基于肠道菌群探讨中医药治疗功能性消化不良研究进展

肠道菌群与功能性消化不良(FD)的发生发展密切相关。在生理状态下,厚壁菌门和拟杆菌门是人类肠道微生物群的优势菌群(>98%),两者的比值是反映肠道微生物群紊乱的重要指标。在病理状态下,紊乱的肠道菌群通过影响胃肠动力、破坏胃肠道屏障功能和免疫功能、紊乱脑-肠轴功能及影响药物吸收代谢等机制参与FD的发生发展。研究表明,中医药能够通过扶植益生菌生长和抑制有害菌增殖来逆转肠道菌群失调,从而减轻FD患者的临床症状。白术、炙甘草、枳实、神曲等中药,以及四君子汤、参苓白术散、逍遥散、半夏泻心汤、焦三仙、调中健脾汤、胃祺饮等复方均能够通过调节肠道菌群起到治疗FD的作用,具有一定的应用前景。

Research progress on treatment of functional dyspepsia with traditional Chinese medicine based on intestinal flora

The intestinal flora is closely related to the occurrence and development of functional dyspepsia(FD).In physiological state,Firmicutes and Bacteroidetes are the dominant flora(>98%)of human gut microbiota,and their ratio is an important index to reflect the disturbance of gut microbiota.Under pathological conditions,disturbed intestinal flora participates in the occurrence and development of FD by affecting gastrointestinal motility,disrupting gastrointestinal barrier function and immune function,disrupting brain-gut axis function and affecting drug absorption and metabolism.Studies have shown that traditional Chinese medicine can reverse the imbalance of intestinal flora by supporting the growth of probiotics and inhibiting the proliferation of harmful bacteria,thereby alleviating the clinical symptoms of FD patients.Both traditional Chinese medicines such as Baizhu,Zhigancao,Zhishi,Shenqu,and Chinese herbal formulae such as Sijunzi decoction,Shenling Baizhu powder,Xiaoyao powder,Banxia Xiexin decoction,Jiaosanxian,Tiaozhong Jianpi decoction and Weiqi Yin can play a role in the treatment of FD by regulating intestinal flora,which has a certain application prospect.