谢晶日 张瑜

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。

关键词：肠道菌群失调;慢性腹泻;中医药;优势;综述

中图分类号：R256.34;R259.744    文献标识码：A    文章编号：1005-5304（2019）02-0141-04

DOI：10.3969/j.issn.1005-5304.2019.02.033

开放科学（资源服务）标识码（OSID）：

Abstract： 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.

Keywords： intestinal flora imbalance; chronic diarrhea; TCM; advantage; review

人類肠道中包含1000～1150种细菌^[1]，大部分根植于结肠。正常情况下，肠道微生态保持动态平衡状态，对宿主的健康具有重要作用。当肠道菌群的类型、数量、比例、位置等发生变化，菌群组成及代谢活动相应改变，肠道微生态失衡现象发生，称为肠道菌群失调^[2]。研究显示，肠道菌群失调与肠易激综合征^[3]、溃疡性结肠炎^[4]、抗生素相关性腹泻^[5]、结直肠癌^[6]等消化系统疾病密切相关。临床表现主要为腹胀、腹痛、腹泻、腹部不适等症状，其中以腹泻症状尤为明显。本病病因复杂多样，主要病因有药物、年龄、环境、饮食、肠道动力异常、免疫功能障碍、外伤及重症感染等^[7]，现代医学在治疗时除纠正原发病，主要方式为微生态调节制剂（如益生菌、益生元、合生元等）和粪菌移植，但单一应用临床疗效欠佳^[8]。中医学运用整体观和辨证论治思想，随证加减，突出个体化治疗的优势，在治疗本病方面疗效得到认可，现综述如下。……