基于“脑-肠轴”探讨腹泻型肠易激综合征病机及针刺取穴思路  

Exploring Pathogenesis of IBS-D and Idea of Acupoints SelectionBased on ‘Brain-Gut Axis’

作　　者：薛茸丹 杨文津[2] 刘迪[2] 侯宗楠 王爱娟 胡慧[2] XUE Rongdan;YANG Wenjin;LIU Di;HOU Zongnan;WANG Aijuan;HU Hui(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《针灸临床杂志》2023年第9期5-9,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家重点研发计划,编号:2019YFC1709004;北京市中医管理局“3+3”薪火传承工程(杨甲三名家工作室),编号:2007-SZ-A-12。

摘　　要：脑-肠轴理论是基于脑肠之间经络相通、生成充养与神明共统的生理特点而形成的。腹泻型肠易激综合征(IBS-D)病位在肠,与脑神密切相关。本研究以脑-肠轴相关理论阐释IBS-D的发病特点,认为邪客肠腑为发病的直接原因,肝郁脾虚为本病的主要病机,脾肾阳虚为疾病迁延难愈的关键因素。在脑-肠轴理论指导下,针对病因病机提出脑肠同调取主穴,通肠腑取上巨虚、天枢、足三里与公孙,调脑神取百会、神庭、本神与内关,同时根据症状辨证论治选取配穴,以期为针灸治疗IBS-D提供一定的理论依据。The theory of brain-gut axis is based on the physiological characteristics of the meridian connection between brain and intestines,generation and nourishment,and common integration of spirit and mind.The disease location of diarrhea-predominant irritable bowel syndrome(IBS-D)is in intestines and is closely related to brain.In this paper,the pathogenesis of IBS-D is elaborated based on the theory of brain-gut axis,and it is believed that the pathogenic factors in intestines are the direct cause of the disease,Liver stagnation and Spleen deficiency are the important pathogenesis of the disease,and Yang-deficiency of Spleen and Kidney is the key factor for the difficult healing of the disease.Under the guidance of the theory of brain-gut axis,according to the etiology and pathogenesis,it is proposed to select the main points for the co-ordination of brain and intestines,Shangjuxu(ST37),Tianshu(ST25),Zusanli(ST36)and Gongsun(SP4)are chosen to open intestines,and Baihui(DU20),Shenting(DU24),Benshen(GB13)and Neiguan(PC6)are used to adjust brain-Shen.Meanwhile,adjunct acupoints are selected based on syndrome differentiation.This study aims to provide a certain theoretical basis for acupuncture treatment of IBS-D.

关 键 词：脑-肠轴 腹泻型肠易激综合征 病因病机 针刺 

分 类 号：R246.1[医药卫生—针灸推拿学]