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Abstract: Patients with depression are more likely to have chronic gastrointestinal (GI) symptoms than the general population, but such symptoms are considered only somatic symptoms of depression and lack special attention. There is a chronic lack of appropriate diagnosis and effective treatment for patients with depression accompanied by GI symptoms, and studying the association between depression and GI disorders (GIDs) is extremely important for clinical management. There is growing evidence that depression is closely related to the microbiota present in the GI tract, and the microbiota-gut-brain axis (MGBA) is creating a new perspective on the association between depression and GIDs. Identifying and treating GIDs would provide a key opportunity to prevent episodes of depression and may also improve the outcome of refractory depression. Current studies on depression and the microbially related gut-brain axis (GBA) lack a focus on GI function. In this review, we combine preclinical and clinical evidence to summarize the roles of the microbially regulated GBA in emotions and GI function, and summarize potential therapeutic strategies to provide a reference for the study of the pathomechanism and treatment of depression in combination with GI symptoms.

依赖于微生物的肠脑通路治疗伴有胃肠道症状抑郁症的新视角：从实验室到临床

刘梦琳^1,2, 樊根豪^2,4, 孟令凯³, 杨阔³, 刘华一^3
1河南中医药大学第一附属医院脑病区域诊疗中心， 中国郑州， 450000
²天津中医药大学， 中国天津市， 301600
³天津市中医药研究院附属医院， 中国天津市， 300131
⁴郑州大学第一附属医院老年病科， 中国郑州， 450052
摘要：与普通人群相比，抑郁症患者更易出现慢性胃肠道症状，但这些症状仅被视为抑郁症的躯体症状而缺少特别关注。长期以来，对伴有胃肠道症状的抑郁症患者缺乏适当诊断和有效治疗，因此研究抑郁症与胃肠道疾病间的关联对临床治疗极为重要。越来越多的证据表明，抑郁症与消化道中的微生物群密切相关，而微生物群-肠-脑轴则为抑郁症与胃肠道疾病之间的关联开创了一个新的视角。识别和治疗胃肠道疾病可能预防抑郁症的发作，也可能改善难治性抑郁症的治疗效果。目前抑郁症和微生物相关的肠-脑轴的研究缺乏对胃肠道功能的关注。本综述结合临床前和临床证据，归纳了微生物调控的肠-脑轴在情绪和胃肠道功能中的作用，并总结了潜在治疗策略，为抑郁症伴胃肠道症状的病理机制研究和诊治提供参考。

关键词：抑郁症；胃肠道疾病；肠-脑轴；病理机制；治疗

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