1.辽宁中医药大学研究生学院,沈阳 110847
2.辽宁中医药大学附属第三医院肛肠科,沈阳 110005
Received:14 October 2025,
Revised:2025-12-22,
Accepted:30 December 2025,
Published:30 January 2026
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孔祥瑞,张齐猛,邹跃,等.基于肠道菌群-胆汁酸轴的中医药治疗功能性便秘机制研究进展 [J].中国药房,2026,37(02):244-249.
KONG Xiangrui,ZHANG Qimeng,ZOU Yue,et al.Research progress on the mechanisms of traditional Chinese medicine in treating functional constipation based on the gut microbiota-bile acid axis[J].ZHONGGUO YAOFANG,2026,37(02):244-249.
孔祥瑞,张齐猛,邹跃,等.基于肠道菌群-胆汁酸轴的中医药治疗功能性便秘机制研究进展 [J].中国药房,2026,37(02):244-249. DOI: 10.6039/j.issn.1001-0408.2026.02.19.
KONG Xiangrui,ZHANG Qimeng,ZOU Yue,et al.Research progress on the mechanisms of traditional Chinese medicine in treating functional constipation based on the gut microbiota-bile acid axis[J].ZHONGGUO YAOFANG,2026,37(02):244-249. DOI: 10.6039/j.issn.1001-0408.2026.02.19.
功能性便秘(FC)是一种常见的肠道功能紊乱性疾病,主要表现为排便次数减少、排便困难、排便不尽感及粪便干结等症状,严重影响患者的生活质量。研究表明,FC的发病机制与肠道菌群紊乱和胆汁酸分泌异常密切相关。胆汁酸作为内源性天然泻药,通过促进结肠分泌与调节肠道运动发挥通便作用;而肠道菌群则可通过调节肠神经系统、免疫系统及其代谢产物影响结肠传导功能。本文在概述肠道菌群与胆汁酸代谢关系的基础上,系统综述了中医药通过调控肠道菌群-胆汁酸轴的平衡治疗FC机制的研究现状,发现单味中药(如白术)、中药单体(如桔梗多糖)、中药复方(如上二黄丸)、针刺、艾灸均能通过上调益生菌丰度,重塑菌群结构,纠正胆汁酸代谢,激活武田G蛋白偶联受体5/法尼醇X受体通路从而治疗FC。
Functional constipation (FC) is a common functional disorder of the intestines, mainly characterized by reduced bowel movement frequency, difficulty in defecation, a sensation of incomplete evacuation, and hard stools, which severely affect patients’ quality of life. Research indicates that the pathogenesis of FC is closely related to gut microbiota dysbiosis and abnormal bile acid secretion. Bile acids, as endogenous natural laxatives, promote bowel movements by enhancing colonic secretion and regulating intestinal motility; meanwhile, gut microbiota influence colonic transit function by regulating the enteric nervous system, immune system, and their metabolic products. Based on an overview of the relationship between gut microbiota and bile acid metabolism, this article systematically reviews the current research status on the mechanisms of traditional Chinese medicine (TCM) in treating FC by regulating the balance of the gut microbiota-bile acid axis. It is found that single Chinese medicinal herbs (such as
Atractylodes macrocephala
), isolated compounds (such as
Platycodon grandiflorum
polysaccharides), herbal formulas (such as Shanger huang pill), acupuncture, and moxibustion can up-regulate the abundance of beneficial bacteria, reshape the microbial structure, correct bile acid metabolism, and activate the Takeda G-protein receptor 5/farnesoid X receptor pathway to treat FC.
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