肠道菌群与功能性腹泻中医药研究进展

Research Progress of Gut Microflora,Functional Diarrhea and Traditional Chinese Medicine

功能性腹泻是临床中常见的消化系统疾病,其病因和发病机制尚不完全明确。随着我国人民生活水平提高,功能性腹泻的发病率已在亚洲呈高发状态,其反复或持续的稀便给患者带来了巨大的生活压力。近年来研究认为肠道中有害菌大量繁殖,产生的有害物质导致脑-肠轴功能紊乱、肠道黏膜屏障破坏及菌群移位等病理变化,进而引起功能性腹泻。中医药以祛邪扶正为基本治则,运脾化湿为基本治法,治疗功能性腹泻的疗效已取得广泛认可,研究发现中医药可以通过促进肠道有益菌生成,调节肠道菌群代谢产物,抑制有害菌繁殖等途径缓解功能性腹泻。该文就肠道菌群的生理功能,肠道菌群导致功能性腹泻的机制,以及中医药调节肠道菌群的研究进展进行综述,以期为功能性腹泻的治疗提供思路。

Functional diarrhea(FD)is a common clinical disorder of the digestive system,the etiology and pathogenesis of which are not fully understood.With the improvement of living standards in our society,the incidence of FD has become highly prevalent in Asia,and its recurrent or persistent loose stools bring great stress to the lives of patients.Recent studies indicate that the proliferation of harmful bacteria in the intestinal tract and the production of harmful substances lead to pathological changes such as dysfunction of the brain-gut axis,destruction of the intestinal mucosal barrier and displacement of the flora,which in turn cause FD.The efficacy of traditional Chinese medicine(TCM)in treating FD has been widely recognized,with the basic therapeutic principle of eliminating the pathogenic factors and promoting the healthy Qi,and the basic treatment method of transporting the spleen and resolving dampness,and it has been found that TCM can alleviate FD by promoting the production of beneficial bacteria,regulating the metabolites of gut microbiota(GM),and inhibiting the proliferation of harmful bacteria.This paper reviews the physiological functions of GM,the mechanisms of intestinal flora leading to FD,and the research progress of TCM in regulating GM,with a view to providing ideas for the treatment of FD.