基于脑肠互动探析中医药改善功能性消化不良的作用机制

Exploring the mechanism of traditional Chinese medicine to improve functional dyspepsia based on brain-gut interaction

功能性消化不良(FD)是临床上常见的功能性胃肠道疾病,发病率高,其发病机制尚未完全明确,多项研究显示脑肠轴功能紊乱是FD发病的重要机制,贯穿疾病始终。脑肠轴通过神经传导、内分泌免疫因子的释放等方式连接脑、肠,形成双向调节的通路;脑肠轴功能紊乱同样参与其他发病机制作用的过程。中医理论认为脑与胃肠之间同样存在着广泛的联系,生理功能上相互调节,病理上相互影响。中医药可以通过脑肠轴对脑肠肽等神经递质或激素的释放及肠道菌群等产生相应影响,从而改善FD患者胃肠动力障碍、肠道菌群失调及焦虑抑郁的精神心理状态等临床症状。现论述了中医药通过脑肠轴对FD的调节作用及其可能机制,为后续中医药治疗FD的研究提供参考。

Functional dyspepsia(FD)is a common clinical functional gastrointestinal disease with a high incidence rate and its pathogenesis is not yet fully understood.Several studies have shown that disturbance of brain-gut interaction is a major pathogenesis of FD throughout the disease.The brain-gut axis enables bidirectional regulation and mutual influence between brain and gut through nerve conduction and release of endocrine immune factors.Traditional Chinese Medicine(TCM)theory also suggests that there is an extensive connection between brain and gastrointestinal,with mutual regulation in physiological function and mutual influence in pathology.TCM can improve the clinical symptoms of FD patients such as gastrointestinal motility disorder,intestinal flora dysbiosis,and anxiety depression,through the brain-gut axis on the release of brain-gut peptides and the effect of intestinal flora.This paper reviews the regulatory effects of TCM on FD through the brain-gut axis and its possible mechanisms,and provides a reference for the subsequent research on TCM treatment of FD.