功能性消化不良重叠肠易激综合征的发病机制及中医药干预研究进展

Research progress on the pathogenesis and traditional Chinese medicine intervention of functional dyspepsia overlapping irritable bowel syndrome

功能性消化不良(FD)重叠肠易激综合征(IBS)是一种病程长、复发率高、缠绵难愈的慢性疾病,在全球内发病率均高,且呈逐年递增趋势。FD重叠IBS的发生机制十分复杂,基于现有的研究水平和深度基本可知其发病是由于胃肠动力障碍、内脏高敏感性、社会心理因素等多因素共同作用的结果。而目前西医治疗手段以对症治疗为主,例如改善胃肠动力、对症止泻、干预焦虑抑郁状态、心理疏导等治疗,但其临床治疗效果不佳且疾病呈反复发作状态,再度损害了患者身心健康,严重加重了患者家庭经济负担及医疗资源消耗。当下研究表明,近年来中药单体、中药复方及中医外治治疗FD重叠IBS症状具有极好的效果,可能与其能多途径、多靶点、多效应地干预FD重叠IBS有关,且其临床治愈率远高于单一西医治疗,反复发病率远低于纯西医治疗,具有西医治疗无法替代的显著优势。本文主要综述FD重叠IBS的发病机制及中医药治疗的研究进展,以期为FD重叠IBS的治疗、新药的研发、中医药传承与创新发展提供思路。

Functional dyspepsia(FD)overlapping irritable bowel syndrome(IBS)is a chronic disease with long course of disease,high recurrence rate,lingering and difficult to cure.The incidence is high in the world and is increasing year by year.The pathogenesis of FD overlapping IBS is very complex.Based on the existing research level and depth,it is basically known that its pathogenesis is due to gastrointestinal motility disorder,visceral hypersensitivity,social psychological factors and other factors.At present,western medicine treatment is mainly based on symptomatic treatment,such as improving gastrointestinal motility,symptomatic antidiarrheal,intervention of anxiety and depression,psychological counseling and other treatments.However,the clinical treatment effect is not good and the disease is in a state of recurrent attacks,which again damages the physical and mental health of patients,seriously increases the economic burden of patients′families and the consumption of medical resources.Current studies have shown that in recent years,traditional Chinese medicine monomer,traditional Chinese medicine compound and external treatment of traditional Chinese medicine have excellent effects in the treatment of FD overlapping IBS symptoms,which may be related to its multi-pathway,multi-target and multi-effect intervention.Moreover,the clinical cure rate is much higher than that of single western medicine treatment,and the recurrence rate is much lower than that of pure western medicine treatment,which has significant advantages that western medicine treatment cannot replace.This article mainly reviews the pathogenesis of FD overlapping IBS and the research progress of traditional Chinese medicine treatment,in order to provide ideas for the treatment of FD overlapping IBS,the research and development of new drugs,and the inheritance and innovation of traditional Chinese medicine.