Chen Qiyi, Jiang Jun
Research Institute of General Surgery, Jinling Hospital, Nanjing 210002, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Dec 25;20(12):1345-1347.
Although with the higher prevalence, the overall treatment result of functional constipation is still not satisfied at home and abroad. The diagnosis and treatment of functional constipation are still to focus on colon itself. Functional constipation has complex interactions among intestinal flora, intestinal autonomic nerve and central nervous system. Patients with functional constipation have different degrees of mental and psychological dysfunction, and abnormal brain function can result in disorders of colon dynamics, secretion and immune function. At the same time, there is a significant imbalance of intestinal flora in patients with functional constipation. Intestinal flora plays an important role in the release of neurotransmitter and the activity of hypothalamic-pituitary-adrenal axis (HPA axis). Intestinal flora is an important regulator of development, maturity and activity of central nervous system. Therefore, the interaction in the brain-gut-microbiota axis may provide a broader strategy for the diagnosis and treatment of functional constipation and neuropsychiatric disorder.
尽管功能性便秘的患病率较高,但国内外的整体治疗效果仍不尽人意。功能性便秘的诊断和治疗仍聚焦于结肠本身。功能性便秘在肠道菌群、肠道自主神经和中枢神经系统之间存在复杂的相互作用。功能性便秘患者存在不同程度的精神和心理功能障碍,脑功能异常可导致结肠动力、分泌及免疫功能紊乱。同时,功能性便秘患者的肠道菌群存在显著失衡。肠道菌群在神经递质释放及下丘脑-垂体-肾上腺轴(HPA轴)的活动中起重要作用。肠道菌群是中枢神经系统发育、成熟及活动的重要调节因子。因此,脑-肠-微生物群轴的相互作用可能为功能性便秘及神经精神障碍的诊断和治疗提供更广阔的策略。