张润涛 刘聪 张悦 李佳 倪艳 康永

[摘要]功能性便秘是一种较为常见的胃肠道疾病，且发病年龄趋于年轻化，肠动力障碍是其主要的发病机制。功能性便秘发生后会引起肠道菌群的紊乱，如乳酸杆菌、双歧杆菌等益生菌的减少和肠杆菌、肠球菌等致病菌的增多，肠道菌群在调节肠动力障碍导致的功能性便秘中发挥着重要作用。肠道是人体最大的内分泌器官和免疫器官，近年来肠道菌群通过肠内分泌细胞、肠相关淋巴组织之间的相互作用对肠动力进行调节成为国内外研究的热点，因此探讨其中的具体作用机制对功能性便秘与肠道菌群之间相关性的认识具有重要意义。

[关键词]功能性便秘;肠道菌群;肠内分泌细胞;肠相關淋巴组织; Toll 样受体

[中图分类号] R574.62 [文献标识码] A  [文章编号]2095-0616（2021）22-0031-04

Research progress on the correlation between functional constipation and intestinal flora

ZHANG  Runtao   LIU  Cong   ZHANG  Yue   LI  Jia   NI  Yan   KANG  Yong

Shanxi Academy ofTraditional Chinese Medicine， Shanxi， Taiyuan 030012， China

[Abstract] Functional constipation is a common gastrointestinal disease， and its onset age tends to be younger. Intestinal dyskinesia is its main pathogenesis. After the occurrence of functional constipation， functional constipation will cause the disorder of intestinal flora， such as the decrease of probiotics such as Lactobacillus and Bifidobacterium and the increase of pathogenic bacteria such as Enterobacter and Enterococcus. Intestinal flora plays an important role in regulating functional constipation caused by intestinal dyskinesia. Intestinal tract is the largest endocrine organ and immune organ of human body. In recent years， it has become a research hotspot at home and abroad that intestinal flora regulates intestinal motility through the interaction between intestinal endocrine cells and intestinal related lymphoid tissues. Therefore， it is of great significance to explore the specific mechanism of action for understanding the correlation between functional constipation and intestinal flora.

[Key words] Functional constipation; Intestinal flora; Intestinal endocrine cells; Intestinal related lymphoid tissue; Toll-like receptors

功能性便秘主要表现为排便次数减少，每周排便次数<3次，同时发生排便困难以及大便干结，并伴有排便时肛门疼痛和阻塞感甚至出血，需要辅助方法帮助排便，且病程普遍>6个月。便秘在世界范围内是一种高发疾病，在成人和老年人中的患病率为2.5%～79%[1]，症状较为严重的便秘在老年女性中更为多见[2]。全球儿童功能性便秘的总患病率约为9.5%[3]，多发于2～4岁[4]。罗马Ⅳ型标准将慢性便秘分为功能性便秘、肠易激综合征伴便秘、阿片类药物诱发便秘、功能性排便障碍[5]，有研究表明在慢性便秘的患者中，功能性便秘的患病率较高[6]。最新研究表明肠道菌群在功能性便秘的发生过程中发挥着非常重要的作用[7]。动物实验结果提示，肠道菌群与胃肠道动力学密切相关，健康的肠道微生态有助于促进肠道蠕动，缺乏有益的菌群会导致肠功能障碍甚至会促使功能性便秘的发生[8]。……