Research progress of Crohn's disease treated with Traditional Chinese and Western Medicine
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摘要: 克罗恩病(Crohn's disease,CD)是一种慢性肉芽肿性肠道炎性疾病,本病具有病程长、易反复、难根除的特点,患病率也不断攀升,严重影响患者的生活质量。鉴于本病治疗的困境,近年来中西医在CD的病因病机和治疗方面取得了较大进展。本文总结近年来CD前沿的治疗方法,如细胞疗法、肠内营养以及中医药、中医外治法。CD是一种复杂的疾病,应进行个性化治疗,本综述的目的在于更新对本病的认识,为CD的临床治疗方案提供新思路。Abstract: Crohn's disease(CD) is a chronic granulomatous inflammatory bowel disease. This disease is characterized by long course, easy relapse and difficult to eradicate, prevalence rates are also rising, seriously affect the quality of life of patients. Because of the difficulty in treating the disease, in recent years, Traditional Chinese and Western Medicine have made great progress in the etiology, pathogenesis and treatment of CD. This article summarizes the treatment methods of CD in recent years, such as cell therapy, enteral nutrition, and Traditional Chinese Medicine, external treatment of Traditional Chinese Medicine. CD is a complex disease, personalized treatment is needed, the purpose of this review is update the understanding of this disease, it provides a new idea for the clinical treatment of CD.
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[1] 黄杨文, 范琳, 刘育梅, 等. 克罗恩病诊断方法的研究进展[J]. 赣南医学院学报, 2022, 42(6): 649-655. https://www.cnki.com.cn/Article/CJFDTOTAL-GNYX202206019.htm
[2] Safarpour AR, Mehrabi M, Keshtkar A, et al. Systematic review and meta-analysis of the incidence and prevalence and 30-year trend of inflammatory bowel diseases in Asia: a study protocol[J]. BMJ Open, 2019, 9(11): e031854. doi: 10.1136/bmjopen-2019-031854
[3] 吴开春, 梁洁, 冉志华, 等. 炎症性肠病诊断与治疗的共识意见(2018年·北京)[J]. 中国实用内科杂志, 2018, 38(9): 796-813.
[4] Lautenschlager SA, Barry MP, Rogler G, et al. Lifestyle factors associated with inflammatory bowel disease: data from the Swiss IBD cohort study[J]. BMC Gastroenterol, 2023, 23(1): 71. doi: 10.1186/s12876-023-02692-9
[5] Vegh Z, Kurti Z, Lakatos PL. Epidemiology of inflammatory bowel diseases from west to east[J]. J Dig Dis, 2017, 18(2): 92-98. doi: 10.1111/1751-2980.12449
[6] Lo CH, Lochhead P, Khalili H. Dietary inflammatory potential and risk of crohn's disease and ulcerative colitis[J]. Gastroenterology, 2020, 159(3): 873-883. e1. doi: 10.1053/j.gastro.2020.05.011
[7] Khalili H, Chan SSM, Lochhead P, et al. The role of diet in the aetiopathogenesis of inflammatory bowel disease[J]. Nat Rev Gastroenterol Hepatol, 2018, 15(9): 525-535. doi: 10.1038/s41575-018-0022-9
[8] 范一宏, 吕宾. 炎性肠疾病研究前沿[J]. 浙江大学学报(医学版), 2019, 48(3): 334-341.
[9] 巫协宁, 吴坚炯. 克罗恩病和自身免疫[J]. 胃肠病学和肝病学杂志, 2018, 27(10): 1081-1085. doi: 10.3969/j.issn.1006-5709.2018.10.001
[10] 巫协宁. 饮食、肠道菌群、免疫等因素在克罗恩病发病机制中的作用[J]. 国际消化病杂志, 2016, 36(6): 325-328.
[11] Li N, Shi RH. Updated review on immune factors in pathogenesis of Crohn's disease[J]. World J Gastroenterol, 2018, 24(1): 15-22. doi: 10.3748/wjg.v24.i1.15
[12] Biragyn A, Ferrucci L. Gut dysbiosis: a potential link between increased cancer risk in ageing and inflammaging[J]. Lancet Oncol, 2018, 19(6): e295-e304. doi: 10.1016/S1470-2045(18)30095-0
[13] 巫协宁. 克罗恩病发病机制的初步探索[J]. 国际消化病杂志, 2017, 37(3): 135-139. doi: 10.3969/j.issn.1673-534X.2017.03.001
[14] Palmela C, Chevarin C, Xu ZL, et al. Adherent-invasive Escherichia coli in inflammatory bowel disease[J]. Gut, 2018, 67(3): 574-587. doi: 10.1136/gutjnl-2017-314903
[15] Lopez-Siles M, Camprubi-Font C, Gomez Del Pulgar EM, et al. Prevalence, abundance, and virulence of adherent-invasive Escherichia coli in ulcerative colitis, colorectal cancer, and coeliac disease[J]. Front Immunol, 2022, 13: 748839. doi: 10.3389/fimmu.2022.748839
[16] Zhang J, Chen SL, Li LB. Correlation between intestinal flora and serum inflammatory factors in patients with Crohn's disease[J]. Eur Rev Med Pharmacol Sci, 2017, 21(21): 4913-4917.
[17] Clemente JC, Manasson J, Scher JU. The role of the gut microbiome in systemic inflammatory disease[J]. BMJ, 2018, 360: j5145.
[18] 邓欢, 刘颖慧, 曹攀, 等. 克罗恩病相关基因的研究进展[J]. 胃肠病学和肝病学杂志, 2018, 27(5): 577-581. doi: 10.3969/j.issn.1006-5709.2018.05.023
[19] Yang EP, Shen J. The roles and functions of Paneth cells in Crohn's disease: a critical review[J]. Cell Prolif, 2021, 54(1): e12958.
[20] Verstockt B, Smith KG, Lee JC. Genome-wide association studies in Crohn's disease: past, present and future[J]. Clin Transl Immunology, 2018, 7(1): e1001. doi: 10.1002/cti2.1001
[21] Tawfik A, Knight P, Duckworth CA, et al. Replication of crohn's disease mucosal E. coli isolates inside macrophages correlates with resistance to superoxide and is dependent on macrophage NF-kappa B activation[J]. Pathogens, 2019, 8(2): 74. doi: 10.3390/pathogens8020074
[22] Wu WKK, Sun R, Zuo T, et al. A novel susceptibility locus in MST1 and gene-gene interaction network for Crohn's disease in the Chinese population[J]. J Cell Mol Med, 2018, 22(4): 2368-2377. doi: 10.1111/jcmm.13530
[23] Liu JZ, van Sommeren S, Huang HL, et al. Association analyses identify 38 susceptibility loci for inflammatory bowel disease and highlight shared genetic risk across populations[J]. Nat Genet, 2015, 47(9): 979-986. doi: 10.1038/ng.3359
[24] 王木岭, 万苹, 李娅琳, 等. 克罗恩病发病机制及其药物治疗的研究进展[J]. 中国医院药学杂志, 2020, 40(17): 1891-1895.
[25] 刘伟. 益生菌联合美沙拉嗪治疗炎症性肠病患者的效果[J]. 中国医药指南, 2022, 20(2): 102-104, 108.
[26] 葛均波, 徐永健, 王辰. 内科学[M]. 9版. 北京: 人民卫生出版社, 2018: 377-380.
[27] Mantzaris GJ. Thiopurines and methotrexate use in IBD patients in a biologic era[J]. Curr Treat Options Gastro, 2017, 15(1): 84-104. doi: 10.1007/s11938-017-0128-0
[28] 罗立姣. 克罗恩病患者应用英夫利昔单抗治疗后的感染风险及相关因素分析[D]. 南京: 南京中医药大学, 2020.
[29] 杨婷婷, 孟立娜. 乌司奴单抗用于克罗恩病治疗的研究进展[J]. 国际消化病杂志, 2022, 42(1): 9-12.
[30] Einwächter H. Current concepts of pharmacotherapy in crohn's disease[J]. Visc Med, 2019, 35(6): 344-347. doi: 10.1159/000504101
[31] Hernanz N, Sierra M, Volpato N, et al. Autologous haematopoietic stem cell transplantation in refractory Crohn's disease: Experience in our centre[J]. Gastroenterol Hepatol, 2019, 42(1): 16-22. doi: 10.1016/j.gastrohep.2018.08.004
[32] Delemarre EM, van den Broek T, Mijnheer G, et al. Autologous stem cell transplantation aids autoimmune patients by functional renewal and TCR diversification of regulatory T cells[J]. Blood, 2016, 127(1): 91-101. doi: 10.1182/blood-2015-06-649145
[33] 王雪. 粪菌移植治疗克罗恩病的疗效及相关因素的Meta分析[D]. 济南: 山东大学, 2020.
[34] 蔡弘, 余绪超, 肖慧荣, 等. 基于CiteSpace的近年来国内克罗恩病治疗可视化分析[J]. 中国现代医生, 2022, 60(29): 22-26.
[35] 朱维铭, 胡品津, 龚剑峰. 炎症性肠病营养支持治疗专家共识(2013·深圳)[J]. 胃肠病学, 2015, 20(2): 97-105.
[36] 陈延, 张北平. 克罗恩病[M]. 北京: 科学出版社, 2020: 4-19.
[37] 谭毅, 蔡海荣, 赵帅, 等. 基于虚、毒、浊、瘀论治克罗恩病理论探讨[J]. 新中医, 2022, 54(14): 189-192. https://www.cnki.com.cn/Article/CJFDTOTAL-REND202214042.htm
[38] 费梦雪, 吴正祥, 方华蓥, 等. 克罗恩病患者的凝血指标变化情况研究[J]. 临床医学研究与实践, 2020, 5(1): 84-86.
[39] 罗曌, 宾东华, 王爱华. 王爱华教授辨治克罗恩病经验[J]. 亚太传统医药, 2021, 17(5): 101-103.
[40] 黄智斌, 刘奇, 刘刚, 等. 从整合医学角度探讨克罗恩病中医发病机制[J]. 医学与哲学, 2018, 39(9): 71-75.
[41] 江海燕, 刘果, 王建云, 等. 基于阳虚致瘀理论探讨克罗恩病的治疗思路[J]. 环球中医药, 2022, 15(5): 866-869. https://www.cnki.com.cn/Article/CJFDTOTAL-HQZY202205030.htm
[42] 李乾构, 周学文, 单兆伟. 中医消化病诊疗指南[M]. 北京: 中国中医药出版社, 2006: 33-37.
[43] 李悠然, 谷云飞. 谷云飞教授中西医结合诊治克罗恩病肛瘘临证经验[J]. 现代中西医结合杂志, 2022, 31(4): 546-549. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH202204023.htm
[44] 赵梦瑜, 王凯, 吕玲, 等. 张伯礼教授治疗克罗恩病验案一例[J]. 天津中医药大学学报, 2019, 38(1): 6-8. https://www.cnki.com.cn/Article/CJFDTOTAL-TZYY201901002.htm
[45] 莫黎, 谢彪, 何永恒. 何永恒教授论治克罗恩病经验[J]. 湖南中医药大学学报, 2021, 41(9): 1418-1421.
[46] 刘书贤, 买振江, 赵爱妮. 四君子汤治疗中医内科疾病脾胃气虚证的临床效果[J]. 临床医学研究与实践, 2022, 7(29): 150-153.
[47] 袁红昌, 卢乙众. 基于网络药理学探讨四君子汤治疗克罗恩病的作用机制[J]. 新中医, 2022, 54(5): 14-22. https://www.cnki.com.cn/Article/CJFDTOTAL-REND202205052.htm
[48] 诸猜猜, 伍静, 毛坤洪, 等. 张小萍治疗克罗恩病经验举隅[J]. 江西中医药, 2022, 53(3): 29-30.
[49] 袁红昌, 逯中民, 陈颖, 等. 基于网络药理学分析痛泻要方治疗克罗恩病的作用机制[J]. 中国合理用药探索, 2021, 18(3): 29-34. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYS202103007.htm
[50] 盛好, 拉扎提·巴合提, 徐杰, 等. 健脾祛湿方联合美沙拉嗪治疗克罗恩病疗效观察[J]. 西部中医药, 2022, 35(1): 115-118.
[51] 陈聪, 李品, 彭莉, 等. 国医大师王琦从"脾胃外感"论治克罗恩病验案一则[J]. 环球中医药, 2018, 11(5): 720-721. https://www.cnki.com.cn/Article/CJFDTOTAL-HQZY201805021.htm
[52] 林晋濠, 张淼, 兰美华. 附桂健脾方联合隔药灸治疗克罗恩病38例[J]. 环球中医药, 2021, 14(7): 1336-1339. https://www.cnki.com.cn/Article/CJFDTOTAL-HQZY202107041.htm
[53] 林志宾, 郑明岚. 基于数据挖掘中药治疗克罗恩病的用药规律分析[J]. 中医临床研究, 2022, 14(21): 7-11. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYLY202221003.htm
[54] 祁琴, 王晓梅, 吴焕淦, 等. 针灸对克罗恩病大鼠低氧环境下结肠DNA甲基转移酶的影响[J]. 世界中医药, 2022, 17(3): 317-322.
[55] 樊雨倩, 袁思成, 王和生. 针灸对肠道黏膜屏障保护机制的研究进展[J]. 湖南中医杂志, 2022, 38(1): 184-187. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZO202201047.htm
[56] 谢文松, 魏录翠, 王金周, 等. 针刺联合中药治疗溃疡性结肠炎疗效及对相关指标的影响[J]. 上海针灸杂志, 2019, 38(4): 378-383. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZJ201904006.htm
[57] 罗春艳, 韩韬. 艾灸治疗胃肠疾病的研究进展[J]. 中医药临床杂志, 2022, 34(10): 1980-1984.
[58] 陈俊余, 王剑, 程丽敏. 穴位贴敷配合药物治疗湿热内蕴型溃疡性结肠炎疗效观察[J]. 上海针灸杂志, 2018, 37(10): 1144-1147. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZJ201810009.htm
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