基于“脑-肠-菌轴”探讨胃食管反流病伴抑郁的研究进展  

Research progress of gastroesophageal reflux disease with depression based on "brain intestine bacteria axis"

作　　者：刘芙蓉 刘礼剑(审校)[2] 黎丽群 王玉燕 钟焕英 马超北 黎秀娟 谢胜[2] LIU Furong;LIU Lijian;LI Liqun;WANG Yuyan;ZHONG Huanying;MA Chaobei;LI Xiujuan;XIE Sheng(Graduate School of Guangxi University of Traditional Chinese Medicine,Nanning,530000,China;Department of Spleen and Stomach Diseases,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine)

机构地区：[1]广西中医药大学研究生院,南宁530000 [2]广西中医药大学第一附属医院脾胃病科

出　　处：《中国中西医结合消化杂志》2023年第5期384-390,共7页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家自然科学基金地区基金项目(No:82160877);国家自然科学基金地区基金项目(No:82260900);广西科技厅自然科学基金青年基金项目(No:2021GXNSFBA196055);广西高校中青年教师科研基础能力提升项目(No:2021ky0309,No:2022ky0286);广西中医药大学校级课题(No:2021MS024,No:2021QN018);广西壮族自治区中医药管理局自筹经费科研课题(No:GXZYZ20210560)。

摘　　要：胃食管反流病是由于食管下括约肌压力降低、短暂和过度的食管下括约肌松弛、黏膜屏障损伤等因素导致胃内容物反流造成食管和食管外不适的一种疾病,目前胃食管反流病的患病率逐年增加,且往往伴有焦虑、抑郁症状。质子泵抑制剂以及抗焦虑抑郁药物是现在治疗此病的首选治疗方案,但效果不尽人意。近年来研究发现,脑-肠-菌轴与胃食管反流病、抑郁症密切相关,肠道菌群可以导致情志的改变,加重胃食管反流病,中医认为胃食管反流病伴抑郁主要与肝、脾密切相关,从肝、脾之气机入手,中医药治疗可以良性调节治疗胃食管反流病伴抑郁症状,且还可维护肠道内环境的稳态和菌群的种类及丰度,改变胃肠道相关激素的水平。本文旨在从中医病因病机、脑-肠-菌轴作用机制探讨胃食管反流病伴抑郁的发病机制,收集整理近年来肠道菌群以及中医药对胃食管反流病的治疗方式及效果,为未来胃食管反流病的研究提供参考。Gastroesophageal reflux disease(GERD) is a disease of esophagus and extraesophageal discomfort caused by reflux of gastric contents due to lower esophageal sphincter pressure reduction, transient and excessive lower esophageal sphincter relaxation, mucosal barrier damage and other factors. At present, the prevalence of GERD is increasing year by year, and often accompanied by anxiety and depression symptoms. Proton pump inhibitors and anti-anxiety and depression drugs are the first choice for the treatment of this disease, but the effect is not satisfactory. In recent years, studies have found that the brain gut microbiota axis is closely related to GERD and depression. Intestinal flora can lead to emotional changes and aggravate GERD. Traditional Chinese Medicine believes that GERD with depression is closely related to the liver and spleen. Starting with the qi mechanism of the liver and spleen, Traditional Chinese Medicine treatment can benign regulate and treat GERD with depression symptoms, maintain the stability of the intestinal environment, the types and abundance of flora, and change the levels of gastrointestinal hormones. The purpose of this paper is to explore the pathogenesis of GERD with depression from the etiology and pathogenesis of Traditional Chinese Medicine and the action mechanism of brain gut microbiota axis, collect and sort out the intestinal flora in recent years and the treatment of GERD with Traditional Chinese Medicine, and provide reference for the future research of GERD.

关 键 词：脑-肠-菌轴 中医药治疗 胃食管反流病 抑郁 研究进展 

分 类 号：R473.5[医药卫生—护理学]