温阳祛风法在慢性复发型溃疡性结肠炎阳虚湿滞证的应用及治疗作用机制的探析

Application of Yang-warming and Wind-dispelling Method in Yang Deficiency and Dampness Stagnation Syndrome of Chronic Recurrent Ulcerative Colitis and Its Therapeutic Mechanism

溃疡性结肠炎(UC)是一种由肌体自身免疫介导的慢性、复发性炎症性肠病,慢性复发型是临床最为常见的分型。慢性复发型UC临床多表现久泻夹带黏液脓血、腹痛、形寒肢冷等阳虚湿滞证,风、湿、虚是重要致病因素,脾肾阳虚、风湿阻滞是根本病机。慢性复发型UC阳虚湿滞证的机理与钠-氢交换体、Cl^(-)/HCO_(3)^(-)交换体和水通道蛋白(AQPs)表达异常相关。温阳祛风法是治疗慢性复发型UC阳虚湿滞证行之有效的治法,该法以温补脾肾阳气为根本,配合风药以祛风除湿止泻。温阳祛风法的作用机制涉及调节免疫反应、干预信号通路、调节肠道菌群、调节肠黏膜屏障及调节水液代谢。研究探析慢性复发型UC阳虚湿滞证的发病机理及温阳祛风法的作用机制,为温阳祛风法治疗慢性复发型UC提供科学依据。

Ulcerative colitis(UC)is a chronic and recurrent inflammatory bowel disease mediated by body autoimmunity.Chronic recurrence is the most common clinical type.The chronic recurrent UC clinically manifests as yang deficiency and dampness stagnation syndrome such as long diarrhea with mucus,purulent blood,abdominal pain,cold body and limbs,in which wind,dampness and deficiency are important pathogenic factors,and the fundamental pathogenesis is spleen and kidney yang deficiency and wind-dampness obstruction.The mechanism of yang deficiency and dampness stagnation syndrome of chronic recurrent UC is related to the abnormal expression of sodium-hydrogen exchanger,Cl^(-)/HCO_(3)^(-)exchanger and aquaporins(AQPs).The method of warming yang and expelling wind is an effective method for the treatment of yang deficiency and dampness stagnation syndrome of chronic recurrent UC.It is based on warming yang qi of spleen and kidney,combined with wind medicinal to dispel wind,remove dampness and stop diarrhea.The mechanism of warming yang and expelling wind involves regulating immune response,interfering with signal pathway,regulating intestinal flora,regulating intestinal mucosal barrier and regulating fluid metabolism.This paper is to study the pathogenesis of yang deficiency and dampness stagnation syndrome of chronic recurrent UC and the mechanism of warming yang and expelling wind,so as to provide scientific basis for the yang-warming and wind-expelling method in the treatment of chronic recurrent UC.