基于肠-肝-脑轴理论论治儿童抽动障碍的探讨

doi:10.20274/j.cnki.issn.1674-3865.2026.01.007

中国中西医结合儿科学 ›› 2026, Vol. 18 ›› Issue (1): 35-39.doi: 10.20274/j.cnki.issn.1674-3865.2026.01.007

基于肠-肝-脑轴理论论治儿童抽动障碍的探讨

刘英, 隋宇航, 张迪()

330004 南昌，江西中医药大学附属医院儿科

收稿日期:2025-10-16 修回日期:2025-12-23 出版日期:2026-02-25 上线日期:2026-02-25
通讯作者: 张迪 E-mail:zdkeyan@163.com
作者简介:刘英(1977-)，女，医学博士，教授、主任医师。研究方向：中医药防治小儿神经系统疾病
基金资助:
江西省中医药管理局科技计划项目(2023B1239);江西省教育厅科学技术研究项目(GJJ2200983);江西省卫生健康委科技计划项目(202310696)

Exploration on the treatment for tic disorder in children based on the gut-liver-brain axis theory

Ying LIU, Yuhang SUI, Di ZHANG()

Jiangxi University of Chinese Medicine Affiliated Hospital，Nanchang 330004，China

Received:2025-10-16 Revised:2025-12-23 Published:2026-02-25 Online:2026-02-25
Contact: Di ZHANG E-mail:zdkeyan@163.com
Supported by:
Science and Technology Program of Jiangxi Provincial Administration of Traditional Chinese Medicine(2023B1239)

摘要/Abstract

摘要：

抽动障碍是一种好发于儿童及青少年的慢性神经精神障碍性疾病，中医病位主要在肝、脾、脑，基本病机为“脑髓神机失调，肝脾疏泄失常”。基于“肠-肝-脑轴”理论，“肝脾疏泄失常”可对应现代医学的肠道菌群紊乱、肠道屏障损伤及肝脏代谢功能障碍，进而影响大脑神经免疫应答，导致“脑髓神机失调”。通过干预肠道菌群，减轻肝脏负担，下调炎症因子等途径调节大脑功能，可为抽动障碍治疗提供新靶点。中药方剂、针刺等中医治法可通过调节肠道微生态，减轻神经炎症改善抽动症状。基于“肠-肝-脑轴”理论，可为抽动障碍的临床治疗提供新的思路与方向。

关键词: 抽动障碍, 肠-肝-脑轴, 肠道菌群, 儿童

Abstract:

Tic disorder is a chronic neuropsychiatric disorder predominantly affecting children and adolescents. In traditional Chinese medicine, its pathogenesis is primarily located in the liver, spleen, and brain, with the core mechanism being "disharmony of brain marrow and spiritual mechanism, and dysfunction of liver-spleen conveyance and drainage." Based on the "gut-liver-brain axis" theory, "dysfunction of liver-spleen conveyance and drainage" corresponds to intestinal microbiota dysbiosis, intestinal barrier damage, and hepatic metabolic dysfunction in modern medical concepts, which subsequently influence neuroimmune responses in the brain, leading to "disharmony of brain marrow and spiritual mechanism" Modulating brain function through intervening the intestinal microbiota, reducing hepatic burden, and downregulating inflammatory factors offers new therapeutic targets for the treatment of tic disorder. Traditional Chinese medicine approaches, including herbal formulas and acupuncture, can ameliorate tic symptoms by regulating the intestinal microecology and mitigating neuroinflammation. The "gut-liver-brain axis" theory provides a novel perspective and direction for the clinical management of tic disorder.

Key words: Tic disorder, Gut-liver-brain axis, Intestinal microbiota, Child

中图分类号:

R749.94

刘英, 隋宇航, 张迪. 基于肠-肝-脑轴理论论治儿童抽动障碍的探讨[J]. 中国中西医结合儿科学, 2026, 18(1): 35-39.

Ying LIU, Yuhang SUI, Di ZHANG. Exploration on the treatment for tic disorder in children based on the gut-liver-brain axis theory[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2026, 18(1): 35-39.

参考文献 45

[1]	徐欣梅.基于脑肠轴理论从肝脾论治儿童抽动障碍的探讨[J].中国中西医结合儿科学,2023,15(5):384-388.
[2]	Trapecar M, Wogram E, Svoboda D, et al. Human physiomimetic model integrating microphysiological systems of the gut, liver, and brain for studies of neurodegenerative diseases[J]. Sci Adv, 2021, 7(5): eabd1707.
[3]	陈蛟,张映林,刘作金.肝肠轴相关机制研究进展[J].现代医药卫生,2014,30(22):3405-3408.
[4]	Smith ML, Wade JB, Wolstenholme J, et al. Gut microbiome-brain-cirrhosis axis[J]. Hepatology, 2024, 80(2): 465-485.
[5]	D’Mello C, Swain MG. Liver-brain inflammation axis[J]. Am J Physiol Gastrointest Liver Physiol, 2011, 301(5): G749-761.
[6]	Goehler LE, Gaykema RP, Hansen MK, et al. Vagal immune-to-brain communication: a visceral chemosensory pathway[J]. Auton Neurosci, 2000, 85(1-3): 49-59.
[7]	Harrison NA, Brydon L, Walker C, et al. Neural origins of human sickness in interoceptive responses to inflammation[J]. Biol Psychiatry, 2009, 66(5): 415-422.
[8]	Yasuda K, Churchill L, Yasuda T, et al. Unilateral cortical application of interleukin-1β (IL1β) induces asymmetry in fos, IL1β and nerve growth factor immunoreactivity: implications for sleep regulation[J]. Brain Res, 2007, 1131: 44-59.
[9]	D'Mello C, Swain MG. Immune-to-brain communication pathways in inflammation-associated sickness and depression[J]. Curr Top Behav Neurosci, 2017, 31: 73-94.
[10]	Moon J, Yoon CH, Choi SH, et al. Can gut microbiota affect dry eye syndrome[J]? Int J Mol Sci, 2020, 21(22): 8443.
[11]	Walrath T, Dyamenahalli KU, Hulsebus HJ, et al. Age-related changes in intestinal immunity and the microbiome[J]. J Leukoc Biol, 2021, 109(6): 1045-1061.
[12]	Dinan TG, Cryan JF. Gut instincts: microbiota as a key regulator of brain development, ageing and neurodegeneration[J]. J Physiol, 2017, 595(2): 489-503.
[13]	Bajaj JS. Alcohol, liver disease and the gut microbiota[J]. Nat Rev Gastroenterol Hepatol, 2019, 16(4): 235-246.
[14]	Albillos A, de Gottardi A, Rescigno M. The gut-liver axis in liver disease: pathophysiological basis for therapy[J]. J Hepatol, 2020, 72(3): 558-577.
[15]	Wang Y, Kasper LH. The role of microbiome in central nervous system disorders[J]. Brain Behav Immun, 2014, 38: 1-12.
[16]	Shetty S, Lalor PF, Adams DH. Liver sinusoidal endothelial cells—gatekeepers of hepatic immunity[J]. Nat Rev Gastroenterol Hepatol, 2018, 15(9): 555-567.
[17]	Baizabal-Carvallo JF, Alonso-Juarez M. The link between gut dysbiosis and neuroinflammation in Parkinson's disease[J]. Neuroscience, 2020, 432: 160-173.
[18]	隆红艳,张骠.从“脑髓神机失调”角度认识小儿多发性抽动症的关键病机[J].辽宁中医杂志,2012,39(1):73-75.
[19]	程申,陈雅琴,王庆,等.王晓鸣教授运用调和肝脾法治疗儿童抽动障碍经验探讨[J].浙江中医药大学学报,2024,48(6):669-673.
[20]	赵赛,陈自佳.从“脑-肠轴”探讨肠道脂代谢异常在儿童抽动障碍中的作用机制[J/OL].中医学报,1-9[2026-01-03]..
[21]	Augustine F, Singer HS. Merging the pathophysiology and pharmacotherapy of tics[J]. Tremor Other Hyperkinet Mov (N Y), 2019, 8: 595.
[22]	Egolf A, Coffey BJ. Current pharmacotherapeutic approaches for the treatment of Tourette syndrome[J]. Drugs Today (Barc), 2014, 50(2): 159-179.
[23]	任思洋. 静心止动方治疗中重度TD及对神经递质影响的研究[D]. 北京: 北京中医药大学, 2014: 1-73.
[24]	高汉媛, 王维红, 李小芹, 等. 菖蒲郁金汤对多发性抽动症模型大鼠单胺类神经递质的影响[J]. 中药药理与临床, 2017, 33(3): 135-138.
[25]	于文静, 白雪, 张雯, 等. 健脾止动汤对多发性抽动症患儿神经递质的影响[J]. 中华中医药杂志,2015, 30(5): 1757-1761.
[26]	康碧,陈宜.健脾止动汤联合耳穴贴压对儿童多发性抽动症的下丘脑-垂体-肾上腺轴激素、神经递质的影响[J].世界中医药,2019,14(6):1524-1527.
[27]	李旭蕊,李剑,李岩鹏,等.卡巴拉汀对阿尔茨海默病模型小鼠肠道菌群及认知功能的影响[J].现代生物医学进展,2020,20(20):3827-3831.
[28]	范菲,韩斐,汪琼.抽动障碍儿童血清TNF-α和IL-6的表达[J].江苏医药,2017,43(14):1005-1007.
[29]	刘守娟,乐原.血清总免疫球蛋白E、特异性免疫球蛋白E、维生素A、维生素D水平与儿童抽动障碍相关性分析[J].陕西医学杂志,2021,50(10):1257-1259.
[30]	王丹霞,孟珂,尚玉.肠道菌群情况与发声和多种运动联合抽动障碍患儿神经递质、神经功能及T细胞亚群的相关性分析[J].中国现代医学杂志,2024,34(16):56-61.
[31]	Konturek PC, Haziri D, Brzozowski T, et al. Emerging role of fecal microbiota therapy in the treatment of gastrointestinal and extra-gastrointestinal diseases[J]. J Physiol Pharmacol, 2015, 66(4): 483-491.
[32]	García-Domínguez I, Veselá K, García-Revilla J, et al. Peripheral inflammation enhances microglia response and nigral dopaminergic cell death in an in vivo MPTP model of Parkinson's disease[J]. Front Cell Neurosci, 2018, 12: 398.
[33]	Luczynski P, McVey Neufeld KA, Oriach CS, et al. Growing up in a bubble: using germ-free animals to assess the influence of the gut microbiota on brain and behavior[J]. Int J Neuropsychopharmacol, 2016, 19(8): pyw020.
[34]	范祎铭,鲍超,李建兵.基于脑-肠轴理论探讨针灸治疗抽动障碍作用机制[J].辽宁中医药大学学报,2025,27(4):134-139.
[35]	Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing[J]. Nature, 2010, 464(7285): 59-65.
[36]	Wei C, Jiang W, Wang R, et al. Brain endothelial GSDMD activation mediates inflammatory BBB breakdown[J]. Nature, 2024, 629(8013): 893-900.
[37]	张蔷,刘拓,王俊宏,等.菖菊止动方对抽动障碍患儿肠道菌群的影响[J].中国实验方剂学杂志,2024,30(23):104-110.
[38]	司原成, 苗维纳, 何嘉悦, 等. 基于“脑-肠-菌” 轴探讨健脾益气针法对肥胖鼠肠道菌群及TLR4的调控机制[J]. 中华中医药杂志, 2017, 32(10): 4457-4460.
[39]	常虹,唐烨霞,王紫玄,等.针刺联合小儿推拿对抽动障碍患儿肠道菌群的影响[J].中国针灸,2023,43(5):509-516.
[40]	罗文珍, 尚菁, 史正刚, 等. 菖蒲郁金汤对抽动-秽语综合征模型大鼠小胶质细胞的异常活化和神经炎症的影响[J]. 中医儿科杂志, 2023, 19(6): 1-9.
[41]	周红亮,陈洁,章建英,等.儿童抽动障碍与肠道菌群及炎症反应、免疫指标相关性研究[J].安徽医药,2024,28(6):1208-1211.
[42]	赵梦洁. 加味泻黄散经TLR4/NF-κB通路调控小胶质细胞极化治疗抽动障碍的机制研究[D]. 成都: 成都中医药大学, 2023.
[43]	张川,王伯韬,于雷雷,等.透明质酸调节肠道微生物和代谢物缓解炎症:一项分子量依赖性研究（英文）[J].Science Bulletin,2024,69(17):2683-2687.
[44]	曹思慧,陈琳,何灏龙,等.基于1H-NMR和16S rDNA测序技术探讨针与灸不同刺激方法对大鼠结肠代谢物和肠道菌群的影响[J].中国病理生理杂志,2023,39(9):1620-1633.
[45]	Wang H, Chen D, Li H, et al. Bifidobacterium regulates premature infant gut metabolites, reducing serum inflammatory factors: a randomised controlled trial[J]. Pediatr Res, 2024, 97(3): 1171-1182.

基于肠-肝-脑轴理论论治儿童抽动障碍的探讨

Exploration on the treatment for tic disorder in children based on the gut-liver-brain axis theory

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 45

相关文章 15

编辑推荐

Metrics

本文评价

[1]	曾中和, 雷龙鸣, 赵骏, 王琼潇, 富林, 吴梦芸, 苏丹璐, 陈广辉. 指南推荐的中医外治法治疗儿童厌食症临床疗效的网状Meta分析[J]. 中国中西医结合儿科学, 2026, 18(1): 23-30.
[2]	程芳, 向红. 基于“玄府气液学说”论治儿童上气道咳嗽综合征[J]. 中国中西医结合儿科学, 2026, 18(1): 31-34.
[3]	韩斯昂, 张鑫业, 林一辰, 蔡畅, 吴振起. “肝升肺降”论治儿童咳嗽变异性哮喘[J]. 中国中西医结合儿科学, 2026, 18(1): 40-44.
[4]	薛静囡, 杨庆, 张焱, 贾六金. 贾六金教授基于“脾苦湿”论治小儿特应性皮炎经验[J]. 中国中西医结合儿科学, 2026, 18(1): 45-49.
[5]	秦胜娟, 肖和印, 郭凯, 张子燕. 从咽喉论治儿童肠系膜淋巴结肿大经验[J]. 中国中西医结合儿科学, 2026, 18(1): 50-53.
[6]	邵立鹏, 胡燕. 基于数据挖掘探究湖湘医派治疗小儿抽动症[J]. 中国中西医结合儿科学, 2026, 18(1): 54-59.
[7]	万慕湲, 易鹏飞, 徐清怡, 颜劲松, 张甜, 刘丽琴, 陈梦琦, 李青青. 2025版《中国药典》收载儿科中成药的系统分析[J]. 中国中西医结合儿科学, 2026, 18(1): 60-66.
[8]	常婉莹, 董幼祺. 董幼祺运用二陈汤及类方治疗小儿痰湿证验案举隅[J]. 中国中西医结合儿科学, 2026, 18(1): 67-70.
[9]	孔森, 张亮, 廖楠, 涂光. 基于随机森林模型的小儿重症肺炎支原体肺炎风险因素分析的应用研究[J]. 中国中西医结合儿科学, 2026, 18(1): 71-76.
[10]	宋亚文, 陈波. 维生素D与儿童急性炎症合并贫血的相关性研究[J]. 中国中西医结合儿科学, 2026, 18(1): 77-81.
[11]	蔡瑞琪, 郝欧美, 王雪峰, 张柯欣. 消积理脾散与厌食贴联合常规治疗儿童厌食症（脾失健运证）的临床观察[J]. 中国中西医结合儿科学, 2025, 17(6): 461-465.
[12]	王庆, 陈雅琴, 殷丹飞, 王素丽, 王晓鸣. 基于数据挖掘的王晓鸣教授治疗小儿积滞组方规律探索[J]. 中国中西医结合儿科学, 2025, 17(6): 466-471.
[13]	唐其民, 涂一世. 健脾益气膏治疗小儿厌食(脾胃气虚证)的疗效观察[J]. 中国中西医结合儿科学, 2025, 17(6): 472-476.
[14]	王雪峰, 王琦, 白明华, 王济, 许华, 王力宁, 张葆青, 崔振泽, 吴振起, 赵雪, 张秀英, 孔馨悦, 赫昊, 刘馨蔚. 《1⁺～7岁儿童中医体质量表》评价研究[J]. 中国中西医结合儿科学, 2025, 17(6): 477-487.
[15]	景一珏, 姚政宇, 高旅. 平痫冲剂治疗小儿癫痫的研究进展[J]. 中国中西医结合儿科学, 2025, 17(6): 488-492.