1.首都医科大学附属北京中医医院消化中心(北京 100010)
苗艳芳,女,硕士研究生,主要从事中医药治疗功能性胃肠病的临床与基础研究工作
王玉贤,主治医师;E-mail:daisy-yuxian@hotmail.com
扫 描 看 全 文
苗艳芳, 王玉贤. 腹泻型肠易激综合征(肝郁脾虚证)的中医研究进展[J]. 上海中医药杂志, 2021,55(7):91-94.
Yanfang MIAO, Yuxian WANG. Traditional Chinese medicine research progress of diarrhea predominant irritable bowel syndrome (liver depression and spleen deficiency syndrome)[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(7):91-94.
苗艳芳, 王玉贤. 腹泻型肠易激综合征(肝郁脾虚证)的中医研究进展[J]. 上海中医药杂志, 2021,55(7):91-94. DOI: 10.16305/j.1007-1334.2021.2008055.
Yanfang MIAO, Yuxian WANG. Traditional Chinese medicine research progress of diarrhea predominant irritable bowel syndrome (liver depression and spleen deficiency syndrome)[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(7):91-94. DOI: 10.16305/j.1007-1334.2021.2008055.
腹泻型肠易激综合征(IBS-D)是临床常见的一种肠功能紊乱性疾病,中医病机虽然有肝脾失调、肝旺脾虚、肝郁脾虚之别,但总与肝、脾两脏相关,且以肝郁脾虚最为常见。从病因病机、临床研究、作用机制研究三个方面综述肝郁脾虚型IBS-D的中医研究进展。以痛泻要方为代表,具有调肝理脾功效的中药方剂能很好地改善肝郁脾虚型IBS-D患者的腹痛、腹泻症状及心理、行为状态,进而提高患者的生活质量;在作用机制方面,中医药可能是通过调节脑-肠轴、内脏高敏感及相关离子转运等途径发挥治疗作用。
Diarrhea predominant irritable bowel syndrome (IBS-D) is a common intestinal dysfunction disease in clinic. Traditional Chinese medicine (TCM) pathogenesis may vary in different cases, for instance, liver-spleen imbalance, liver hyperactivity and spleen deficiency and liver depression and spleen deficiency, but it is the liver and spleen that are always affected and the most common syndrome is liver depression and spleen deficiency. The TCM research progress of IBS-D (liver depression and spleen deficiency syndrome) was reviewed from three aspects: etiology and pathogenesis, clinical research and mechanism of action. TCM prescription with the effect of regulating liver and spleen, represented by Tongxie Yaofang, can improve symptoms of abdominal pain and diarrhea, psychological and behavioral state of patients with IBS-D of liver depression and spleen deficiency syndrome, and then improve their quality of life. When it comes to the mechanism of action, the therapeutic effects of TCM can be realized by regulating brain-gut axis, visceral hypersensitivity and related ion transport.
腹泻型肠易激综合征肝郁脾虚证痛泻要方脑-肠轴内脏高敏感综述
diarrhea predominant irritable bowel syndromeliver depression and spleen deficiency syndromeTongxie Yaofangbrain-gut axisvisceral hypersensitivityreview
MEARIN F, LACY B E, CHANG L, et al. Bowel disorders[J]. Gastroenterology, 2016, 150(6): 1393-1407.
中华中医药学会脾胃病分会. 肠易激综合征中医诊疗专家共识意见(2017)[J]. 中医杂志,2017, 58(18): 1614-1620.
中国中西医结合学会消化系统疾病专业委员会. 肠易激综合征中西医结合诊疗共识意见[J]. 中国中西医结合杂志,2011, 31(5): 587-590.
WILEY J W, CHANG L. Functional bowel disorders[J]. Gastroenterology, 2018, 155(1): 1-4.
CHEY W D, KURLANDER J, ESWARAN S. Irritable bowel syndrome: a clinical review[J]. JAMA, 2015, 313(9): 949-958.
李梅. 肠易激综合征中医证候临床流行病学调查研究[D]. 广州:广州中医药大学,2012.
ZHU J J, LIU S, SU X L, et al. Efficacy of Chinese herbal medicine for diarrhea-predominant irritable bowel syndrome: A meta-analysis of randomized, double-blind, placebo-controlled trials[J/OL]. Evid Based Complement Alternat Med, 2016, 2016: 4071260[2020-07-30]. https://pubmed.ncbi.nlm.nih.gov/27547226/https://pubmed.ncbi.nlm.nih.gov/27547226/.
张伟,孙建华,裴丽霞,等. 中医药治疗肠易激综合征的系统评价/Meta分析的再评价[J]. 世界华人消化杂志,2014, 22(12): 1747-1755.
孟娟,杜锦辉. 中西医治疗腹泻型肠易激综合征的研究进展[J]. 世界最新医学信息文摘,2018, 18(88): 70-71.
张声生,周滔,汪红兵. 肠易激综合征中医药诊疗现状与挑战[J]. 世界华人消化杂志,2010, 18(21): 2216-2220.
成坤,沈舒文,梁海云. 沈舒文教授治疗肠易激综合征经验[J]. 陕西中医药大学学报,2019, 42(1): 14-16.
钮月. 中药治疗肝郁脾虚IBS-D的临床观察及疗效与脑肠肽相关性研究[D]. 广州:广州中医药大学,2016.
王怡嘉,冯五金. 缓急止痛方治疗肝郁脾虚腹泻型肠易激综合征的临床研究[C]//中国中西医结合学会. 第三十一届全国中西医结合消化系统疾病学术会议论文集. 济南:中国中西医结合学会消化系统疾病专业委员会,2019: 227-228.
路晶. 加味白术芍药散治疗腹泻型肠易激综合征肝郁脾虚证的临床研究[D]. 太原:山西中医药大学,2019.
郑欢. 肠激灵治疗肝郁脾虚证腹泻型肠易激综合征的临床研究[D]. 广州:广州中医药大学,2017.
覃冰心. 疏肝健脾方治疗腹泻型肠易激综合征(肝郁脾虚证)的临床观察[D]. 武汉:湖北中医药大学,2018.
周萍,曾志华,江琼,等. 加减逍遥散联合针灸治疗腹泻型肠易激综合征的临床研究[J]. 世界科学技术-中医药现代化,2014, 16(6): 1331-1335.
梁杰斌,邓铭俊,黄丹丹. 柴胡疏肝散合痛泻要方加减治疗肝郁脾虚型肠易激综合征临床观察[J]. 四川中医,2015, 33(4): 103-105.
钟毅,郭红. 肠激宁改善肝郁脾虚证腹泻型肠易激综合征患者身心症状的研究[J]. 江西中医药,2018, 49(10): 29-32.
李敏. 解郁醒脾汤治疗腹泻型肠易激综合征(肝郁脾虚型)临床观察[D]. 武汉:湖北中医药大学,2019.
贾玉,杨晋翔,汪正芳,等. 调肝理脾方治疗腹泻型肠易激综合征的随机对照研究[J]. 环球中医药,2018, 11(7): 1132-1137.
尹秋凤,贾鸣. 加味四逆散加减治疗腹泻型肠易激综合征(肝郁脾虚证)临床观察[J]. 世界最新医学信息文摘,2018, 18(44): 128-129.
刘小琼,陈红梅,谈华南. 综合疗法治疗腹泻型肠易激综合征临床观察[J]. 实用中医药杂志,2020, 36(5): 572-573.
YIN Y, ZHONG L, WANG J W, et al. Tong Xie Yao Fang relieves irritable bowel syndrome in rats via mechanisms involving regulation of 5-hydroxytryptamine and substance P[J]. World J Gastroenterol, 2015, 21(15): 4536-4546.
LI J,CUI H,CAI Y,et al. Tong-Xie-Yao-Fang Regulates 5-HT level in diarrhea predominant irritable bowel syndrome through gut microbiota modulation[J]. Front Pharmacol, 2018(9): 1110.
陈富丽,窦志芳. 痛泻要方治疗肠易激综合征肝郁脾虚证5-羟色胺作用机制研究[J]. 世界中西医结合杂志,2017, 12(12): 1686-1690.
何顺勇,陈朝元,林瑜,等. 加味痛泻要方对肝郁脾虚腹泻型肠易激综合征患者血CGRP、ET的影响[J]. 河南中医,2014, 34(12): 2492-2493.
MAO Q, SHI L, WANG Z G, et al. Chemical profiles and pharmacological activities of Chang-Kang-Fang, a multi-herb Chinese medicinal formula, for treating irritable bowel syndrome[J/OL]. J Ethnopharmacol, 2017, 201: 123-135[2020-07-30]. https://pubmed.ncbi.nlm.nih.gov/27547226/https://pubmed.ncbi.nlm.nih.gov/27547226/.
宋亚璐,张梦宇,杨莹,等. 健脾安肠丸对IBS-D大鼠模型血浆VIP、P物质水平的影响[J]. 安徽医药,2016, 20(9): 1626-1629.
王玉娟,刘维明,张梦宇,等. 健脾安肠丸对腹泻型肠易激综合征结肠组织SP、VIP、CGRP的影响[J]. 世界中医药,2017, 12(12): 3071-3073.
黄适,刘鹏,林春李,等. 肝郁脾虚型肠易激综合征大鼠pPKCγ和ERK1基因在背根神经节的表达研究[J]. 中华中医药学刊,2018, 36(1): 19-22.
韩亚飞,王允亮,郭一,等. 痛泻安肠方对腹泻型肠易激综合征模型大鼠结肠TRPV1表达及血浆SP、CGRP含量的影响[J]. 长春中医药大学学报,2018, 34(2): 224-227.
黄育生. 基于BDNF/JAK2/STAT3/GABAAR通路探讨疏肝健脾方对肝郁脾虚IBS-D大鼠的作用机制[D]. 广州:广州中医药大学,2017.
方健松. 疏肝健脾方调控PKA-TRPV1-CGRP通路治疗腹泻型肠易激综合征的临床和实验研究[D]. 南宁:广西中医药大学,2017.
陈颖. 基于Pirt-TRPV1通路的针刺缓解IBS-D大鼠内脏高敏感的作用研究[D]. 成都:成都中医药大学,2019.
吴皓萌. 疏肝健脾法干预腹泻型肠易激综合征的临床和实验研究[D]. 广州:广州中医药大学,2016.
陈敏,黄德铨,唐太春,等. 痛泻要方调控BDNF mRNA表达缓解肠易激综合征腹泻大鼠内脏高敏的机制研究[J]. 中华中医药学刊,2017, 35(12): 3095-3097.
CHAO G, WANG Y, YE F, et al. Regulation of colonic mucosal microRNA expression via multiple targets in visceral hypersensitivity rats by Tongxieyaofang[J]. Yonsei Med J, 2018, 59(8): 945-950.
王跃旗. 枫寥肠胃康对腹泻型肠易激综合征大鼠结肠动力及氯离子分泌的影响[D]. 北京:北京中医药大学,2017.
LU X F, ZHANG S S, YANG C,et al. Effect of TongXie-YaoFang on Cl(-) and HCO3 (-) transport in diarrhea-predominant irritable bowel syndrome rats[J/OL]. Evid Based Complement Alternat Med, 2016, 2016: 7954982[2020-07-30]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923577/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923577/.
张声生,汪正芳,郭前坤,等. 疏肝健脾方对实验性腹泻型肠易激综合征5-羟色胺相关的结肠黏膜离子通道转运机制的影响[J]. 中国中西医结合杂志,2012, 32(11): 1516-1520.
李培彩. 疏肝健脾方对腹泻型肠易激综合征大鼠肥大细胞/5-HT通路及离子转运的影响[D]. 北京:北京中医药大学,2016.
0
浏览量
1398
下载量
0
CSCD
9
CNKI被引量
关联资源
相关文章
相关作者
相关机构