基于5-羟色胺信号通路探讨中医药辨证治疗腹泻型肠易激综合征的研究进展  

Syndrome Differentiation-based Treatment of Diarrhea-predominant Irritable Bowel Syndrome with Chinese Medicine via 5-HT Signaling Pathway:A Review

作　　者：杨清瑞 胡泽玉 雷玉玉 李昕株 陈欢 崔伟 刘海涛 杜晓泉 YANG Qingrui;HU Zeyu;LEI Yuyu;LI Xinzhu;CHEN Huan;CUI Wei;LIU Haitao;Du Xiaoquan(Shaanxi University of Chinese Medicine,Xianyang 712046,China;The Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《中国实验方剂学杂志》2023年第24期250-259,共10页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中医药治疗难治性胃肠病的传承与创新团队项目(ZYYCXTD-C-202010);中医药循证能力建设项目(2019XZZXXHO11);陕西省重点研发计划项目(2019SF-099);陕西省第三届名中医传承工作室建设项目(2019021)。

摘　　要：腹泻型肠易激综合征(IBS-D)是以腹痛、腹泻为主要特征的慢性功能性肠病,内脏高敏感和胃肠动力异常是其重要的病理生理基础。脑-肠相互作用在许多疼痛相关的功能性胃肠道疾病(尤其是IBS-D)中起重要作用,5-羟色胺(5-HT)作为调节胃肠功能的重要脑肠肽,通过脑-肠互动作用影响大脑活动、胃肠运动、疼痛感知、黏膜炎症及免疫反应等,与IBS-D的发生、发展密切相关。近年来凭借“整体观”和“辨证论治”等特色理念,中医药在改善胃肠道症状和提高生活质量方面展现出巨大潜力。诸多研究表明中医药治疗IBS-D的作用机制与调控5-HT信号通路关系密切。该文拟基于5-HT信号通路,以中医辨证论治为着重点,系统阐述中医药对IBS-D不同中医证候的疗效及机制研究特点,为中医药治疗IBS-D提供科学依据。Diarrhea-predominant irritable bowel syndrome(IBS-D)is a chronic functional bowel disorder characterized by abdominal pain and diarrhea,with visceral hypersensitivity and abnormal gastrointestinal dynamics as the pathophysiological basis.The brain-gut interaction plays a role in pain-related functional gastrointestinal disorders,especially IBS-D.5-Hydroxytryptamine(5-HT),as an important brain-gut peptide regulating gastrointestinal function,affects brain activity,gastrointestinal motility,pain perception,mucosal inflammation,and immune response through brain-gut interaction and is associated with the occurrence and development of IBS-D.In recent years,traditional Chinese medicine(TCM)has shown great potential to mitigate gastrointestinal symptoms and improve the quality of life with its holistic view and treatment based on syndrome differentiation.Studies have shown that TCM treats IBS-D by regulating the 5-HT signaling pathway.With a focus on syndrome differentiation in TCM,this paper systematically describes the efficacy and mechanism of TCM in treating different TCM syndromes of IBS-D via the 5-HT signaling pathway,aiming to provide a scientific basis for TCM treatment of this disease.

关 键 词：腹泻型肠易激综合征 5-羟色胺 血清素 中医药 中医证候 

分 类 号：R2-0[医药卫生—中医学] R22R285.5R2-031R259