Research Progress on Mechanism of Tongxie Yaofang in Treating Diarrhea-Predominate Irritable Bowel Syndrome Based on Brain-gut Interaction Function

Xia LI; Feng-yun WANG; Hao-meng WU; Jin-yan QIN; Jin-xin MA; Xu-dong TANG

doi:10.13422/j.cnki.syfjx.20202041

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Research Progress on Mechanism of Tongxie Yaofang in Treating Diarrhea-Predominate Irritable Bowel Syndrome Based on Brain-gut Interaction Function

Review | 更新时间：2020-09-16

- Research Progress on Mechanism of Tongxie Yaofang in Treating Diarrhea-Predominate Irritable Bowel Syndrome Based on Brain-gut Interaction Function
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 26, Issue 20, Pages: 229-234(2020)
- 作者机构：
  
  1.北京中医药大学研究生院，北京 100029
  2.中国中医科学院西苑医院，北京市中医脾胃病研究所，北京 100091
  3.中国中医科学院研究生院，北京 100700
  4.中国中医科学院，北京 100700
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20202041
  CLC： R2-0;R285;G353.11;R516.1
- Received：08 October 2019，
  
  Published Online：13 August 2020，
  
  Published：20 October 2020
- 稿件说明：
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李夏,王凤云,吴皓萌等.基于脑-肠互动功能探讨痛泻要方治疗腹泻性肠易激综合征机制的研究进展[J].中国实验方剂学杂志,2020,26(20):229-234.

LI Xia,WANG Feng-yun,WU Hao-meng,et al.Research Progress on Mechanism of Tongxie Yaofang in Treating Diarrhea-Predominate Irritable Bowel Syndrome Based on Brain-gut Interaction Function[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(20):229-234.
李夏,王凤云,吴皓萌等.基于脑-肠互动功能探讨痛泻要方治疗腹泻性肠易激综合征机制的研究进展[J].中国实验方剂学杂志,2020,26(20):229-234. DOI： 10.13422/j.cnki.syfjx.20202041.

LI Xia,WANG Feng-yun,WU Hao-meng,et al.Research Progress on Mechanism of Tongxie Yaofang in Treating Diarrhea-Predominate Irritable Bowel Syndrome Based on Brain-gut Interaction Function[J].Chinese Journal of Experimental Traditional Medical Formulae,2020,26(20):229-234. DOI： 10.13422/j.cnki.syfjx.20202041.

摘要

腹泻型肠易激综合征（IBS-D）是临床上常见的功能性胃肠病之一，发病机制多样，因其发作突然、缠绵难治，严重影响了患者的工作生活。IBS-D患者因病情反复难愈，影响生活常伴随焦虑、抑郁等精神症状。其焦虑，抑郁的状态亦可影响内脏感受，增加肠道敏感性，躯体症状与精神症状相互影响，加重病情。IBS-D的主要发病机制如内脏高敏感性、胃肠动力紊乱、肠道感染、社会心理因素等均与脑肠互动紊乱相关。IBS-D患者长期精神慢性应激状态易诱发脑肠互动功能紊乱，脑肠互动是脑肠轴调控胃肠功能的主要调控方式，以脑肠轴及脑肠肽为物质基础进行脑与肠之间的交互作用。中医认为IBS-D患者的主要证型为肝郁脾虚证，肝郁则情志不畅，而脑内各类神经递质的分泌及含量与情绪密切相关。痛泻要方为临床治疗IBS-D肝郁脾虚证的常用基础方，具有柔肝补脾，祛湿止泻的功能，临床疗效显著。目前已有多项动物实验、临床研究探讨痛泻要方治疗IBS-D的机制及其对脑肠互动功能及脑肠肽含量的影响，但未将肝主疏泄与脑肠互动联系起来。笔者以肝主疏泄与脑肠互动的相关性为切入点，基于脑肠互动紊乱探讨痛泻要方治疗IBS-D的机制，阐释三者之间的相关性。笔者综合近5年来痛泻要方治疗IBS-D及痛泻药方与脑肠互动关系的研究文献，探讨痛泻要方通过影响脑肠轴及脑肠肽来治疗IBS-D。

Abstract

Diarrhea-predominant irritable bowel syndrome (IBS-D) is one of the common functional gastrointestinal diseases in clinical practice

its pathogenesis is diverse. Because of its sudden and lingering intractable symptoms

it seriously affects patients' work and life. IBS-D patients suffer from repeated illnesses

which often affect their lives with mental symptoms such as anxiety and depression. Anxiety and depression can also affect visceral sensation

increase intestinal sensitivity

aggravated by interaction between physical symptoms and mental symptoms. The main pathogenesis of IBS-D such as visceral hypersensitivity

gastrointestinal motility disorders

intestinal infections

and psychosocial factors are all related to brain-gut interaction disorders. Patients with IBS-D are prone to brain-gut interaction disorders due to long-term chronic mental stress. Brain-gut interaction is the main mode of regulation of gastrointestinal function in the brain-gut axis. Traditional Chinese medicine （TCM） believes that the main syndrome type of IBS-D patients is liver stagnation and spleen deficiency

while liver stagnation will be unsatisfactory

and the secretion and content of various neurotransmitters in the brain are closely related to emotions. Tongxie Yaofang is a commonly basic prescription used for the clinical treatment of IBS-D liver stagnation and spleen deficiency syndrome. It has the functions of softening the liver and replenishing the spleen

removing dampness and stopping diarrhea

and has a significant clinical effect. At present

many animal experiments and clinical studies have explored the mechanism of Tongxie Yaofang in treating IBS-D and its effect on brain-gut interaction function and brain-gut peptide content

but the main liver drainage and brain-gut interaction have not been linked. The author took the correlation between liver liver govers regulating and brain-gut interaction as the starting point

explored the mechanism of Tongxie Yaofang in treating IBS-D based on brain-gut interaction disorder

and explained the correlation between the three. Based on the research literature of Tongxie Yaofang in the past 5 years and the interaction between Tongxie Yaofang and brain-gut interaction

the author explored the effect of Tongxie Yaofang in treating IBS-D by affecting the brain-gut axis and brain-gut peptides.

关键词

Keywords

references

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