基于脑-肠轴理论的便秘型肠易激综合征伴焦虑抑郁中西医认识述要  

Understanding of Constipation-predominant Irritable Bowel Syndrome with Anxiety and Depression Based on Brain-gut Axis Theory from Traditional Chinese and Western Medicine Perspectives

作　　者：邹欣甫 王得昌 邹欣妍 王康锋[3] 陈泽涛[3] ZOU Xinfu;WANG Dechang;ZOU Xinyan;WANG Kangfeng;CHEN Zetao(First Clinical School of Medicine,Shandong University of Traditional Chinese Medicine,Ji′nan 250014,China;College of Traditional Chinese Medicine,Hebei University,Baoding 071030,China;Shandong Traditional Chinese Hospital,Ji′nan 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,济南250014 [2]河北大学中医学院,保定071030 [3]山东省中医院,济南250014

出　　处：《世界中医药》2024年第12期1833-1839,共7页World Chinese Medicine

基　　金：国家自然基金青年科学基金项目(81303028);山东省自然科学基金项目(ZR2020MH354)。

摘　　要：随着西医学的研究和进展,多数医家认为精神心理状态与便秘型肠易激综合征(IBS-C)二者之间有着明确的联系。脑肠轴在二者的发病机制中皆处于重要的地位,以脑肠互动理论来论治本病已经受到了广泛的关注。西医认为脑-肠肽、肠道菌群失调等因素可导致肠易激综合征腹痛、精神心理状态改变等症状,中医上则多把脑-肠轴理论与中医各证型特点相关联。因此,以脑-肠轴为基点从脑-肠肽、肠道微生物、下丘脑-垂体-肾上腺(HPA)轴、心理因素、中医药治疗方面综述IBS-C伴焦虑抑郁状态的发病机制,为同行在临床的诊疗中提供新的思路。With the research and advancements in Western medicine,most medical experts believe that there is a clear link between the psychological state and constipation-predominant irritable bowel syndrome(IBS-C).The brain-gut axis plays a crucial role in the pathogenesis of both conditions,and the use of brain-gut interaction theory for treating this disease has received widespread attention.According to Western medicine,factors such as brain-gut peptides and imbalances in gut microbiota can lead to symptoms of IBS-C,including abdominal pain and changes in mental and psychological state.Traditional Chinese medicine(TCM) often associates the brain-gut axis theory with different TCM syndrome types.This article reviewed the pathogenesis of IBS-C with anxiety and depression from the perspective of the brain-gut axis,focusing on brain-gut peptides,gut microbiota,hypothalamic-pituitary-adrenal(HPA) axis,psychological factors,and TCM treatment,so as to offer new insights to clinicians for the diagnosis and treatment of this condition.

关 键 词：脑-肠轴 肠道菌群 焦虑 抑郁 心理因素 便秘型肠易激综合征 心 肝 脾 

分 类 号：R259[医药卫生—中西医结合]