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1.广西中医药大学 研究生院,南宁 530001
2.广西中医药大学 第一附属医院,南宁 530001
Received:28 March 2022,
Published Online:25 August 2022,
Published:20 January 2023
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王金鑫,谢胜,黄茂光等.肠紧密连接在腹泻型肠易激综合征中的作用及中医药干预的研究进展[J].中国实验方剂学杂志,2023,29(02):253-259.
WANG Jinxin,XIE Sheng,HUANG Maoguang,et al.Effect of Intestinal Tight Junction in Diarrhea-predominant Irritable Bowel Syndrome and Traditional Chinese Medicine Intervention: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(02):253-259.
王金鑫,谢胜,黄茂光等.肠紧密连接在腹泻型肠易激综合征中的作用及中医药干预的研究进展[J].中国实验方剂学杂志,2023,29(02):253-259. DOI: 10.13422/j.cnki.syfjx.20222493.
WANG Jinxin,XIE Sheng,HUANG Maoguang,et al.Effect of Intestinal Tight Junction in Diarrhea-predominant Irritable Bowel Syndrome and Traditional Chinese Medicine Intervention: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(02):253-259. DOI: 10.13422/j.cnki.syfjx.20222493.
腹泻型肠易激综合征(IBS-D)是以腹痛、大便含水量增加为主要表现的慢性肠道病变。该病病理机制复杂,由多因素共同促成。其中,肠黏膜屏障功能受损在IBS-D的发病中起重要作用。肠黏膜细胞间紧密连接(TJ)主要由闭合蛋白(Occludin)、紧密连接蛋白(Claudins)及闭锁小带蛋白(ZOs)组成,是机械屏障的重要成分,可显著影响黏膜功能。现代医学认为该病发病机制尚未明确,治疗常以对症处理,疗效往往不尽人意。中医学认为,肠黏膜上皮屏障功能与“脾为之卫”理论相对应,较多研究报道中药活性成分及复方可通过调控TJ蛋白恢复IBS-D大鼠肠上皮屏障功能,降低其通透性,减少肠腔内水和电解质渗出,从而改善症状。该文综述了TJ及其关键靶点蛋白与IBS-D的关系,以明确TJ在IBS-D病理生理的关键作用。同时,对靶向调控TJ从而可能治疗IBS-D的中医药进行总结,以期为IBS-D的治疗及进一步的药物开发提供理论依据。
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a chronic intestinal disease characterized by abdominal pain and increased water content in stool. The pathological mechanism of this disease is complex and attributed to many factors, where the impairment of intestinal mucosal barrier is pivotal in the pathogenesis of IBS-D. The intercellular tight junction (TJ)in intestinal mucosa is mainly composed of Occludin,Claudins, and zonula occludens (ZOs),which is an important component of mechanical barrier and can significantly affect mucosal function. Since modern medicine holds that the pathogenesis of this disease is not fully revealed,symptomatic treatment is the first choice in clinical practice even though the outcomes are not satisfactory. According to traditional Chinese medicine (TCM),the epithelial barrier function in intestinal mucosa corresponds to the TCM theory of "the spleen acts as the guard". Many studies have reported that the active components of Chinese medicine and compound prescriptions can restore the intestinal epithelial barrier function of IBS-D rats by regulating TJ protein,reduce its permeability, and inhibit intestinal water and electrolyte exudation,thereby improving symptoms. This study reviewed the relationship of IBS-D with TJ and its key target proteins to clarify the key role of TJ in the pathophysiology of IBS-D and summarized the TCM treatment of IBS-D through the target regulation of TJ, with the purpose to provide a theoretical basis for the treatment of IBS-D and further drug development.
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