摘要
溃疡性结肠炎是一种病因复杂、临床表现多样的慢性非特异性肠道炎症性疾病,以反复发作的黏液脓血便、腹痛及里急后重为特征。现行西医治疗手段及疗效有限,虽能短期控制炎症,但存在缓解率低、激素依赖率高、复发风险大等局限性,部分患者甚至面临结肠切除等风险。而中医药防治溃疡性结肠炎具有多维度整合调节优势,不仅可协同西药加速诱导缓解、减少激素依赖,还能维持长期缓解并显著提升患者生活质量。基于临床实践与病机演化规律认识,本文提出“湿热伏邪”理论作为整合溃疡性结肠炎复杂病机、贯通中西医认知的核心理论,揭示疾病发展的动态病理过程,为贯通中西医认知提供关键纽带。然而,针对中医核心理论的现代化研究仍面临共性瓶颈,如高质量循证研究依据薄弱、病证结合动物模型及疗效评价体系不完善、证型诊断缺乏客观量化标准、复方作用机制阐释不明等诸多问题。未来亟需以中西医结合为切入点,通过多学科交叉创新破解上述难题,推动溃疡性结肠炎中医诊疗的标准化与国际化进程。
Ulcerative colitis(UC)is a chronic non-specific inflammatory bowel disease characterized by complex etiology,diverse clinical manifestations,and recurrent symptoms such as mucopurulent bloody stools,abdominal pain,and tenesmus.Current western medical therapeutic approaches have limited efficacy.Although they can control inflammation in the short term,they are plagued by limitations including low remission rates,high rates of steroid dependence,and a high risk of recurrence,with some patients even facing the risk of colectomy.In contrast,traditional Chinese medicine(TCM)exhibits advantages in multi-dimensional integrated regulation for the prevention and treatment of UC.It not only synergizes with Western medicines to accelerate the induction of remission and reduce steroid dependence,but also maintains long-term remission and significantly improves patients’quality of life.Based on clinical practice and insights into the evolutionary rules of pathogenesis,this article proposes the theory of“latent dampness-heat pathogen”as a core framework for integrating the complex pathogenesis of UC and bridging the gap between TCM and western medicine.This theory reveals the dynamic pathological progression of the disease,serving as a key link to unify TCM and western medical perspectives.Modern research on TCM core theories still encounters common bottlenecks,such as insufficient evidence from high-quality evidence-based studies,inadequate disease-syndrome combination animal models and efficacy evaluation systems,lack of objective quantitative criteria for syndrome diagnosis,and unclear elucidation of the mechanisms of action of TCM compound prescriptions.In the future,it is imperative to take integrative Chinese and western medicine as a starting point,address these challenges through interdisciplinary innovation,and promote the standardization and internationalization of TCM diagnosis and treatment for UC.
作者
唐旭东
戴心怡
TANG Xudong;DAI Xinyi(Institute of Digestive Diseases,Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China)
出处
《环球中医药》
2025年第8期1517-1522,共6页
Global Traditional Chinese Medicine
基金
国家自然科学基金(82341233、81830118)
中国中医科学院西苑医院中医药临床科研一体化平台建设专项(XYZX0405-34)。
关键词
溃疡性结肠炎
中医药
湿热伏邪
病证结合
循证研究
脾胃病辨证新八纲
中西医结合
黏膜免疫
ulcerative colitis
traditional Chinese medicine
damp-heat retention pathogenic mechanism
disease-syndrome combination
evidence-based research
new eight principles for differentiating spleen and stomach disorders
integrated Chinese and western medicine
mucosal immunity
