Research progress of gastroesophageal reflux disease with depression based on "brain intestine bacteria axis"
-
摘要: 胃食管反流病是由于食管下括约肌压力降低、短暂和过度的食管下括约肌松弛、黏膜屏障损伤等因素导致胃内容物反流造成食管和食管外不适的一种疾病，目前胃食管反流病的患病率逐年增加，且往往伴有焦虑、抑郁症状。质子泵抑制剂以及抗焦虑抑郁药物是现在治疗此病的首选治疗方案，但效果不尽人意。近年来研究发现，脑-肠-菌轴与胃食管反流病、抑郁症密切相关，肠道菌群可以导致情志的改变，加重胃食管反流病，中医认为胃食管反流病伴抑郁主要与肝、脾密切相关，从肝、脾之气机入手，中医药治疗可以良性调节治疗胃食管反流病伴抑郁症状，且还可维护肠道内环境的稳态和菌群的种类及丰度，改变胃肠道相关激素的水平。本文旨在从中医病因病机、脑-肠-菌轴作用机制探讨胃食管反流病伴抑郁的发病机制，收集整理近年来肠道菌群以及中医药对胃食管反流病的治疗方式及效果，为未来胃食管反流病的研究提供参考。Abstract: Gastroesophageal reflux disease(GERD) is a disease of esophagus and extraesophageal discomfort caused by reflux of gastric contents due to lower esophageal sphincter pressure reduction, transient and excessive lower esophageal sphincter relaxation, mucosal barrier damage and other factors. At present, the prevalence of GERD is increasing year by year, and often accompanied by anxiety and depression symptoms. Proton pump inhibitors and anti-anxiety and depression drugs are the first choice for the treatment of this disease, but the effect is not satisfactory. In recent years, studies have found that the brain gut microbiota axis is closely related to GERD and depression. Intestinal flora can lead to emotional changes and aggravate GERD. Traditional Chinese Medicine believes that GERD with depression is closely related to the liver and spleen. Starting with the qi mechanism of the liver and spleen, Traditional Chinese Medicine treatment can benign regulate and treat GERD with depression symptoms, maintain the stability of the intestinal environment, the types and abundance of flora, and change the levels of gastrointestinal hormones. The purpose of this paper is to explore the pathogenesis of GERD with depression from the etiology and pathogenesis of Traditional Chinese Medicine and the action mechanism of brain gut microbiota axis, collect and sort out the intestinal flora in recent years and the treatment of GERD with Traditional Chinese Medicine, and provide reference for the future research of GERD.
-
-
[1] Clarrett DM, Hachem C. Gastroesophageal reflux disease(GERD)[J]. Mo Med, 2018, 115(3): 214-218.
[2] Richter JE, Rubenstein JH. Presentation and epidemiology of gastroesophageal reflux disease[J]. Gastroenterology, 2018, 154(2): 267-276. doi: 10.1053/j.gastro.2017.07.045
[3] Diaz LI, Mony S, Klapman J. Narrative review of the role of gastroenterologist in the diagnosis, treatment and palliation in gastric and gastroesophageal cancer[J]. Ann Transl Med, 2020, 8(17): 1106. doi: 10.21037/atm-20-4143
[4] Zheng Z, Shang YX, Wang N, et al. Current advancement on the dynamic mechanism of gastroesophageal reflux disease[J]. Int J Biol Sci, 2021, 17(15): 4154-4164. doi: 10.7150/ijbs.65066
[5] Sandhu DS, Fass R. Current trends in the management of gastroesophageal reflux disease[J]. Gut Liver, 2018, 12(1): 7-16. doi: 10.5009/gnl16615
[6] Münch NS, Fang HY, Ingermann J, et al. High-fat diet accelerates carcinogenesis in a mouse model of barrett's esophagus via interleukin 8 and alterations to the gut microbiome[J]. Gastroenterology, 2019, 157(2): 492-506. e2. doi: 10.1053/j.gastro.2019.04.013
[7] 周肸, 钱海华, 张丹, 等. 基于肠道菌群与脑肠轴的相互作用机理探讨中医脑肠学说[J]. 中华中医药学刊, 2020, 38(3): 119-122. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS202003033.htm
[8] 刘翠, 贺倩, 王婷, 等. 基于"脑肠菌轴"的中药调节胃肠功能的研究进展[J]. 广东药科大学学报, 2021, 37(1): 154-158. https://www.cnki.com.cn/Article/CJFDTOTAL-GDYX202101040.htm
[9] 聂玉婷, 高利. 基于肠道菌群失调探讨脑系疾病从脾胃论治[J]. 中国中西医结合杂志, 2019, 39(11): 1390-1394. doi: 10.7661/j.cjim.20191012.328
[10] 程越, 王彩霞, 于漫, 等. 基于脑肠轴理论探讨从脾胃论治老年性痴呆科学内涵[J]. 辽宁中医药大学学报, 2021, 23(1): 129-132.
[11] 李军祥, 陈誩, 李岩. 胃食管反流病中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志, 2018, 26(3): 221-226, 232. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXPW201803001.htm
[12] 石啸双, 尹晓岚, 段园志, 等. 从脾虚角度探讨胃食管反流病的诊治[J]. 新中医, 2018, 50(6): 215-217. https://www.cnki.com.cn/Article/CJFDTOTAL-REND201806065.htm
[13] Rutsch A, Kantsjo JB, Ronchi F. The gut-brain axis: how microbiota and host inflammasome influence brain physiology and pathology[J]. Front Immunol, 2020, 11: 604179. doi: 10.3389/fimmu.2020.604179
[14] Dicks LMT. Gut bacteria and neurotransmitters[J]. Microorganisms, 2022, 10(9): 1838. doi: 10.3390/microorganisms10091838
[15] Margolis KG, Cryan JF, Mayer EA. The microbiota-gut-brain axis: from motility to mood[J]. Gastroenterology, 2021, 160(5): 1486-1501. doi: 10.1053/j.gastro.2020.10.066
[16] Wei DN, Zhao YF, Zhang MM, et al. The volatile oil of Zanthoxylum bungeanum pericarp improved the hypothalamic-pituitary-adrenal axis and gut microbiota to attenuate chronic unpredictable stress-induced anxiety behavior in rats[J]. Drug Des Dev Ther, 2021, 15: 769-786. doi: 10.2147/DDDT.S281575
[17] DeMorrow S. Role of the hypothalamic-pituitary-adrenal axis in health and disease[J]. Int J Mol Sci, 2018, 19(4): 986. doi: 10.3390/ijms19040986
[18] Clark A, Mach N. Exercise-induced stress behavior, gut-microbiota-brain axis and diet: a systematic review for athletes[J]. J Int Soc Sports Nutr, 2016, 13: 43. doi: 10.1186/s12970-016-0155-6
[19] Zajkowska Z, Gullett N, Walsh A, et al. Cortisol and development of depression in adolescence and young adulthood-a systematic review and meta-analysis[J]. Psychoneuroendocrinology, 2022, 136: 105625. doi: 10.1016/j.psyneuen.2021.105625
[20] Oligschlaeger Y, Yadati T, Houben T, et al. Inflammatory bowel disease: a stressed "gut/feeling"[J]. Cells, 2019, 8(7): 659. doi: 10.3390/cells8070659
[21] Tache Y, Larauche M, Yuan PQ, et al. Brain and gut CRF signaling: biological actions and role in the gastrointestinal tract[J]. Curr Mol Pharmacol, 2018, 11(1): 51-71.
[22] Ng QX, Soh AYS, Loke W, et al. The role of inflammation in irritable bowel syndrome(IBS)[J]. J Inflamm Res, 2018, 11: 345-349. doi: 10.2147/JIR.S174982
[23] Lach G, Schellekens H, Dinan TG, et al. Anxiety, depression, and the microbiome: a role for gut peptides[J]. Neurotherapeutics, 2018, 15(1): 36-59. doi: 10.1007/s13311-017-0585-0
[24] Tack J, Verbeure W, Mori H, et al. The gastrointestinal tract in hunger and satiety signalling[J]. UEG J, 2021, 9(6): 727-734. doi: 10.1002/ueg2.12097
[25] Diz-Chaves Y, Herrera-Pérez S, González-Matías LC, et al. Glucagon-like peptide-1(GLP-1) in the integration of neural and endocrine responses to stress[J]. Nutrients, 2020, 12(11): 3304. doi: 10.3390/nu12113304
[26] Martin AM, Sun EW, Keating DJ. Mechanisms controlling hormone secretion in human gut and its relevance to metabolism[J]. J Endocrinol, 2019, 244(1): R1-R15.
[27] Hou XQ, Rong CP, Wang FG, et al. GABAergic system in stress: implications of GABAergic neuron subpopulations and the gut-vagus-brain pathway[J]. Neural Plast, 2020, 2020: 8858415.
[28] Holzer P, Reichmann F, Farzi A. Neuropeptide Y, peptide YY and pancreatic polypeptide in the gut-brain axis[J]. Neuropeptides, 2012, 46(6): 261-274. doi: 10.1016/j.npep.2012.08.005
[29] Deng YQ, Pan L, Qian WJ. Associations between the severity of reflux esophagitis in children and changes in oxidative stress, serum inflammation, vasoactive intestinal peptide and motilin[J]. Exp Ther Med, 2019, 18(5): 3509-3513.
[30] Sun LJ, Li JN, Nie YZ. Gut hormones in microbiota-gut-brain cross-talk[J]. Chin Med J(Engl), 2020, 133(7): 826-833.
[31] Hunne B, Stebbing MJ, McQuade RM, et al. Distributions and relationships of chemically defined enteroendocrine cells in the rat gastric mucosa[J]. Cell Tissue Res, 2019, 378(1): 33-48. doi: 10.1007/s00441-019-03029-3
[32] Roth W, Zadeh K, Vekariya R, et al. Tryptophan metabolism and gut-brain homeostasis[J]. Int J Mol Sci, 2021, 22(6): 2973. doi: 10.3390/ijms22062973
[33] Nennstiel S, Bajbouj M, Schmid RM, et al. Prucalopride reduces the number of reflux episodes and improves subjective symptoms in gastroesophageal reflux disease: a case series[J]. J Med Case Rep, 2014, 8: 34. doi: 10.1186/1752-1947-8-34
[34] Karayol R, Medrihan L, Warner-Schmidt JL, et al. Serotonin receptor 4 in the hippocampus modulates mood and anxiety[J]. Mol Psychiatry, 2021, 26(6): 2334-2349. doi: 10.1038/s41380-020-00994-y
[35] Bhatt S, Devadoss T, Manjula SN, et al. 5-HT receptor antagonism a potential therapeutic approach for the treatment of depression and other disorders[J]. Curr Neuropharmacol, 2021, 19(9): 1545-1559. doi: 10.2174/1570159X18666201015155816
[36] Engevik MA, Luck B, Visuthranukul C, et al. Human-derived Bifidobacterium dentium modulates the mammalian serotonergic system and gut-brain axis[J]. Cell Mol Gastroenterol Hepatol, 2021, 11(1): 221-248. doi: 10.1016/j.jcmgh.2020.08.002
[37] Ganci M, Suleyman E, Butt H, et al. The role of the brain-gut-microbiota axis in psychology: the importance of considering gut microbiota in the development, perpetuation, and treatment of psychological disorders[J]. Brain Behav, 2019, 9(11): e01408.
[38] D'Souza SM, Houston K, Keenan L, et al. Role of microbial dysbiosis in the pathogenesis of esophageal mucosal disease: a paradigm shift from acid to bacteria?[J]. World J Gastroenterol, 2021, 27(18): 2054-2072. doi: 10.3748/wjg.v27.i18.2054
[39] Duan XY, Chen P, Xu XX, et al. Role of gastric microorganisms other than Helicobacter pylori in the development and treatment of gastric diseases[J]. Biomed Res Int, 2022, 2022: 6263423.
[40] Selling J, Swann P, Madsen LR 2nd, et al. Improvement in gastroesophageal reflux symptoms from a food-grade maltosyl-isomaltooligosaccharide soluble fiber supplement: a case series[J]. Integr Med(Encinitas), 2018, 17(5): 40-42.
[41] Liang S, Wu XL, Hu X, et al. Recognizing depression from the Microbiota Gut Brain axis[J]. Int J Mol Sci, 2018, 19(6): 1592. doi: 10.3390/ijms19061592
[42] Zhao Y, Li Y, Hu J, et al. The Effect of Helicobacter pylori Eradication in Patients with Gastroesophageal Reflux Disease: A Meta-Analysis of Randomized Controlled Studies[J]. Dig Dis, 2020, 38(4): 261-268. doi: 10.1159/000504086
[43] Hsu PI, Pan CY, Kao JY, et al. Helicobacter pylori eradication with bismuth quadruple therapy leads to dysbiosis of gut microbiota with an increased relative abundance of Proteobacteria and decreased relative abundances of Bacteroidetes and Actinobacteria[J]. Helicobacter, 2018, 23(4): e12498. doi: 10.1111/hel.12498
[44] Jang SH, Woo YS, Lee SY, et al. The brain-gut-microbiome axis in psychiatry[J]. Int J Mol Sci, 2020, 21(19): 7122. doi: 10.3390/ijms21197122
[45] Peter J, Fournier C, Durdevic M, et al. A microbial signature of psychological distress in irritable bowel syndrome[J]. Psychosom Med, 2018, 80(8): 698-709. doi: 10.1097/PSY.0000000000000630
[46] Du Y, Gao XR, Peng L, et al. Crosstalk between the microbiota-gut-brain axis and depression[J]. Heliyon, 2020, 6(6): e04097. doi: 10.1016/j.heliyon.2020.e04097
[47] Li NN, Wang Q, Wang Y, et al. Fecal microbiota transplantation from chronic unpredictable mild stress mice donors affects anxiety-like and depression-like behavior in recipient mice via the gut microbiota-inflammation-brain axis[J]. Stress, 2019, 22(5): 592-602. doi: 10.1080/10253890.2019.1617267
[48] Yoo JY, Groer M, Dutra SVO, et al. Gut microbiota and immune system interactions[J]. Microorganisms, 2020, 8(10): 1587. doi: 10.3390/microorganisms8101587
[49] Heym N, Heasman BC, Hunter K, et al. The role of microbiota and inflammation in self-judgement and empathy: implications for understanding the brain-gut-microbiome axis in depression[J]. Psychopharmacology, 2019, 236(5): 1459-1470. doi: 10.1007/s00213-019-05230-2
[50] Zhang CX, Wang HY, Chen TX. Interactions between intestinal microflora/probiotics and the immune system[J]. Biomed Res Int, 2019, 2019: 6764919.
[51] De Luca F, Shoenfeld Y. The microbiome in autoimmune diseases[J]. Clin Exp Immunol, 2019, 195(1): 74-85.
[52] Meng CT, Bai CM, Brown TD, et al. Human gut microbiota and gastrointestinal cancer[J]. Genomics Proteomics Bioinformatics, 2018, 16(1): 33-49. doi: 10.1016/j.gpb.2017.06.002
[53] Cheng J, Ouwehand AC. Gastroesophageal reflux disease and probiotics: a systematic review[J]. Nutrients, 2020, 12(1): 132. doi: 10.3390/nu12010132
[54] Belei O, Olariu L, Dobrescu A, et al. Is it useful to administer probiotics together with proton pump inhibitors in children with gastroesophageal reflux?[J]. J Neurogastroenterol Motil, 2018, 24(1): 51-57. doi: 10.5056/jnm17059
[55] Salleh RM, Kuan G, Aziz MNA, et al. Effects of probiotics on anxiety, stress, mood and fitness of badminton players[J]. Nutrients, 2021, 13(6): 1783. doi: 10.3390/nu13061783
[56] Yadav MK, Kumari I, Singh B, et al. Probiotics, prebiotics and synbiotics: safe options for next-generation therapeutics[J]. Appl Microbiol Biotechnol, 2022, 106(2): 505-521. doi: 10.1007/s00253-021-11646-8
[57] Kaur AP, Bhardwaj S, Dhanjal DS, et al. Plant prebiotics and their role in the amelioration of diseases[J]. Biomolecules, 2021, 11(3): 440. doi: 10.3390/biom11030440
[58] Beckett JM, Singh NK, Phillips J, et al. Anti-heartburn effects of sugar cane flour: a double-blind, randomized, placebo-controlled study[J]. Nutrients, 2020, 12(6): 1813. doi: 10.3390/nu12061813
[59] Marco ML, Sanders ME, Gänzle M, et al. The International Scientific Association for Probiotics and Prebiotics(ISAPP)consensus statement on fermented foods[J]. Nat Rev Gastroenterol Hepatol, 2021, 18(3): 196-208. doi: 10.1038/s41575-020-00390-5
[60] Kvakova M, Bertkova I, Stofilova J, et al. Co-encapsulated synbiotics and immobilized probiotics in human health and gut microbiota modulation[J]. Foods, 2021, 10(6): 1297. doi: 10.3390/foods10061297
[61] Krumbeck JA, Rasmussen HE, Hutkins RW, et al. Probiotic Bifidobacterium strains and galactooligosaccharides improve intestinal barrier function in obese adults but show no synergism when used together as synbiotics[J]. Microbiome, 2018, 6(1): 121. doi: 10.1186/s40168-018-0494-4
[62] Xu WT, Xu LM, Xu CF. Relationship between Helicobacter pylori infection and gastrointestinal microecology[J]. Front Cell Infect Microbiol, 2022, 12: 938608. doi: 10.3389/fcimb.2022.938608
[63] Lv J, Guo L, Liu JJ, et al. Alteration of the esophageal microbiota in barrett's esophagus and esophageal adenocarcinoma[J]. World J Gastroenterol, 2019, 25(18): 2149-2161. doi: 10.3748/wjg.v25.i18.2149
[64] Horvath A, Leber B, Feldbacher N, et al. The effects of a multispecies synbiotic on microbiome-related side effects of long-term proton pump inhibitor use: a pilot study[J]. Sci Rep, 2020, 10(1): 2723.
[65] 周佩琳, 刘万里, 杨璐, 等. 难治性胃食管反流病中医药研究进展[J]. 辽宁中医药大学学报, 2020, 22(8): 217-220. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB202008056.htm
[66] 徐洪远, 朱晨柳, 梁雪. 中医药治疗胃食管反流病研究进展[J]. 辽宁中医药大学学报, 2021, 23(10): 186-189.
[67] 朱淑云, 瞿兵, 谭远忠. 丹栀逍遥散合左金丸加减治疗肝胃郁热型胃食管反流病的疗效以及对胃肠激素水平的影响[J]. 辽宁中医杂志, 2021, 48(4): 92-95. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY202104029.htm
[68] 王玥, 乔会侠, 贾乐乐, 等. 温胆汤联合针刺督脉背段胸椎棘突下阳性反应点对非糜烂性胃食管反流病合并焦虑抑郁患者自主神经功能及生活质量的影响[J]. 现代中西医结合杂志, 2021, 30(18): 1995-1999. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH202118014.htm
[69] 杨璐, 刘万里, 颜延凤, 等. 通降合剂对大鼠单纯性胃食管反流模型脑-肠轴的影响[J]. 上海中医药杂志, 2018, 52(12): 96-100. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZZ201812028.htm
[70] 张辉凯, 罗宏伟, 张亚静. 半夏厚朴汤加减联合奥美拉唑对痰气郁结型胃食管反流患者的临床疗效[J]. 中成药, 2021, 43(11): 3019-3023.
-
计量
- 文章访问数: 959
- PDF下载数: 412
- 施引文献: 0
下载: