益生菌缓解肠易激综合征症状的研究进展

Research progress in probiotics for alleviating irritable bowel syndrome symptoms

摘要:

肠易激综合征(irritable bowel syndrome, IBS)是一种以腹痛、腹胀及排便异常为特征的功能性胃肠疾病，其发病机制涉及肠道菌群失衡、免疫激活、肠-脑轴功能障碍等多因素交互作用。传统疗法虽能短期缓解症状，但存在药物副作用、疗效持续性不足等局限性，促使微生物靶向疗法成为研究热点。益生菌是活的微生物，已被证实对人体健康有益。现有研究表明，益生菌可通过定殖竞争抑制致病菌黏附，调节免疫应答，还能借助代谢产物修复肠屏障功能，改善肠道动力与渗透压平衡。本综述探讨了益生菌对IBS患者便秘、腹泻、腹痛腹胀及精神症状的具体作用效果和潜在作用途径。然而，益生菌临床应用仍面临挑战，包括菌株异质性、宿主个体差异以及缺乏标准化治疗方案等。未来需结合多组学技术筛选生物标志物，开发个体化干预策略，并通过动态监测优化疗效，为IBS治疗提供更精准的微生物靶向疗法。

Abstract:

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain, abdominal distension, and abnormal bowel movements. Its pathogenesis involves multiple factors such as imbalance of gut microbiota, immune activation, and dysfunction of the gut-brain axis. Although conventional therapies can alleviate symptoms temporarily, the limitations such as drug side effects and insufficient efficacy persistence have made microbial-targeted therapy a research hotspot. Probiotics are live microorganisms and have been proven to be beneficial to human health. Studies have shown that probiotics inhibit pathogen adhesion through competitive colonization, regulate immune responses, and repair the intestinal barrier function through metabolic products, thereby improving intestinal motility and osmotic balance. This review discusses the specific effects and potential pathways of probiotics on constipation, diarrhea, abdominal pain and distension, and mental symptoms in IBS patients. However, the clinical application of probiotics still faces challenges, including strain heterogeneity, host individual differences, and the lack of standardized treatment plans. In the future, it is necessary to combine multi-omics technologies to screen biomarkers, develop individualized intervention strategies, and optimize efficacy through dynamic monitoring, which are expected to provide more precise microbial-targeted therapy for the treatment of IBS.