基于“脑-肠轴”理论论治儿童功能性便秘探析

Exploring the treatment for functional constipation in children based on the theory of"brain-gut axis"

功能性便秘为一种排便困难、排便频次减少或排便不尽感为主要临床表现的功能性肠病,是儿科临床的常见病和多发病之一。功能性便秘会严重影响患儿的生活质量和心理健康,给患儿及家庭带来一定的困扰。近年来随着“脑-肠轴”研究逐渐深入,越来越多的证据表明脑与肠存在密切联系,“脑-肠轴”作为由中枢神经系统、自主神经系统和肠神经系统共同组成的联络大脑与胃肠道的双向交通机制的神经-内分泌网络系统,脑肠肽能够连接并调控“脑-肠轴”交互作用的各个环节,功能性便秘的产生也和“脑-肠轴”密切相关。在中医理论中,便秘病机为大肠传导失调,脑与肠密切相关,脑居于上,统御五脏六腑,肠腑居于下,传化糟粕,影响人体气机,肠腑通畅,则府精神明,脑肠生理相连、病理相关,脑、肠功能失调,共同导致儿童功能性便秘的发生。本文基于“脑-肠轴”理论,结合中医理论及病因病机,探讨“脑-肠轴”对儿童功能性便秘的影响,并探析基于“脑-肠轴”理论论治儿童功能性便秘。

Functional constipation(FC)is a kind of functional intestinal disease with the main clinical manifestations of difficulty in defecation,reduced frequency of defecation or incomplete defecation,and it is one of the common and frequently-encountered diseases in pediatrics,which will seriously affect the children's quality of life and psychological health,and bring certain troubles to the children and their families.In recent years,with the gradual deepening of the research on the"brain-gut axis",more and more evidence have shown that there is a close connection between the brain and the intestine,and the"brain-gut axis"is a neuro-endogenous network system mechanism of bidirectional transportation mechanism between the brain and the gastrointestinal tract,which is composed of the central nervous system,the autonomic nervous system,and the enteric nervous system.The"brain-gut axis"as a neuro-endocrine network system consisting of the central nervous system,autonomic nervous system and enteric nervous system to liaise between the brain and the gastrointestinal tract,brain-gut peptides are able to connect and regulate the various aspects of the interaction of the"brain-gut axis",and the production development of FC is also closely related to the"brain-gut axis".In traditional Chinese medicine theory,the pathogenesis of constipation is a conduction disorder in the large intestine,and the brain and intestine are closely related.The brain resides in the upper part of the brain body,which governs the five viscera and six bowels,and the intestine resides in the lower part of the intestine,which transmits and transforms the dregs and affects the human body's qi,and when the intestine and bowels are functions smoothly,then the spirit of the government is bright mind is clear.The physiology of the brain and intestine is connected in physiology and related to each other in pathology,and the dysfunction of the brain and the intestine jointly leads to the occurrence of FC in children.Based on the theory of"brain-gut axis",and combined with Chinese medicine theory and etiology,this paper discusses the influence of"brain-gut axis"on children's FC,and analyzes the treatment for children's functional constipation based on the theory of"brain-gut axis".