王雪峰教授基于“脑肠相关”理论治疗儿童功能性便秘经验探析

Professor Wang Xuefeng′s experience in the treatment of functional constipation in children based on the theory of "brain-gut relatedness"

儿童功能性便秘作为儿科常见病之一,主要表现为排便困难、排便频次减少、排便时间延长。本病发病率、复发率较高,严重影响患儿生活质量,不利于儿童的生长发育。近年来随着社会压力的增大,本病发病率又逐年升高,除身体症状外,患儿的精神症状也逐渐受到关注,且功能性便秘患儿伴发情志异常症状多见。罗马Ⅳ中针对功能性便秘提出其发病的机制主要为“脑与肠间互动异常”,结合中医学“五脏一体”的整体观念与形神俱为一体的理论观点,故本文从“脑肠相关”理论和现代医学中的“脑-肠轴”作为切入点,对“脑肠相关”学说进行深入分析,基于脑与肠生理上相互关联、病理上相互影响的特殊联系,认为治疗功能性便秘不仅应调节胃肠功能以改善肠道症状,也应重视心脑的调神作用以改善患者焦虑、抑郁等精神症状,探究从调神以达运肠之效的治疗方法,以期找寻出治疗功能性便秘的新思路,为提高功能性便秘患儿生活质量提供新方法。

Functional constipation in children is a common disease in pediatrics,which is mainly manifested as difficulty in defecation,reduced frequency of defecation and/or prolonged defecation.The incidence and recurrence rate of this disease is relatively high,and at the same time,functional constipation seriously affects the quality of life of children,which is unfavorable to the growth and development of children.In recent years,with the increase of social pressure,the incidence of this disease has been increasing year by year;in addition to physical symptoms,children′s mental symptoms also gradually gain concern,and very often functional constipation is accompanied by abnormal emotional symptoms in children.The mechanism of functional constipation is mainly "abnormal interaction between the brain and intestines" as proposed in Rome Ⅳ,which is also related to the holistic concept of "five organs as one" and the theoretical view of form and spirit being all as one in Chinese medicine,so this article takes the theory of "brain-intestine correlation" and the "brain-intestine axis" in modern medicine as the entry point to make an in-depth analysis of the doctrine of "brain-intestine correlation".Based on the special connection between the brain and the intestine,which are physiologically related to each other and pathologically influenced by each other,we believe that the treatment for functional constipation should not only regulate the gastrointestinal function to improve intestinal symptoms,but also pay attention to the role of the heart and brain in regulating the spirit to improve the patient′s anxiety,depression and other mental symptoms,and explore the treatment method of regulating the spirit to achieve the effect of intestinal transport,aiming to find a new way of thinking about the treatment for functional constipation,and provide a new method to improve the quality of life of children with functional constipation.