Page 71 - 《中国药房》2024年13期
P. 71
痛泻要方通过调控肠道菌群-ENS-MM串扰减轻IBS-D结肠运动
亢进的机制研究
Δ
＊
#
彭 龙 ，马佳乐，尹艺璇，步 曦，赵双梅（天津中医药大学第二附属医院消化科，天津 300250）
中图分类号 R965 文献标志码 A 文章编号 1001-0408（2024）13-1605-07
DOI 10.6039/j.issn.1001-0408.2024.13.11
摘 要 目的 探讨痛泻要方通过调控肠道菌群-肠神经系统（ENS）-肌层巨噬细胞（MM）串扰减轻腹泻型肠易激综合征（IBS-D）
大鼠结肠运动亢进的作用机制。方法 将40只新生雄性SD大鼠随机分为对照组、模型组、中药组[痛泻要方2.68 g/（kg·d），以生药
量计]、阳性对照组[双歧杆菌乳杆菌三联活菌片0.27 g/（kg·d）]，每组10只。除对照组外，其余3组大鼠均采用母子分离+慢性束
缚+番泻叶致泻法复制肝郁脾虚证型IBS-D模型。造模后，各药物组大鼠灌胃相应药液，每天1次，持续2周。于造模结束时和给
药后观察各组大鼠的粪便性质（稀便出现率、稀便率）、结肠运动功能（小球排出时间）、内脏敏感性[不同压力下的腹部回缩反射
（AWR）评分]；于给药后检测各组大鼠血清脂多糖（LPS）浓度，结肠组织中骨形态生成蛋白2（BMP2）、集落刺激因子1（CSF1）、Toll
样受体4（TLR4）蛋白的表达和分布情况，以及肠道菌群的多样性、物种组成及差异。结果 造模结束时，除对照组外的其余3组大
鼠均 100% 出现稀便，稀便率和各压力下的 AWR 评分均较对照组显著升高，小球排出时间均较对照组显著缩短（P＜0.01 或 P＜
0.05）。中药组和阳性对照组大鼠的稀便出现率分别为20%、80%；中药组大鼠稀便率、各压力下的AWR评分、血清LPS浓度和结
肠组织肌层中CSF1、TLR4蛋白的表达均较模型组显著降低；小球排出时间，结肠组织肌层中BMP2蛋白的平均光密度，Chao 1、
Shannon、Faith’s PD、Simpson均较模型组显著延长或升高（P＜0.01或P＜0.05）；厚壁菌门/拟杆菌门相对丰度比值由低到高依次
为中药组、对照组、阳性对照组、模型组，中药组大鼠的肠道菌群物种组成更贴近于对照组，其优势菌属包括普雷沃氏菌属、布劳特
氏菌属等。结论 痛泻要方能通过调节肠道菌群来调控肠道菌群-ENS-MM串扰关键蛋白BMP2、CSF1的表达，从而发挥减轻IBS-
D大鼠结肠运动亢进的作用。
关键词 痛泻要方；腹泻型肠易激综合征；肝郁脾虚证型；肠道菌群-ENS-MM串扰；骨形态发生蛋白2；集落刺激因子1
Mechanism of Tongxie yaofang reducing colon hypermotility in IBS-D rats by regulating gut microbiota-
ENS-MM crosstalk
PENG Long，MA Jiale，YIN Yixuan，BU Xi，ZHAO Shuangmei（Dept. of Gastroenterology， the Second Affiliated
Hospital of Tianjin University of Traditional Chinese Medicine， Tianjin 300250， China）
ABSTRACT OBJECTIVE To study the effects of Tongxie yaofang reducing colon hypermotility in irritable bowel syndrome
with diarrhea （IBS-D） rats by regulating gut microbiota-enteric nervous system （ENS）-muscularis macrophages （MM） crosstalk.
METHODS Forty newborn male SD rats were randomly divided into control group， model group， TCM group [Tongxie yaofang
2.68 g/（kg·d）， calculated by raw material]， and positive control group [Live combined bifidobacterium and lactobacillus tablets
0.27 g/（kg·d）]， with 10 rats in each group. Except for the control group， the IBS-D model of liver stagnation and spleen
deficiency syndrome was induced in the other 3 groups with the method of mother-child separation+chronic restraint+Folium Sennae-
induced diarrhea. After modeling， the administration groups were given relevant drug liquid intragastrically， once a day， for
consecutive 2 weeks. At the end of modeling and after administration， the fecal properties （the incidence and the rate of loose
stools）， colonic motility （colon emptying time）， and visceral sensitivity [abdominal withdrawal reflex （AWR） scores under
different pressures] of rats were observed in each group. The concentration of lipopolysaccharide （LPS） in serum was detected after
medication， and the expressions and distribution of bone morphogenetic protein 2 （BMP2）， colony stimulating factor 1 （CSF1）
and Toll-like receptor 4 （TLR4） in colon tissue were detected； the diversity， species composition and differences of gut microbiota
were also determined. RESULTS At the end of modeling， compared with the control group， all rats of the other three groups
suffered from loose stools （100%）， the rate of loose stools and AWR scores at different pressures increased significantly， and colon
emptying time was shortened significantly （P＜0.01 or P＜0.05）. The incidences of loose stools were 20% in TCM group and 80%
in the positive control group； the rate of loose stools and AWR scores at different pressures， serum concentration of LPS and
protein expressions of CSF1 and TLR4 in muscle layer of colon tissue in TCM group significantly decreased， compared with the
model group； colon emptying time， the average optical
density of BMP2 protein in muscle layer of colon tissue， and
Δ 基金项目 天津市教委科研计划项目（No.2021KJ152）
＊第一作者 主治医师。研究方向：中医药防治慢性脾胃病。 the indexes of Chao 1， Shannon and Faith’s PD and Simpson
E-mail：772699670@qq.com index of rats in TCM group were all prolonged or increased
# 通信作者 主任医师。研究方向：中医药防治功能性胃肠病。 significantly， compared with the model group （P＜0.01 or P＜
E-mail：aiwangzi312@163.com 0.05）. The relative abundance ratio of Firmicutes/
中国药房 2024年第35卷第13期 China Pharmacy 2024 Vol. 35 No. 13 · 1605 ·
