痛泻要方治疗腹泻型肠易激综合征的作用机制研究进展

Research Progress on Mechanism of Tongxie Yaofang(痛泻要方) in Clinical Treatment of Irritable Bowel Syndrome with Diarrhea

腹泻型肠易激综合征(irritable bowel syndrome with diarrhoea,IBS-D)是最常见的消化系统疾病之一,发病机制复杂,临床表现个体差异性大。目前西药主要是对症治疗,但仍存在停药后反复发作等弊端。中药治疗IBS-D辨证施治,疗效显著。IBS-D属于中医学“肠郁”“腹痛”“泄泻”等范畴,病变部位主要在肝脾。中医药疏肝健脾方法治疗IBS-D从改善脾胃功能、调节情志出发,对肝郁脾虚型IBS-D腹痛腹泻等临床症状疗效确切,其中以痛泻要方为代表。痛泻要方能够缓解肠肌痉挛导致的腹痛,改善腹泻的症状;且具有降低IBS-D模型大鼠的内脏高敏感、改善免疫功能、调节脑肠肽等作用。近几年的研究表明痛泻要方对改善肠道菌群失调、降低肠道通透性以及表观遗传等方面亦有影响。该文章全面综述了目前关于痛泻要方治疗IBS-D作用机制,为经方治疗IBS-D提供最新的理论依据。

Diarrhea-type of irritable bowel syndrome(IBS-D)is one of the most common digestive system diseases with complex pathogenesis and individual clinical manifestations.At present,western medicine is mainly symptomatic treatment,but there are still some disadvantages such as repeated attacks after drug withdrawal.Traditional Chinese medicine treatment of IBS-D is effective.IBS-D belongs to the categories of“intestinal depression”,“abdominal pain”and“diarrhea”in traditional Chinese medicine,and the lesions are mainly in liver and spleen.Based on improving the function of spleen and stomach and regulating emotions,traditional Chinese medicine treatment of IBS-D has a definite curative effect on clinical symptoms such as abdominal pain as well as diarrhea of liver depression and spleen deficiency type of IBS-D,which is represented by Tongxie Yaofang(痛泻要方).Tongxie Yaofang can relieve abdominal pain caused by intestinal muscle spasm and improve diarrhea symptoms.Moreover,it can reduce visceral hypersensitivity,improve immune function and regulate brain-gut peptide in IBS-D model rats.Recent studies have shown that Tongxie Yaofang can improve intestinal microflora disorder,reduce intestinal permeability and epigenetic effects.This paper comprehensively reviewed the current mechanism of Tongxie Yaofang in the treatment of IBS-D,and provided the latest theoretical basis for the treatment of IBS-D by prescription.