中西医结合治疗腹泻型肠易激综合征研究进展OA

Irritable bowel syndrome with diarrhea(IBS-D)is a prevalent functional gastrointestinal disorder with an annually rising in-cidence,which severely impairs patients'quality of life.Modern medicine holds that its pathogenesis involves disordered 5-HT signaling pathways,intestinal microecological imbalance,visceral hypersensitivity and dysfunction of the gut-brain axis.Therapeutic strategies mainly consist of antispasmodics,antidiarrheals and microecological regulators.Although these interventions can relieve symptoms tem-porarily,they are associated with frequent disease recurrence and unsatisfactory long-term efficacy.From the perspective of TCM,the core pathogenesis of IBS-D lies in liver depression and spleen deficiency complicated by internal retention of dampness turbidity.Syn-drome differentiation and treatment can regulate visceral functions via multi-target pathways and exhibit unique therapeutic strengths;nevertheless,insufficient standardization of syndrome differentiation restricts its widespread clinical application.This paper reviews the theoretical basis and latest research advances of integrated TCM and Western medicine for IBS-D.Classical formulas such as Important Formula for Painful Diarrhea and Mume Pill,combined with acupuncture therapy and Western medicines including antispasmodics and probiotics,exert synergistic effects in alleviating clinical manifestations,lowering recurrence rates,reducing adverse reactions and impro-ving patients'quality of life.Nevertheless,the integrated therapy still confronts multiple challenges at present,including superficial mechanistic research,low-level clinical evidence,lack of standardized syndrome differentiation and operational protocols,and the ab-sence of an individualized precise treatment system.Therefore,future research directions include in-depth multi-omics mechanistic ex-ploration,construction of a correlation model linking TCM syndromes and biomarkers,development of AI-assisted syndrome differentia-tion and intelligent diagnosis and treatment technologies,conduct of large-sample,high-quality randomized controlled trials to upgrade the grade of clinical evidence,and formulation of unified clinical guidelines and evaluation systems to realize standardized,individual-ized and full-course management of IBS-D.