基于脑-肠轴探讨中药防治功能性便秘的作用机制

Research Progress on the Use of Traditional Chinese Medicine in Preventing and Treating Functional Constipation based on the Brain-Gut axis

近年来,随着研究者关于“脑-肠轴”的提出,越来越多的证据表明脑肠肽及肠道菌群与功能性便秘的发生密切相关。这其中包括胃动素、5-羟色胺、血管活性肽、生长抑素等兴奋和抑制型胃肠激素,还涉及种类繁杂的肠道微生物。中药治疗功能性便秘具有显著疗效,临床主要以复方中药,如枳实导滞丸、加味济川煎;中成药,如麻仁丸、芪蓉润肠口服液多见;另外,单味中药的独特成分可以通过多种途径对胃肠道产生积极影响,如厚朴、枳实等。中药不仅能够直接促进胃肠道的运动功能,还能调节胃肠激素和菌群,维持免疫内环境的稳定,减轻肠道炎症反应,从而改善便秘症状。因此,中药广泛应用于临床上,以缓解便秘症状,改善患者的生活质量。文章从功能性便秘脑肠肽及肠道菌群变化以及发生机制等方面概述中药在干预功能性便秘中的作用机理,为进一步深入研究提供基础。

In recent years,with the proposal of the“brain-gut axis”by researchers,more and more evidence shows that brain-gut peptides and intestinal flora are closely related to the occurrence of functional constipation.These include excitatory and inhibitory gastrointestinal hormones such as motilin,5-hydroxytryptamine,vasoactive peptides,and somatostatin,as well as a wide variety of intestinal microorganisms.Traditional Chinese medicine has a significant effect in the treatment of functional constipation.Clinically,it is mainly based on compound Chinese medicine,such as Zhishi Daozhi Pills and Jiawei Jichuan Decoction;Chinese patent medicines,such as Ma Ren Pills and Qi Rong Runchang Oral Liquid,are common;in addition,the unique ingredients of single Chinese medicines can have a positive effect on the gastrointestinal tract through various channels,such as Magnolia officinalis and Zhishi.Traditional Chinese medicine can not only directly promote the motor function of the gastrointestinal tract,but also regulate gastrointestinal hormones and flora,maintain the stability of the immune environment,and reduce intestinal inflammatory reactions,thereby improving constipation symptoms.Therefore,traditional Chinese medicine is widely used in clinical practice to relieve constipation symptoms and improve the quality of life of patients.This article will summarize the mechanism of action of traditional Chinese medicine in intervening functional constipation from the aspects of brain-gut peptides and intestinal flora changes and the mechanism of occurrence,so as to provide a basis for further in-depth research.