脑-肠轴与功能性消化不良相关性的研究进展
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摘要
功能性消化不良(functional dyspepsia,FD)是消化内科常见病症,但其确切发病机制尚未完全阐明,目前普遍认为与胃肠动力、内脏敏感性、精神心理、肠道免疫与微生态等多种因素有关。近年来随着对FD的深入研究,众多学者认为脑-肠轴在FD的发病中起着重要作用,本文旨在通过以上几方面对脑-肠轴与FD的相关性做一综述。
Functional dyspepsia(FD) is a common disease in gastroenterology,but its exact pathogenesis has not been fully elucidated.Currently, it is generally believed to be related to gastrointestinal motility, visceral sensitivity, mental state, intestinal immunity,microecology and other factors. In recent years,with the in-depth study of FD,many scholars believe that brain-gut axis plays an important role in the pathogenesis of FD.This paper aims to summarize the correlation between brain-gut axis and FD from the above aspects.
Functional dyspepsia(FD) is a common disease in gastroenterology,but its exact pathogenesis has not been fully elucidated.Currently, it is generally believed to be related to gastrointestinal motility, visceral sensitivity, mental state, intestinal immunity,microecology and other factors. In recent years,with the in-depth study of FD,many scholars believe that brain-gut axis plays an important role in the pathogenesis of FD.This paper aims to summarize the correlation between brain-gut axis and FD from the above aspects.
引文
[1]中华医学会消化病学分会胃肠动力学组,中华医学会消化病学分会胃肠功能性疾病协作组.中国功能性消化不良专家共识意见(2015年,上海)[J].中华消化杂志,2016,36(4):217-229.
[2]孙晓红.功能性消化不良的罗马Ⅳ标准解读[J].中华全科医师杂志,2017,16(9):661-663.
[3]Stanghellinii V,Chan FK,Haseler WL,et al.Gastroduodenal Disorders[J].Gast roenterology,2016,150(6):1380-1392.
[4]刘文忠.幽门螺杆菌感染与非溃疡性消化不良[J].现代消化及介入诊疗,2010,15(2):94-97.
[5]Drossman DA.Functional Gastrointestinal Disorders:History Pathophysiology,Clinical Features,and Rome IV[J].Gastroenterolo gy,2016,150(6):1262-1279.
[6]Tack J,Drossman DA.What’s new in Rome IV?[J].Neurogastroenterology Motility,2017,29(9):e13053.
[7]吴时胜,张飞.胃肠动力、功能性疾病的神经胃肠病学研究[J].中国实用神经疾病志,2014,17(5):95-96.
[8]倪敏,丁义江,丁曙晴.神经调节在功能性胃肠病发病中的作用及其研究进展[J].世界华人消化杂志,2011,19(25):2649-2653.
[9]Breit S,Kupferberg A,Rogler G,et al.Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders[J].Front Psychiatry,2018,9:44.
[10]Browning KN,Travagli RA.Central nervous system control of gastrointestinal motility and secretion and modulation of gastrointestina functions[J].Compr Physiol,2014,4(4):1339-1368.
[11]Zheng H,Xu J,Sun X.et al.Electroacupuncture for patients with refractory functional dyspepsia:A randomized controlled trial[J].Neurogastroentero Motil,2018,30(7):e13316.
[12]高飞,刘铁钢,白辰,等.脑肠轴与胃肠动力之间相关性的研究进展[J].天津中医药大学学报,2018,37(6):520-524.
[13]Simren M,Tornblom H,Palsson OS,et al.Visceral hypersensitivity is associated with GI symptom severity in functional GI disorders:consistent findings from five different patient cohorts[J].Gut,2018,67(2):255-262.
[14]Van Oudenhove L,Crowell MD,Drossman DA,et al.Biopsychosocia Aspects of Functional Gastrointestinal Disorder[J].Gastroenterology2016,S0016-5085(16):00218-3.
[15]Kano M,Dupont P,Aziz Q,et al.Understanding Neurogastroenterology From Neuroimaging Perspective:A Comprehensive Review of Functiona and Structural Brain Imaging in Functional Gastrointestinal Disorders[J]Neurogastroenterol Motil,2018,24(4):512-527.
[16]Babygirija R,Sood M,Kannampalli P,et al.Percutaneous electrica nerve field stimulation modulates central pain pathways and attenuates post-inflammatory visceral and somatic hyperalgesia in rats[J]Neuroscience,2017,356:11-21.
[17]Ahluwalia B,Magnusson MK,?hman L,Mucosal immune system of the gastrointestinal tract:maintaining balance between the good and the bad[J]Scand.J.Gastroenterol,2017,52(11):1185-1193.
[18]Du L,Chen B,Kim JJ.et al.Micro-inflammation in functional dyspepsia A systematic review and meta-analysis[J].Neurogastroenterol Motil,2018,30(4):e13304.
[19]Yuan HP,Li Z,Zhang Y,et al.Anxiety and depression are associated with increased counts and degranulation of duodenal mast cells in functiona dyspepsia[J].Int J Clin Exp Med,2015,8(5):8010-8014.
[20]Cirillo C,Bessissow T,Desmet AS.et al.Evidence for neuronal and structural changes in submucous ganglia of patients with functional dyspepsia[J].Am.JGastroenterol,2015,110(8):1205-1215.
[21]何旭霞,李景南.肠道菌群对脑-肠轴和功能性消化不良的影响[J].胃肠病学,2018,23(10):622-625.
[22]Osadchiy V,Martin CR,Mayer EA.The Gut-Brain Axis and the Microbiome:Mechanisms and Clinical Implications[J].Clin Gastroentero Hepatol,2019,17(2):322-332.
[23]Cenit MC,Sanz Y,Codoner-Franch P.Influence of gut microbiota on neuropsychiatric disorders[J].Word J Gastroenterol,2017,23(30):5486-5498.
[24]Houlden A,Goldrick M,Brough D,et al.Brain injury induces specific changes in the caecal microbiota of mice via altered autonomic activity and mucoprotein production[J].Brain Behav Immun,2016,57:10-20.
[25]Quigley EMM.The Gut-Brain Axis and the Microbiome:Clues to Pathophysiology and Opportunities for Novel Management Strategies in Irritable Bowel Syndrome(IBS)[J].Clin Med,2018,7(1):6.
[26]李勇,贺丹军,魏睦新.功能性消化不良与精神心理因素的相关性及中药的干预作用[J].世界华人消化杂志,2012,(32):3081-3086.
[27]Powell N,Walker MM,Talley NJ.The mucosal immune system:master regulator of bidirectional gut-brain communications[J].Nat Rev Gastroenterol Hepatol,2017,14(3):143-159.
[28]Koloski NA,Jones M,Kalantar J,et al.The brain-gut pathway in functiona gastrointestinal disorders is bidirectional:a 12year prospective populationbased study[J].Gut,2012,61(9):1284-1290.
[29]杨昌妮,刘纯伦.精神心理因素与功能性消化不良的相关性研究进展[J].重庆医学,2015,(15):2129-2131.
[30]Zeng F,Qin W,Yang Y,et al.Regional brain structural abnormality in mealrelated functional dyspepsia patients:a voxel-based morphometry study[J]PLoS One,2013,8(7):e68383.
[31]Liu P,Wang G,Zeng F,et al.Abnormal brain structure implicated in patients with functional dyspepsia[J].Brain Imaging Behav,2018,12(2):459-466.
[2]孙晓红.功能性消化不良的罗马Ⅳ标准解读[J].中华全科医师杂志,2017,16(9):661-663.
[3]Stanghellinii V,Chan FK,Haseler WL,et al.Gastroduodenal Disorders[J].Gast roenterology,2016,150(6):1380-1392.
[4]刘文忠.幽门螺杆菌感染与非溃疡性消化不良[J].现代消化及介入诊疗,2010,15(2):94-97.
[5]Drossman DA.Functional Gastrointestinal Disorders:History Pathophysiology,Clinical Features,and Rome IV[J].Gastroenterolo gy,2016,150(6):1262-1279.
[6]Tack J,Drossman DA.What’s new in Rome IV?[J].Neurogastroenterology Motility,2017,29(9):e13053.
[7]吴时胜,张飞.胃肠动力、功能性疾病的神经胃肠病学研究[J].中国实用神经疾病志,2014,17(5):95-96.
[8]倪敏,丁义江,丁曙晴.神经调节在功能性胃肠病发病中的作用及其研究进展[J].世界华人消化杂志,2011,19(25):2649-2653.
[9]Breit S,Kupferberg A,Rogler G,et al.Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders[J].Front Psychiatry,2018,9:44.
[10]Browning KN,Travagli RA.Central nervous system control of gastrointestinal motility and secretion and modulation of gastrointestina functions[J].Compr Physiol,2014,4(4):1339-1368.
[11]Zheng H,Xu J,Sun X.et al.Electroacupuncture for patients with refractory functional dyspepsia:A randomized controlled trial[J].Neurogastroentero Motil,2018,30(7):e13316.
[12]高飞,刘铁钢,白辰,等.脑肠轴与胃肠动力之间相关性的研究进展[J].天津中医药大学学报,2018,37(6):520-524.
[13]Simren M,Tornblom H,Palsson OS,et al.Visceral hypersensitivity is associated with GI symptom severity in functional GI disorders:consistent findings from five different patient cohorts[J].Gut,2018,67(2):255-262.
[14]Van Oudenhove L,Crowell MD,Drossman DA,et al.Biopsychosocia Aspects of Functional Gastrointestinal Disorder[J].Gastroenterology2016,S0016-5085(16):00218-3.
[15]Kano M,Dupont P,Aziz Q,et al.Understanding Neurogastroenterology From Neuroimaging Perspective:A Comprehensive Review of Functiona and Structural Brain Imaging in Functional Gastrointestinal Disorders[J]Neurogastroenterol Motil,2018,24(4):512-527.
[16]Babygirija R,Sood M,Kannampalli P,et al.Percutaneous electrica nerve field stimulation modulates central pain pathways and attenuates post-inflammatory visceral and somatic hyperalgesia in rats[J]Neuroscience,2017,356:11-21.
[17]Ahluwalia B,Magnusson MK,?hman L,Mucosal immune system of the gastrointestinal tract:maintaining balance between the good and the bad[J]Scand.J.Gastroenterol,2017,52(11):1185-1193.
[18]Du L,Chen B,Kim JJ.et al.Micro-inflammation in functional dyspepsia A systematic review and meta-analysis[J].Neurogastroenterol Motil,2018,30(4):e13304.
[19]Yuan HP,Li Z,Zhang Y,et al.Anxiety and depression are associated with increased counts and degranulation of duodenal mast cells in functiona dyspepsia[J].Int J Clin Exp Med,2015,8(5):8010-8014.
[20]Cirillo C,Bessissow T,Desmet AS.et al.Evidence for neuronal and structural changes in submucous ganglia of patients with functional dyspepsia[J].Am.JGastroenterol,2015,110(8):1205-1215.
[21]何旭霞,李景南.肠道菌群对脑-肠轴和功能性消化不良的影响[J].胃肠病学,2018,23(10):622-625.
[22]Osadchiy V,Martin CR,Mayer EA.The Gut-Brain Axis and the Microbiome:Mechanisms and Clinical Implications[J].Clin Gastroentero Hepatol,2019,17(2):322-332.
[23]Cenit MC,Sanz Y,Codoner-Franch P.Influence of gut microbiota on neuropsychiatric disorders[J].Word J Gastroenterol,2017,23(30):5486-5498.
[24]Houlden A,Goldrick M,Brough D,et al.Brain injury induces specific changes in the caecal microbiota of mice via altered autonomic activity and mucoprotein production[J].Brain Behav Immun,2016,57:10-20.
[25]Quigley EMM.The Gut-Brain Axis and the Microbiome:Clues to Pathophysiology and Opportunities for Novel Management Strategies in Irritable Bowel Syndrome(IBS)[J].Clin Med,2018,7(1):6.
[26]李勇,贺丹军,魏睦新.功能性消化不良与精神心理因素的相关性及中药的干预作用[J].世界华人消化杂志,2012,(32):3081-3086.
[27]Powell N,Walker MM,Talley NJ.The mucosal immune system:master regulator of bidirectional gut-brain communications[J].Nat Rev Gastroenterol Hepatol,2017,14(3):143-159.
[28]Koloski NA,Jones M,Kalantar J,et al.The brain-gut pathway in functiona gastrointestinal disorders is bidirectional:a 12year prospective populationbased study[J].Gut,2012,61(9):1284-1290.
[29]杨昌妮,刘纯伦.精神心理因素与功能性消化不良的相关性研究进展[J].重庆医学,2015,(15):2129-2131.
[30]Zeng F,Qin W,Yang Y,et al.Regional brain structural abnormality in mealrelated functional dyspepsia patients:a voxel-based morphometry study[J]PLoS One,2013,8(7):e68383.
[31]Liu P,Wang G,Zeng F,et al.Abnormal brain structure implicated in patients with functional dyspepsia[J].Brain Imaging Behav,2018,12(2):459-466.