基于脑肠菌轴从心肝脾论治功能性消化不良

Treating functional dyspepsia from heart，liver and spleen based on cerebral enterobacteria axis

关键词:  功能性消化不良  脑-肠菌轴  脑肠同治  心肝脾论治

Key words:  functional dyspepsia  brain gut microbiota axis  brain and intestine treatment  treat from the heart,liver and spleen

摘要:

功能性消化不良（FD）是功能性胃肠病之一，非常影响患者的生活质量，中医学将其归为“胃脘痛”“胃痞”等范畴。现代医学认为脑肠菌轴功能紊乱是FD的主要发病机制之一，中医认为FD的基本病机是脾虚气滞、胃失和降，中医学从“心肝脾”论治FD在临床上取得良好的效果。中枢神经系统与“脑”相关，而中医学中“脑”的功能又与“心肝”关系密切；外周（肠）神经系统与中医学对应在“肠”，而其本在“脾”。基于此，从“脑肠菌轴”理论出发，探讨“心肝脾同治”治疗FD的治疗思路，认为FD的治疗不仅通过调节胃肠功能以改善症状，同时也应重视心肝的调神作用以改善患者焦虑抑郁等精神症状，以为临床治疗FD提供更优方案。

Abstract:

Functional dyspepsia（FD） is one of the functional gastrointestinal diseases that greatly affects the quality of life of patients. Traditional Chinese medicine classifies it into the categories of “stomach pain” and “stomach ruffian”. Modern medicine believes that dysfunction of the brain gut microbiota axis is one of the main pathogenic mechanisms of FD. Traditional Chinese medicine believes that the basic pathogenesis of FD is spleen deficiency and the stomach lacks the ability to lift and elevate，and TCM has achieved good clinical results in treating FD from the “heart，liver and spleen”. The central nervous system is related to the “brain”，and the function of the “brain” in traditional Chinese medicine is closely related to the “heart and liver”. The peripheral（enteral） nervous system corresponds to the “intestine” in traditional Chinese medicine，and its origin is in the “spleen”. Therefore，starting from the theory of “brain gut microbiota axis”，this paper discusses the treatment idea of “heart，liver and spleen treatment” in the treatment of FD，and believes that the treatment of FD should not only improve the symptoms by regulating gastrointestinal function，but also pay attention to the mind-regulating effect of the heart and liver to improve the mental symptoms of patients such as anxiety and depression，so as to provide a better plan for the clinical treatment of FD.