炎症性肠病处理实践中的消化心身整体医学思维和手段

Integrative Psycho-gastrointestinal Thinking and Strategies in the Practice of Management of Inflammatory Bowel Disease

炎症性肠病(IBD)正成为消化内科治疗领域中巨大的挑战之一。现阶段IBD的临床治疗思维和手段仍主要是针对减轻肠道炎症反应、对抗自身免疫反应等,并辅以外科手术,处理肠道并发症。然而,上述治疗手段在相当数量的IBD患者中并未能阻止病程的进展,患者预后较差。随着"脑-肠微生态"互动机制相关基础和临床研究的深入,IBD认知和处理相关的消化心身整体医学思维和手段日趋涌现,为提升IBD的临床处理水平提供了启示。本文着重阐述运用消化心身整体医学思维和手段,针对肠道炎症相关的精神心理因素、神经免疫调控、肠道环境稳态等多个关键环节,以期提升IBD的临床处理水平。

Treatment for inflammatory bowel disease（ IBD） is becoming a great challenge in clinical practice.Currently,treatment strategies are focused on attenuation of intestinal inflammation and autoimmune reactivity as well as surgical therapy. However,these measures cannot prevent the progression of pathophysiological process in quite a number of patients. The understanding of brain-gut interaction in the pathogenesis of IBD has shed light on the treatment of this disease. This review article discussed the importance of integrative psycho-gastrointestinal thinking and strategies targeting on the intestinal inflammation-associated psychological factors,neuroimmune abnormalities,and intestinal microbiota in the management of IBD in clinical practice.