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中药治疗肠易激综合征的疗效及潜在机制。

The Efficacy and Potential Mechanisms of Chinese Herbal Medicine on Irritable Bowel Syndrome.

机构信息

Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.

School of Chinese Medicine, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China.

出版信息

Curr Pharm Des. 2017;23(34):5163-5172. doi: 10.2174/1381612823666170822101606.

Abstract

Irritable bowel syndrome (IBS) is one of the most common functional bowel disorders (FBD), which is characterized by recurrent abdominal pain, abdominal bloating/distention associated with defecation or changed bowel habits. Currently, there is no evidence of obvious anatomic or physiologic abnormalities on the routine diagnostic examinations. There are multiple pathological factors involved in IBS responsible for its heterogeneous nature, although the exact etiology and pathology of IBS are not well known and it is disappointed to develop biomarkers for this disorder. These factors including low-grade inflammation, activation of immune system, changed intestinal microorganism, small intestinal bacterial overgrowth (SIBO), malabsorption of bile acid (BA), increased number of mast cells (MCs). Current pharmacologic treatment for IBS focuses on alleviation of its symptoms, but not on the elimination of its cause. Although there are a lot of conventional chemical medicines for IBS available, due to the limited clinical benefits, high medical expenses and severe side effects, many IBS patients have turned to alternative medicine, particularly Chinese herbal medicine (CHM). Chinese herbal therapies have been used for thousand years in eastern Asia and have been provided that they are effective in relieving symptoms among IBS patients. Generally, traditional Chinese herbal formulae (CHF) consisting of CHM can be easily adjusted in accordance with concrete conditions, which means the treatment is based on syndrome differentiation and varied from individual to individual. Meanwhile, CHF/CHM containing many different ingredients may act on multiple sites/pathways with potential synergistic effects and chemical reactions.

摘要

肠易激综合征(IBS)是最常见的功能性肠病(FBD)之一,其特征是反复发作的腹痛、与排便相关的腹部饱胀/扩张或排便习惯改变。目前,常规诊断检查未发现明显的解剖或生理异常。IBS 涉及多种病理因素,导致其异质性,尽管 IBS 的确切病因和发病机制尚不清楚,也未能开发出用于诊断这种疾病的生物标志物。这些因素包括低度炎症、免疫系统激活、肠道微生物改变、小肠细菌过度生长(SIBO)、胆汁酸(BA)吸收不良、肥大细胞(MC)数量增加。目前 IBS 的药物治疗侧重于缓解其症状,但不能消除其病因。尽管有很多常规的化学药物可用于治疗 IBS,但由于临床获益有限、医疗费用高和严重的副作用,许多 IBS 患者转向了替代药物,特别是中药(CHM)。中药疗法在东亚已经使用了数千年,被认为可以有效缓解 IBS 患者的症状。一般来说,由中药组成的传统中药配方(CHF)可以根据具体情况进行调整,这意味着治疗是基于辨证论治的,因人而异。同时,CHF/CHM 含有许多不同的成分,可能会对多个靶点/途径产生协同作用和化学反应。

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