从“胆”认识肠易激综合征的发病机制

Understanding the Pathogenesis of Irritable Bowel Syndrome from “Gallbladder”

中医学既往多从肝脾论治肠易激综合征,以疏肝健脾为基本治法。基于对中西医理论的分析及临床观察,认为胆腑参与消化和精神活动,与肠易激综合征的相关性更强。中医胆腑的生理功能异常时,其藏精汁助运化、主决断调情志、主升发调气机和司勇怯御外辱的功能失常,会出现肠道菌群失调、内脏高敏感、焦虑抑郁状态、胃肠道功能紊乱和肠道感染,均与现代医学对肠易激综合征发病机制的认识相合,故而提出从“胆”认识本病的发病,为本病的防治提供新思路。

Irritable bowel syndrome(IBS) is usually treated from the liver and the spleen in traditional Chinese medicine(TCM), with the basic principle of soothing the liver and fortifying the spleen. Based on the theory of both TCM and western medicine and the clinical observation, it is obvious that the gallbladder participates in digestive and mental activities, and has stronger correlation with IBS. When the physiological function of gallbladder is abnormal, the functions of storing essence, assisting transportation and transformation, governing decision, regulating emotions, governing ascent and dispersion, regulating qi movement, managing courage and timidity, and resisting external invasion will be disturbed, thereby bringing intestinal flora imbalance, visceral hypersensitivity, anxiety and depression, gastrointestinal dysfunction and intestinal infection, which are consistent with the understanding of the pathogenesis of IBS by modern medicine. Therefore, it is proposed that the pathogenesis of IBS could be understood from the “gallbladder”, providing new ideas for the prevention and treatment of this disease.