黄连素缓解肠易激综合征作用机制的研究进展

Research progress in mechanisms underlying attenuation of irritable bowel syndrome by berbrine

肠易激综合征(irritable bowel syndrome,IBS)是由饮食、遗传、肠道感染等因素触发,以腹痛、腹胀、腹部不适、排便频率或大便性状改变为主要表现的一种中青年女性多发性肠道功能紊乱性疾病,患者肠道无器质性病变,常伴有乏力、消化不良、焦虑等症状。IBS的症状根据罗马Ⅳ标准可分为腹泻型(IBS-D)、便秘型(IBS-C)、混合型(IBS-M)及不定型(IBS-U),其中IBS-D的发病率最高。流行病学显示,IBS在全球范围内约有1/10的人受IBS的影响,其患病率呈上升趋势,是严重降低人们生活质量的健康问题[1]。每年与IBS相关的直接和间接成本在国内高达71.23亿人民币,在欧洲约80亿欧元,在美国超过100亿美元[2]。目前IBS的治疗以止泻、促动力、抗炎、止痛等方式为主,虽可减轻一般患者的临床症状,但是对于症状交织复杂的IBS患者治疗作用并不理想。黄连素(berberine,BBR)又名小檗碱,是临床常用于治疗机体多个系统病症的药物。多年来,临床报道BBR对减轻IBS症状及改善预后有积极作用。基于此,本文拟对黄连素缓解IBS的作用机制进行综述。

Irritable bowel syndrome(IBS)is a kind of intestinal dysfunction caused by non-organic diseases,mainly induced by lifestyle,environment,genetics and other factors.Patients with IBS often manifest abdominal distension,abdominal discomfort,changes in defecation habits,and even mental anxiety and disorder.Berberine has been widely used in clinical and basic medical research.It has been shown that berberine can improve gastrointestinal function and attenuate IBS through multiple targets and pathways,including regulation of intestinal flora,inflammatory response,peroxidation reaction,and colon smooth muscle cell contraction.This article reviews the mechanisms underlying attenuation of IBS by berberine.