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| 脑肠轴网络化调控与三级协同干预：生物反馈联合八髎穴针刺治疗直肠无力型便秘的研究进展及精准化展望 |
| Research Advances and Precision Prospects of Biofeedback Combined with Baliao Acupoint Acupuncture for Rectal Atonic Constipation Based on Networked Brain-Gut Axis Modulation and Three-Tier Synergistic Intervention |
| 投稿时间：2026-08-05 修订日期：2026-08-05 |
| DOI： |
| 中文关键词: 直肠无力型便秘 脑肠轴网络 生物反馈 八髎穴 三级协同干预 神经可塑性 精准化治疗 |
| 英文关键词: rectal atonic constipation brain-gut axis network biofeedback Baliao acupoints three-tier synergistic intervention neural plasticity precision therapy |
| 基金项目:湖北省中医药管理局立项课题:"基于''肠-脑轴互动异常''理论对生物反馈联合八髎穴针刺治疗直肠无力型便秘的疗效评价研究"（ZY2025L161） |
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| 中文摘要: |
| 直肠无力型便秘(rectal atonic constipation, RAC)在功能性排便障碍中致残率高、治疗棘手,其发病机制已从单纯的肠道动力障碍逐步被重新认识为脑肠轴神经-内分泌-免疫-微生物组多维交互的系统性失稳。本文跳出既往单路径或双靶点平行论述的模式,从脑肠轴网络化调控的视角,对生物反馈与八髎穴针刺联合干预RAC的分子机制、神经电生理基础及临床转化价值进行系统梳理。文中提出"中枢感知重塑－骶髓节段易化－结肠动力激活"的三级协同干预构想,引入神经影像结构-功能耦合、肠道菌群宏基因组与代谢组学特征、自主神经平衡指数等定量指标,用以阐释联合治疗超越单用疗法的可能增效路径。针对当前固定方案未能兼顾个体脑肠状态波动的现实问题,进一步提出基于动态状态依赖的精准适配思路,主张从固定疗程向融入实时生理监测的闭环适应性干预转变。本文希望为RAC的多靶点机制解析、临床决策优化及后续人工智能辅助的个体化治疗探索提供有参考价值的理论框架。 |
| 英文摘要: |
| Rectal atonic constipation (RAC), a highly disabling and refractory subtype of functional defecation disorders, has been increasingly redefined from a mere motility disorder to a systemic homeostatic imbalance across the neuro-endocrine-immune-microbiome multidimensional interaction network of the brain-gut axis. Departing from conventional unidimensional or parallel dual-target narratives, this review systematically integrates and critically examines the molecular mechanisms, neuroelectrophysiological foundations, and translational value of biofeedback combined with Baliao acupoint acupuncture from the perspective of networked brain-gut axis regulation. We propose a "central perceptual reshaping – sacral segmental facilitation – colonic motor activation" three-tier synergistic intervention framework, incorporating quantitative biomarkers such as neuroimaging structure-function coupling, gut metagenomic and metabolomic profiles, and autonomic balance parameters to elucidate the potential synergistic pathways through which combined therapy may overcome the limitations of monotherapies. Addressing the clinical neglect of individual brain-gut state fluctuations in current fixed protocols, we further advance a dynamic state-dependent precision adaptation strategy, advocating a shift from fixed courses to closed-loop adaptive interventions integrated with real-time physiological monitoring. This review aims to provide a theoretically grounded and practically relevant framework for multi-target mechanistic dissection, clinical decision-making optimization, and future AI-assisted personalized management of RAC. |
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