摘要
肠易激综合征(IBS)是一种反复发作的腹痛、腹胀和排便不规律的功能性肠病,其发病机制较为复杂。由于其高发病率和症状反复出现,严重影响了患者的生活质量。自主神经系统(ANS)包括交感神经系统、副交感神经系统和肠道神经系统,而肠易激综合征发病的原因之一是由于自主神经系统功能障碍导致的胃肠动力和肠道分泌紊乱。目前研究表明,针灸作为一种传统的中医疗法,治疗肠易激综合征是有效的。同时,针灸治疗肠易激综合征的机制研究越来越受到重视,现代方法的应用也取得了重大进展,其中,ANS是胃肠道和中枢神经系统之间双向信息传递的关键途径,在针灸治疗IBS中发挥着重要作用。有证据表明,针灸可以减轻肠易激综合征的负面影响,如炎症信号的改变、结肠和中枢神经组织中神经递质水平的降低以及肠道菌群的平衡。文章回顾并讨论了针灸通过ANS治疗IBS的可能作用机制,包括调节胃肠动力、改善内脏超敏反应和肠-脑-微生物群轴的神经支配,同时综述了针灸治疗IBS在临床中的可用证据。然而,ANS和肠脑微生物群轴之间的关系尚不清楚,需要进一步研究。
Irritable bowel syndrome(IBS)is a functional bowel disorder characterized by recurrent abdominal pain,bloating,and irregular bowel movements with complex pathogenesis.Due to its high prevalence and reoccurring symptoms,it seriously impacts patients’quality of life.One of the causes of IBS is turbulence of gastrointestinal motility and intestinal secretion due to dysfunction of the autonomic nervous system(ANS),which the includes the sympathetic nervous system,parasympathetic nervous system,and enteric nervous system.Current research has proven that acupuncture,a traditional Chinese therapy,is useful and effective for treating IBS.The ANS is a key pathway for bidirectional information transmission between the gastrointestinal tract and the central nervous system,which plays an important role in IBS treatment with acupuncture.Research on the mechanisms of acupuncture for IBS is receiving more attention,and the use of contemporary methods has made significant progress.Evidence suggests that acupuncture may mitigate the negative consequences of IBS,as seen by reduced inflammatory signaling,neurotransmitter levels in the colon and central neural tissues,and balanced gut flora.We review and discuss acupuncture’s possible mechanisms of action for IBS treatment via the ANS,including modulation of gastrointestinal motility,improvement of visceral hypersensitivity,and innervation of the gut-brain-microbiota axis.Our review demonstrates the available evidence for acupuncture treatment of IBS in clinical settings;however,we also observe that the relationship between the ANS and the gut-brain-microbiota axis is unclear,and further research is needed.
作者
孙路强
姚俊鹏
罗芳丽
陈帅
秦迪
侯雨君
王路
李瑛
Luqiang Sun;Junpeng Yao;Fangli Luo;Shuai Chen;Di Qin;Yujun Hou;Lu Wang;Ying Li(Acupuncture and Tuina School,Chengdu University of Traditional Chinese Medicine,Chengdu,China;Department of Clinical Medicine of Traditional Chinese and Western Medicine,North Sichuan Medical University,Nanchong,China)
基金
supported by the National Key R&D Program
the Key Project of Modern Research in Traditional Chinese Medicine(2019YFC1712103).
关键词
针灸
自主神经系统
肠易激综合征
肠动力、肠-脑-微生物群轴
内脏超敏反应
Acupuncture
Autonomic nervous system
Gut-brain-microbiota axis
Gut motility
Irritable bowel syndrome
Visceral hypersensitivity
