脑源性神经营养因子在肠道高敏感中的研究进展

肠道微生物群-肠-脑轴在神经精神系统疾病中的研究进展崔佳瞿1, 2 陈启仪1, 2 李宁1, 2［1. 同济大学附属上海市第十人民医院肠道微生态诊疗中心（结直肠病专科）；2. 同济大学消化系统疾病临床研究中心 上海 200072］摘要 肠-脑轴在维持机体内平衡方面起着重要作用，而肠道微生物群在肠道和大脑的双向沟通中扮演着重要角色，故学者们建立了肠道微生物群-肠-脑轴这一概念。

肠道微生物群可通过神经、免疫、神经内分泌和代谢途径对宿主产生影响，包括神经发育、传递和行为，并参与多种神经精神系统疾病的发生发展。

本文根据目前国内外的研究进展，结合本中心的临床经验，对肠道微生物群、肠道、神经系统之间的相互作用关系，肠道微生物群-肠-脑轴在神经精神系统疾病发生发展中扮演的角色，以及以肠道微生物群为神经精神系统疾病治疗靶点的肠-脑轴干预策略进行讨论，以期为神经精神系统疾病治疗提供一些新的理念和方法。

关键词 肠道微生物群 肠-脑轴 神经精神系统疾病中图分类号：R363.21; R454.9 文献标志码：A 文章编号：1006-1533(2023)01-0014-05引用本文崔佳瞿, 陈启仪, 李宁. 肠道微生物群-肠-脑轴在神经精神系统疾病中的研究进展[J]. 上海医药, 2023, 44(1): 14-18.Research progress of gut microbiota-gut-brain axis in neuropsychiatric disordersCUI Jiaqu1, 2, CHEN Qiyi1, 2, LI Ning1, 2[1. Intestinal Microenvironment Treatment Center (Department of Colorectal Disease ), Shanghai Tenth People’s Hospital;2. Clinical Research Center for Digestive Diseases, Tongji University, Shanghai 200072, China]ABSTRACT The gut-brain axis and gut microbiota play an important role in maintaining homeostasis and the bidirectional communication between the gut and the brain, respectively. Therefore, scholars established the concept of a gut microbiota-gut-brain axis. Gut microbiota may affect the host through neural, immune, neuroendocrine, and metabolic pathways, including nerve development, transmission and behavior, and participates in the occurrence and development of a variety of neuropsychiatric diseases. In this review, we discussed the interaction among gut microbiota, gut and brain, the role of gut microbiota-gut-brain axis in the occurrence and development of neuropsychiatric diseases including depression, anxiety, autism spectrum disorders, Alzheimer’s disease, Parkinson’s disease and irritable bowel syndrome, and the intervention strategy of gut-brain axis with gut microbiota as therapeutic target for neuropsychiatric diseases based on the current research progress at home and abroad and the clinical experience of the center, so as to provide some new ideas and methods for the treatment of neuropsychiatric diseases.KEY WORDS gut microbiota; gut-brain axis; neuropsychiatric disorders肠道中有数以万亿计的微生物，它们与人类的健康息息相关。

基于脑肠轴论治肠易激综合征的中西医临床研究进展作者：江苏敏赵艳钧李媛媛杨勤来源：《世界中医药》2020年第21期摘要最新的罗马Ⅳ标准强调了神经胃肠病学和脑肠互动异常在肠易激综合征的发病机制中的重要性，以脑肠轴理论治疗肠易激的研究因此也受到广泛关注。

西医认为脑肠互动异常与脑肠肽分泌紊乱可导致肠易激综合征腹痛，精神紧张等症状，中医上多把脑肠轴紊乱与肝郁脾虚型泄泻相关联。

基于该机制研究肠易激的中西医疗法的也得到了一定的进展，同时脑腸肽的多样性与肠易激其他发病机制如肠道菌群、肠道高敏感性也存在相关性，因而基于脑肠轴治疗肠易激综合征的仍有很大空间。

关键词肠易激综合征;脑肠轴;中西医;脑肠肽AbstractThe latest Rome IV standard emphasizes the importance of neurogastroenterology and abnormal brain-intestine interaction in the pathogenesis of irritable bowel syndrome，so the research on the treatment of irritable bowel with brain-intestinal axis theory has also received extensive attention.Western medicine believes that abnormal brain-intestinal interaction and disturbance of brain-intestinal peptide secretion can lead to irritable bowel syndrome，mental tension and other symptoms.In traditional Chinese medicine，disorders of the brain-gut axis are often associated with diarrhea of liver depression and spleen deficiency.The research on irritable bowel based on this mechanism has also made some progress.At the same time，the diversity of brain-gut peptides is also related to other pathogenesis of irritable bowel，such as intestinal flora and intestinal hypersensitivity.There is still much room for the treatment of irritable bowel syndrome based on the brain-gut axis.KeywordsIrritable bowel syndrome; Brain-gut axis; Traditional Chinese and western medicine; Brain-gut peptide中图分类号：R256.3;R259文献标识码：Adoi：10.3969/j.issn.1673-7202.2020.21.030肠易激综合征（Irritable Bowel Syndrome，IBS）是在消化系统里较为常见的胃肠功能异常的疾病，其在肠道疾病的就诊率高达20%～50%[1]，在全国IBS的发病率高达12%。