(9):961-974.
[15] Appleby RN,Moghul I,Khan S,et al.Non-alcoholic fatty liver disease is associated with dysregulated bile acid synthesis and diarrhea:A prospective observational study[J].PLoS One,2019,14(1):211348.
[16] Frith J,Newton JL.Autonomic dysfunction in chronic liver disease[J].Hepat Med,2011,3:81-87.
[17] Yano H,Kinjo M.Pruritic rash and diarrhea[J].JAMA,2021,325(11):1103-1104.
[18] 赵紫楠,金鹏飞,李可欣,等.双歧杆菌乳杆菌三联活菌临床应用循证评价[J].中国药业,2021,30(17):107-114.
[19] 库水萍,马思毓.不同治疗方法对肝硬化患者肠屏障及肝功能的影响[J].宁夏医学杂志,2018,40(11):1015-1017.
[20] 单宝珍,李胜保,徐 柳.双歧杆菌四联活菌片治疗肝硬化腹泻患者的疗效及其机理探讨[J].现代消化及介入诊疗,2015,20(2):96-98.
[21] 黄鸿燕,万幼云.马来酸曲美布汀片联合双歧杆菌四联活菌片对肝源性腹泻的临床疗效观察[J].中国中西医结合消化杂志,2013,21(6):330-331.
[22] 孙婷婷,邓国炯,郭春辉,等.双歧杆菌四联活菌片联合乳果糖对乙肝肝硬化患者肠道菌群和肠黏膜屏障功能及肝功能水平的影响[J].中国微生态学杂志,2019,31(8):915-918,922.
[23] 程幸种,金灵肖,黄海珍,等.微生态制剂酪酸梭菌治疗乙型肝炎肝硬化腹泻的短期临床疗效分析[J].中华临床感染病杂志,2014,7(1):49-52.
[24] Isono A,Katsuno T,Sato T,et al.Clostridium butyricum TO-A culture supernatant downregulates TLR4 in human colonic epithelial cells[J].Dig Dis Sci,2007,52(11):2963-2971.
[25] 姜春芳.复方消化酶胶囊结合益生菌治疗肝硬化腹胀的应用效果[J].中国医药指南,2019,17(7):149-150.
[26] 杨晓艳,孙长宇,袁 翔,等.特利加压素与生长抑素治疗肝源性腹泻的疗效比较[J].世界华人消化杂志,2015,23(34):5539-5543.
[27] 董永丽,史海霞,王 敏,等.基于网络药理学的葛根芩连汤治疗腹泻作用机制研究[J].陕西中医,2021,42(5):659-664.
[28] 蒋俊娥,王振常,陈丹丹,等.王振常治疗肝硬化的经验浅析[J].辽宁中医杂志,2021,48(8):36-38.
[29] 郭维军.肝脾相关理论在肝硬化腹泻临床诊治中的应用[J].河北中医,2015,37(4):589-590.
[30] 巫小华,钟根民.双歧杆菌四联活菌片联合参苓白术汤治疗肝硬化非感染性腹泻疗效观察[J].新中医,2015,47(2):52-53.
[31] 汤 勤,朱银芳,徒康宛,等.实脾饮合胃苓汤治疗乙肝肝硬化慢性腹泻疗效观察[J].国际中医中药杂志,2015,37(6):562-563.
[32] 席亨平,吴浪士.四逆汤合四神丸加味治疗肝硬化脾肾阳虚型顽固性腹泻的疗效观察[J].中国医院用药评价与分析,2018,18(6):792-793,797.
[33] 刘辉华.四逆汤合四神丸加味治疗肝硬化脾肾阳虚型顽固性腹泻的临床疗效观察[J].河北中医,2016,38(11):1706-1709.
[34] 卢殿强,王修锋,翟雪珍,等.健脾活血解毒汤对肝硬化患者腹胀情况及肠黏膜通透性的影响[J].山东中医药大学学报,2020,44(2):169-173.
[35] 钟焕周,钟 萍,何 玲.柴芪承气汤治疗肝硬化并肠屏障功能障碍的效果[J].深圳中西医结合杂志,2019,29(5):45-46.
[36] 王红霞,党志博,党中勤,等.加味赤石脂禹余粮汤联合热敏灸治疗肝硬化腹水并顽固性腹泻疗效观察[J].广州中医药大学学报,2015,32(2):255-258.
[37] 王 妍,张 玮.疏肝止泻方联合穴位敷贴治疗肝源性腹泻82例[J].中西医结合肝病杂志,2017,27(2):115-116.
[38] 黄 菊,张 曙.吴茱萸外敷改善肝硬化腹胀的疗效观察[J].中国医药指南,2017,15(31):210-211.
[39] 廖 宇,陈青竹,胡文艳,等.加味臌消散治疗肝硬化失代偿期伴肝性腹胀临床研究[J].四川中医,2019,37(11):113-116.

相似文献/References:

[1]傅琪琳,唐颖慧,黄 甫,等.理饮汤治疗肝硬化失代偿期并发肝性胸水疗效研究[J].陕西中医杂志,2019,(6):733.
　FU Qilin,TANG Yinghui,HUANG Fu,et al.Effecte of Liyin decoction adjuvant treatment in decompensated cirrhosis with hepatic pleural effusion[J].,2019,(2):733.
[2]田莉婷,刘雪萍,李丹妮,等.加味苓桂术甘汤对脾肾阳虚型肝硬化失代偿期患者生存率的影响*[J].陕西中医杂志,2019,(10):1373.
　TIAN Liting,LIU Xueping,LI Danni,et al.Effect of Jiawei Lingui Shugan decoction on survival rate of patients with spleen，kidney and Yang deficiency type decompensated cirrhosis[J].,2019,(2):1373.
[3]王子宜,许明岩,王丽媛,等.芪甲软肝丸治疗肝硬化代偿期疗效研究[J].陕西中医杂志,2024,(4):507.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.016]
　WANG Ziyi,XU Mingyan,WANG Liyuan,et al.Effect of Qijia Ruangan pill in the treatment of compensatory stage of liver cirrhosis[J].,2024,(2):507.[doi:DOI:10.3969/j.issn.1000-7369.2024.04.016]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(82074203); 上海市科学技术委员会中医引导类基金资助项目(18401901400)
更新日期/Last Update: 2023-02-08