中医临床研究2025，Vol.17Issue(19)：106-110,5.DOI:10.3969/j.issn.1674-7860.2025.19.016
基于脑-肠-微生物轴探讨胃食管反流病的中西医发病机制
Exploring the pathogenesis of gastroesophageal reflux disease based on the brain-gut-microbiota axis from the aspects of both traditional Chinese medicine and Western medicine
摘要
Abstract
Gastroesophageal reflux disease(GERD)is a common digestive disorder with various pathophysiological factors,including abnormal structure and function of anti-reflux barrier,abnormal esophageal mucosal immune response,reduced esophageal clearance,gastrointestinal motility deficiency,and visceral hypersensitivity.Currently,the main treatment method of Western medicine is the application of acid-suppressing drugs,but these drugs show many adverse reactions,and the recurrence rate of the disease is high,leading to suboptimal clinical outcomes.With the emergence of the bio-psycho-social medical model,the role of the brain-gut interaction in the pathogenesis of digestive diseases has become increasingly important.Gastrointestinal flora can secrete cytokines and neurotransmitters,and transmit signals to the central nervous system through neural,endocrine,and immune pathways,thereby affecting the brain.Then,the central nervous system can provide information feedback to the intestine via the autonomic nervous system,and transmit signals to the peripheral enteric nervous system,thus achieving two-way regulation between the center nervous system and the periphery.Recent research has highlighted the significance of the brain-gut-microbiota axis in GERD pathogenesis,in which the imbalance of gastrointestinal microflora is an important pathological link.The imbalance of bacterial flora can lead to esophageal mucosal barrier damage and lower esophageal sphincter relaxation,which will further cause the abnormal anti-reflux structure or trigger inflammatory responses and so on,and affects the regulation function of brain on the periphery,thereby aggravating the injury of esophagus and leading to reflux.Traditional Chinese medicine believes that the pathogenesis of GERD can be summarized as a disorder of impaired stomach function,leading to reversed stomach Qi(气).In this article,combined with traditional Chinese medicine relevant theories,the mechanism of GERD is explored from the perspectives of both Western medicine and traditional Chinese medicine,emphasizing the importance of the brain-gut-microbiota axis in the pathogenesis process of GERD,so as to offer insights for the treatment of GERD in both Western medicine and traditional Chinese medicine.关键词
胃食管反流病/脑-肠-微生物轴/中医Key words
Gastroesophageal reflux disease/Brain-gut-microbiota axis/Traditional Chinese medicine分类
医药卫生引用本文复制引用
王玉凤,徐晓雯,陈婉珍,王震凯..基于脑-肠-微生物轴探讨胃食管反流病的中西医发病机制[J].中医临床研究,2025,17(19):106-110,5.基金项目
国家自然科学基金(82205014) （82205014）
镇江市中医脾胃病临床医学研究中心开放课题(SSPW2022-KF07) （SSPW2022-KF07）
江苏省卫生健康发展研究中心开放课题(JSHD2021025). （JSHD2021025）
