中药治疗肠道菌群失调相关性慢性腹泻研究进展
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摘要
肠道菌群失调与多种消化系统疾病的发生与发展密切相关。肠道菌群失调相关性腹泻因其反复发作特点,且发病率逐渐上升,近年来受到重视。中医药运用整体观和辨证论治的思想治疗本病,疗效显著。本文总结肠道菌群失调相关性慢性腹泻病因病机,从单味药、复方、辨证施治、基本方加减治疗等方面综述相关研究进展,认为中药治疗本病具有减少感染率、多靶点治疗、提高患者生活质量等优势。
Intestinal flora imbalance is closely related to the occurrence and development of various digestive diseases. Intestinal flora imbalance-related chronic diarrhea is characterized by its recurrent episodes and its incidence is gradually increasing, which has received attention in recent years. TCM uses the concept of holistic view and syndrome differentiation to treat this disease with remarkable curative effect. In this article, the pathogenesis of chronic diarrhea associated with intestinal flora imbalance is reviewed. The research progress is summarized from the aspects of single-dose medicine, compound prescriptions, syndrome differentiation and treatment, and basic prescription addition and subtraction treatment. It is believed that TCM treatment has the advantages of reducing infection rate and multi-target treatment, improving life quality of patients and so on.
Intestinal flora imbalance is closely related to the occurrence and development of various digestive diseases. Intestinal flora imbalance-related chronic diarrhea is characterized by its recurrent episodes and its incidence is gradually increasing, which has received attention in recent years. TCM uses the concept of holistic view and syndrome differentiation to treat this disease with remarkable curative effect. In this article, the pathogenesis of chronic diarrhea associated with intestinal flora imbalance is reviewed. The research progress is summarized from the aspects of single-dose medicine, compound prescriptions, syndrome differentiation and treatment, and basic prescription addition and subtraction treatment. It is believed that TCM treatment has the advantages of reducing infection rate and multi-target treatment, improving life quality of patients and so on.
引文
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[2]中华预防医学会微生态学分会,李兰娟.中国消化道微生态调节剂临床应用共识(2016版)[J].中国微生态学杂志,2016,28(6):621-631.
[3]赖淑媚,王立生.肠道菌群失调与肠易激综合征关系的研究进展[J].当代医学,2018,24(3):182-184.
[4]杨斐,郑晓娟,刘近春.溃疡性结肠炎肠道菌群失调的治疗进展[J].胃肠病学,2018,23(1):56-58.
[5] SELINGER C P, BELL A, CAIRNS A, et al. Probiotic VSL#3 prevents antibiotic-associated diarrhoea in a double-blind, randomized,placebo-controlled clinical trial[J]. Journal of Hospital Infection,2013,84(2):159-165.
[6]张泉,朱蓉,赵逵.幽门螺杆菌感染及肠道菌群失调与结直肠癌发病关系的研究进展[J].山东医药,2017,57(25):101-103.
[7]刘慧.肠道菌群失调的研究进展[J].医学综述,2014,20(3):468-471.
[8]徐永金.微生态制剂培菲康经结肠途径给药联合补中益气丸治疗老年人肠道菌群失调相关性腹泻的临床研究[J].中国微生态学杂志,2016,28(4):420-424.
[9]肖翠霞,吴科锐,韩凌.中医药对肠道菌群的影响研究进展[J].中成药,2017,39(6):1239-1243.
[10]刘佳,彭颖,张硕颖,等.老年脾虚患者肠道菌群16S rDNA变性梯度凝胶电泳分析[J].中华中医药杂志,2010,25(10):1566-1569.
[11]卢林,杨景云,李丹红.脾虚湿盛泄泻患者肠道微生态及舌部菌群变化的临床观察[J].中国微生态学杂志,2007,19(4):333-334.
[12]李吉武,李双蕾,唐爱华,等.2型糖尿病的中医病机与肠道菌群的研究进展[J].世界中西医结合杂志,2016,11(4):585-589.
[13]程成,张军峰,史丽云.湿热证与肠道微生态[J].南京中医药大学学报,2018,34(2):210-213.
[14]刘艳艳,张凯,关家伟,等.人参皂苷对BALB/c小鼠肠道菌群的影响[J].现代生物医学进展,2015,15(6):1041-1045.
[15]宋克玉,江振友,严群超,等.党参及茯苓对小鼠肠道菌群调节作用的实验研究[J].中国临床药理学杂志,2011,27(2):142-145.
[16]鄢伟伦,王帅帅,任霞.白术对小鼠肠道菌群调节作用的实验研究[J].山东中医杂志,2011,30(6):417-419.
[17]蔡子微,杨旭东,胡静,等.中药神曲及其肠道菌群调整和肠保护作用的实验研究[J].牡丹江医学院学报,2006,27(1):1-5.
[18]罗海燕,宋姗姗,黄暨生,等.黄芩苷对小鼠肠道菌群影响的量-时规律观察[J].中国医药指南,2010,8(32):42-43,49.
[19]冯澜,李绍民,代立娟,等.马齿苋多糖对溃疡性结肠炎小鼠肠黏膜细胞因子及肠道菌群的影响[J].中国微生态学杂志,2015,27(2):139-142.
[20] CHEN L, TAI W C S, HSIAO W L W. Dietary saponins from four popular herbal tea exert prebiotic-like effects on gut microbiota in C57BL/6 mice[J]. Journal of Functional Foods,2015,17:892-902.
[21]陈涟昊,张霞,孙世芳,等.桑叶多糖调节小鼠肠道菌群失调的研究[J].现代药物与临床,2015,30(6):633-636.
[22]闫瑶,金美兰,周磊,等.砂仁对抗生素所致肠道菌群失调小鼠调节作用的探讨[J].中国微生态学杂志,2013,25(9):1040-1043.
[23]曾桂梅,成金乐,彭丽华.丹参破壁饮片、常规饮片及传统粉末对小鼠肠道菌群的影响[J].今日药学,2015,25(2):103-106.
[24]杨泽锐,曾桂梅,彭丽华,等.红景天破壁饮片对小鼠肠道菌群影响的初步研究[J].中国中药杂志,2015,40(15):3053-3058.
[25]曾宏亮,肖满,陈波,等.复方苍术方调节肠道菌群及肠保护作用研究[J].现代食品科技,2018(1):1-7.
[26]李建军,李建国,温超,等.厚朴复方制剂对抗生素相关性腹泻大鼠的治疗作用[J].实用药物与临床,2015,18(12):1421-1424.
[27]孙必强,伍参荣,周英,等.不同剂型七味白术散对肠道菌群失调小鼠小肠黏膜超微结构和sIgA的影响[J].中国微生态学杂志,2016,28(2):125-128,137.
[28]孙必强,周英,刘卫东,等.不同剂型七味白术散对肠道菌群失调腹泻小鼠小肠黏膜上皮IL-4,IL-10,IFN-αmRNA表达的影响[J].中国实验方剂学杂志,2016,22(6):84-88.
[29]孙必强,周英,刘卫东,等.不同剂型七味白术散对腹泻小鼠肠道菌群失调和肠粘膜紧密连接蛋白的影响[J].时珍国医国药,2015,26(12):2835-2837.
[30]张卫平,冯晟楠.二术止泻汤对脾虚泄泻小鼠肠道菌群数量的影响[J].中医学报,2015,30(11):1639-1641.
[31]王洋,孟胜男,张鑫,等.中药治疗肠道菌群失调研究进展[J].环球中医药,2015,8(5):620-623.
[32]张北华,王凤云,卞兆祥,等.证候表型与肠道微生态的相关性[J].中医杂志,2018,59(1):21-25.
[33]龙明照,龙凤昌.肠道菌群失调症的中医辨治经验[J].中国中医药信息杂志,2000,7(8):77.
[34]安婉丽,李雪丽,孔冉,等.中医药治疗肠道菌群失调症的方剂用药规律分析[J].中国实验方剂学杂志,2018,24(12):210-215.
[35]徐明鑫,桂艺方,王冬梅.健脾益肠汤治疗老年人肠道菌群失调临床研究[J].中国药物经济学,2013(4):260-261.
[36]张晓明.温肾健脾法治疗肠道菌群失调性腹泻临床体会[J].内蒙古中医药,2016,35(17):119-120.
[37]李怀庆.参苓白术散合四逆散加减治疗菌群失调性肠炎13例临床观察[J].基层医学论坛,2016,20(5):660-661.
[38] WHELAN K, MYERS C E. Safety of probiotics in patients receiving nutritionalsupport:asystematicreviewofcasereports,randomizedcontrolledtrials,andnonrandomizedtrials[J].American Journal of Clinical Nutrition,2010,91(3):687-703.
[39]曹婷,薛新娜,丁亚利.中药治疗肠道菌群失调研究分析[J].中国现代药物应用,2017,11(19):99-101.
[40]孙必强,周英,刘卫东,等.不同剂型七味白术散对肠道菌群失调小鼠肠黏膜和血清TNF-α、IL-6的影响[J].中国实验方剂学杂志,2016,22(4):95-100.
[2]中华预防医学会微生态学分会,李兰娟.中国消化道微生态调节剂临床应用共识(2016版)[J].中国微生态学杂志,2016,28(6):621-631.
[3]赖淑媚,王立生.肠道菌群失调与肠易激综合征关系的研究进展[J].当代医学,2018,24(3):182-184.
[4]杨斐,郑晓娟,刘近春.溃疡性结肠炎肠道菌群失调的治疗进展[J].胃肠病学,2018,23(1):56-58.
[5] SELINGER C P, BELL A, CAIRNS A, et al. Probiotic VSL#3 prevents antibiotic-associated diarrhoea in a double-blind, randomized,placebo-controlled clinical trial[J]. Journal of Hospital Infection,2013,84(2):159-165.
[6]张泉,朱蓉,赵逵.幽门螺杆菌感染及肠道菌群失调与结直肠癌发病关系的研究进展[J].山东医药,2017,57(25):101-103.
[7]刘慧.肠道菌群失调的研究进展[J].医学综述,2014,20(3):468-471.
[8]徐永金.微生态制剂培菲康经结肠途径给药联合补中益气丸治疗老年人肠道菌群失调相关性腹泻的临床研究[J].中国微生态学杂志,2016,28(4):420-424.
[9]肖翠霞,吴科锐,韩凌.中医药对肠道菌群的影响研究进展[J].中成药,2017,39(6):1239-1243.
[10]刘佳,彭颖,张硕颖,等.老年脾虚患者肠道菌群16S rDNA变性梯度凝胶电泳分析[J].中华中医药杂志,2010,25(10):1566-1569.
[11]卢林,杨景云,李丹红.脾虚湿盛泄泻患者肠道微生态及舌部菌群变化的临床观察[J].中国微生态学杂志,2007,19(4):333-334.
[12]李吉武,李双蕾,唐爱华,等.2型糖尿病的中医病机与肠道菌群的研究进展[J].世界中西医结合杂志,2016,11(4):585-589.
[13]程成,张军峰,史丽云.湿热证与肠道微生态[J].南京中医药大学学报,2018,34(2):210-213.
[14]刘艳艳,张凯,关家伟,等.人参皂苷对BALB/c小鼠肠道菌群的影响[J].现代生物医学进展,2015,15(6):1041-1045.
[15]宋克玉,江振友,严群超,等.党参及茯苓对小鼠肠道菌群调节作用的实验研究[J].中国临床药理学杂志,2011,27(2):142-145.
[16]鄢伟伦,王帅帅,任霞.白术对小鼠肠道菌群调节作用的实验研究[J].山东中医杂志,2011,30(6):417-419.
[17]蔡子微,杨旭东,胡静,等.中药神曲及其肠道菌群调整和肠保护作用的实验研究[J].牡丹江医学院学报,2006,27(1):1-5.
[18]罗海燕,宋姗姗,黄暨生,等.黄芩苷对小鼠肠道菌群影响的量-时规律观察[J].中国医药指南,2010,8(32):42-43,49.
[19]冯澜,李绍民,代立娟,等.马齿苋多糖对溃疡性结肠炎小鼠肠黏膜细胞因子及肠道菌群的影响[J].中国微生态学杂志,2015,27(2):139-142.
[20] CHEN L, TAI W C S, HSIAO W L W. Dietary saponins from four popular herbal tea exert prebiotic-like effects on gut microbiota in C57BL/6 mice[J]. Journal of Functional Foods,2015,17:892-902.
[21]陈涟昊,张霞,孙世芳,等.桑叶多糖调节小鼠肠道菌群失调的研究[J].现代药物与临床,2015,30(6):633-636.
[22]闫瑶,金美兰,周磊,等.砂仁对抗生素所致肠道菌群失调小鼠调节作用的探讨[J].中国微生态学杂志,2013,25(9):1040-1043.
[23]曾桂梅,成金乐,彭丽华.丹参破壁饮片、常规饮片及传统粉末对小鼠肠道菌群的影响[J].今日药学,2015,25(2):103-106.
[24]杨泽锐,曾桂梅,彭丽华,等.红景天破壁饮片对小鼠肠道菌群影响的初步研究[J].中国中药杂志,2015,40(15):3053-3058.
[25]曾宏亮,肖满,陈波,等.复方苍术方调节肠道菌群及肠保护作用研究[J].现代食品科技,2018(1):1-7.
[26]李建军,李建国,温超,等.厚朴复方制剂对抗生素相关性腹泻大鼠的治疗作用[J].实用药物与临床,2015,18(12):1421-1424.
[27]孙必强,伍参荣,周英,等.不同剂型七味白术散对肠道菌群失调小鼠小肠黏膜超微结构和sIgA的影响[J].中国微生态学杂志,2016,28(2):125-128,137.
[28]孙必强,周英,刘卫东,等.不同剂型七味白术散对肠道菌群失调腹泻小鼠小肠黏膜上皮IL-4,IL-10,IFN-αmRNA表达的影响[J].中国实验方剂学杂志,2016,22(6):84-88.
[29]孙必强,周英,刘卫东,等.不同剂型七味白术散对腹泻小鼠肠道菌群失调和肠粘膜紧密连接蛋白的影响[J].时珍国医国药,2015,26(12):2835-2837.
[30]张卫平,冯晟楠.二术止泻汤对脾虚泄泻小鼠肠道菌群数量的影响[J].中医学报,2015,30(11):1639-1641.
[31]王洋,孟胜男,张鑫,等.中药治疗肠道菌群失调研究进展[J].环球中医药,2015,8(5):620-623.
[32]张北华,王凤云,卞兆祥,等.证候表型与肠道微生态的相关性[J].中医杂志,2018,59(1):21-25.
[33]龙明照,龙凤昌.肠道菌群失调症的中医辨治经验[J].中国中医药信息杂志,2000,7(8):77.
[34]安婉丽,李雪丽,孔冉,等.中医药治疗肠道菌群失调症的方剂用药规律分析[J].中国实验方剂学杂志,2018,24(12):210-215.
[35]徐明鑫,桂艺方,王冬梅.健脾益肠汤治疗老年人肠道菌群失调临床研究[J].中国药物经济学,2013(4):260-261.
[36]张晓明.温肾健脾法治疗肠道菌群失调性腹泻临床体会[J].内蒙古中医药,2016,35(17):119-120.
[37]李怀庆.参苓白术散合四逆散加减治疗菌群失调性肠炎13例临床观察[J].基层医学论坛,2016,20(5):660-661.
[38] WHELAN K, MYERS C E. Safety of probiotics in patients receiving nutritionalsupport:asystematicreviewofcasereports,randomizedcontrolledtrials,andnonrandomizedtrials[J].American Journal of Clinical Nutrition,2010,91(3):687-703.
[39]曹婷,薛新娜,丁亚利.中药治疗肠道菌群失调研究分析[J].中国现代药物应用,2017,11(19):99-101.
[40]孙必强,周英,刘卫东,等.不同剂型七味白术散对肠道菌群失调小鼠肠黏膜和血清TNF-α、IL-6的影响[J].中国实验方剂学杂志,2016,22(4):95-100.
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