基于5-HT信号通路探讨中医药治疗便秘的研究进展  

Traditional Chinese Medicine in Treatment of Constipation Based on 5-HT Signaling Pathway:A Review

作　　者：梁勇 葛斌 石宇 张洋[2] 张虹玺[2] LIANG Yong;GE Bin;SHI Yu;ZHANG Yang;ZHANG Hongxi(Liaoning University of Traditional Chinese Medicine(TCM),Shenyang 110847,China;Third Affiliated Hospital of Liaoning University of TCM,Shenyang 110003,China)

机构地区：[1]辽宁中医药大学,沈阳110847 [2]辽宁中医药大学附属第三医院,沈阳110003

出　　处：《中国实验方剂学杂志》2024年第8期271-279,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(82174371);辽宁省科学技术计划项目(2022JH2/101300060)。

摘　　要：慢性便秘(CC)是最为常见的功能性胃肠疾病之一,目前国内外对其总体治疗效果仍不满意,严重影响患者生活质量及社会功能。便秘的病因及病理生理机制尚不明确,涉及遗传、社会心理、生活饮食、肠道菌群失调、肠道动力障碍、内脏敏感性改变、盆底肌群功能障碍和肠神经系统(ENS)紊乱等综合因素,其中,脑肠菌轴异常因素尤为显著。脑肠菌轴是肠道与大脑相互作用的复杂网络,整合与协同胃肠道生理功能与病理过程。肠腔中的微生物在其中起到重要作用,可通过神经、内分泌和免疫途径与肠道及中枢神经系统对话。5-羟色胺(5-HT)作为脑肠菌轴调控路径中的关键脑肠肽,参与调节胃肠运动、感觉及分泌等功能。5-HT信号通路传导异常与便秘的发生、发展密切相关。中医药是我国特有的珍贵资源,具有良好的疗效和安全性,近年来在便秘的治疗研究中受到广泛关注,中药及活性成分、针灸推拿特异性的调节5-HT信号传递,使相关分子表达趋于适合个体疾病状态的水平而有效改善便秘症状,优势独特。故笔者以“便秘”“肠道菌群”“5-HT”“中医药”为主要关键词,检索中国知识基础设施工程(CNKI)、PubMed等多种文献数据库,对5-HT与便秘、脑肠菌轴的相关性及中医药干预5-HT信号通路治疗便秘的研究进展进行综述,以期探索5-HT系统在本病中的潜在治疗价值,为后续研究提供参考。Chronic constipation(CC)is one of the most common functional gastrointestinal diseases.At present,the overall therapeutic effect of CC is still not satisfactory worldwide,which seriously affects the quality of life and social function of patients.The etiology and pathophysiological mechanism of constipation are still unclear.It involves comprehensive factors such as heredity,social psychology,diet,intestinal flora imbalance,intestinal motility disorder,visceral sensitivity change,pelvic floor muscle group dysfunction and enteric nervous system(ENS)disorder.Among them,the abnormal factors of the brain-gut-microbiome axis are particularly significant.The brain-gut-microbiome axis is a complex network of interactions between the intestine and the brain,integrating and coordinating the physiological functions and pathological processes of the gastrointestinal tract.Microorganisms in the intestinal lumen play an important role in it,and can communicate with the intestinal tract and the central nervous system through nerve,endocrine and immune pathways.As a key brain-gut peptide in the regulation pathway of the brain-gut-microbiome axis,5-hydroxytryptamine(5-HT)is involved in the regulation of gastrointestinal motility,sensation and secretion.The abnormal conduction of the 5-HT signaling pathway is closely related to the occurrence and development of constipation.Traditional Chinese medicine(TCM)is a unique precious resource in China,which has good curative effects and safety.In recent years,it has received extensive attention in the treatment of constipation.TCM and active ingredients,acupuncture and massage specifically regulate 5-HT signal transmission,so that the expressions of related molecules tend to be suitable for individual disease state levels to effectively improve constipation symptoms,with unique advantages.Therefore,this study used''constipation'',''intestinal flora'',''5-HT'',and''traditional Chinese medicine''as the keywords to search PubMed,China National Knowledge Infrastructure(CNKI)and other litera

关 键 词：便秘 5-羟色胺 肠道菌群 脑肠菌轴 中医 中药 研究进展 

分 类 号：R2-0[医药卫生—中医学] R22R242R285.5