中医药调节黏膜免疫治疗腹泻型肠易激综合征研究进展*

作者：唐钰雯1，唐学贵2

单位：1.川北医学院，四川 南充 637000； 2.川北医学院附属医院，四川 南充 637000

引用：引用：唐钰雯，唐学贵.中医药调节黏膜免疫治疗腹泻型肠易激综合征研究进展[J].中医药导报,2025,31(5):159-165.

DOI：10.13862/j.cn43-1446/r.2025.05.028

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摘要：

腹泻型肠易激综合征（IBS-D）是一种常见的肠功能紊乱性疾病，其具体发病机制尚不完全明确，越来越多的研究发现肠黏膜免疫失衡在其发病中起着不容忽视的作用。基于黏膜免疫总结并探讨了中医药治疗IBS-D的机制，以期为临床治疗IBS-D及相关疾病提供更多思路。中医药不仅能通过干预树突细胞、巨噬细胞、T淋巴细胞、肥大细胞等免疫细胞的活化及功能，下调TLR4/MyD88/NF-κB信号通路，改变下游靶基因的表达，降低肠道内炎症反应，还可以通过调节肠道菌群及其代谢，调控宿主肠道炎症及黏膜免疫。此外，肠黏膜屏障的破坏是黏膜免疫失衡的重要基础，中医药可以通过黏蛋白2、分泌型免疫球蛋白A、紧密连接等靶点改善肠屏障完整性，从而治疗IBS-D。

关键词：腹泻型肠易激综合征；中医药；黏膜免疫；细胞免疫；TLR4/MyD88/NF-κB信号通路；肠道菌群；肠黏膜屏障；综述

Abstract：

Diarrhea-predominant irritable bowel syndrome (IBS-D) is a common intestinal dysfunction disease, and its specific pathogenesis is not fully clear. More and more studies have found that the imbalance of intestinal mucosal immunity plays a non-negligible role in its pathogenesis. Based on mucosal immunity, this paper summarizes and discusses the mechanism of treating IBS-D with traditional Chinese medicine, aiming to provide more ideas for the clinical treatment of IBS-D and related diseases. Traditional Chinese medicine can not only intervene in the activation and functions of immune cells such as dendritic cells, macrophages, T lymphocytes, and mast cells, down-regulate the TLR4/MyD88/NF-κB signaling pathway, change the expression of downstream target genes, and reduce the intestinal inflammatory response, but also regulate the intestinal flora and its metabolism, and control the intestinal inflammation and mucosal immunity of the host. In addition, the destruction of the intestinal mucosal barrier is an important basis for the imbalance of mucosal immunity. Traditional Chinese medicine can improve the integrity of the intestinal barrier through targets such as mucin 2, secretory immunoglobulin A, tight junction and other targets, so as to treat IBS-D.

Key words：diarrhea-predominant irritable bowel syndrome; traditional Chinese medicine; mucosal immunity; cellular immunity; TLR4/MyD88/NF-κB signaling pathway; intestinal flora; intestinal mucosal barrier; review

发布时间：2025-12-31

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