肠道菌群失调相关慢性前列腺炎发生机制及治疗研究进展

徐新宇; 崔云; 吴骏

doi:10.16766/j.cnki.issn.1674-4152.003213

肠道菌群失调相关慢性前列腺炎发生机制及治疗研究进展

doi: 10.16766/j.cnki.issn.1674-4152.003213

徐新宇¹,
崔云^2, ,,
吴骏²

1.
浙江中医药大学第三临床医学院, 浙江杭州 310053
2.
浙江中医药大学附属宁波中医院男科, 浙江宁波 315010

基金项目:

浙江省自然科学基金项目 LY21H270015

崔云全国名老中医药专家传承工作室建设项目国中医药人教函[2022]75号

浙江省中医药科学研究基金项目 2022ZB337

浙江省中医药科学研究基金项目 2022ZB311

宁波市医疗卫生品牌学科资助项目 PPXK2018-07

详细信息

通讯作者:
崔云，E-mail: nbszyy@sina.com

中图分类号: R37 R697.33
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- 被引次数: 0
出版历程
- 收稿日期: 2022-11-17
- 网络出版日期: 2023-11-23

Research progress in the pathogenesis and treatment of chronic prostatitis associated with intestinal microbiota dysregulation

XU Xinyu¹,
CUI Yun^{2
, ,},
WU Jun²

1.
The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China

摘要

摘要: 慢性前列腺炎(CP)是泌尿男科常见病和多发病，典型表现为精神心理症状(焦虑、压抑、认知及行为异常、生活质量下降)、盆腔疼痛症状(泌尿生殖区疼痛、腹部和盆腔肌肉压痛、射精痛、排尿疼痛)、性功能障碍症状(阳痿、性欲低下、射精功能障碍)以及下尿路症状(尿频、尿急、夜尿增多、尿后余沥、尿不尽等)。现代医学认为CP的发生机制与免疫失调、内分泌紊乱和局部微循环障碍密切相关，但核心发病机制尚不清晰。肠道菌群与人体健康息息相关，近年来国内外学者对肠道菌群与CP关系的研究愈加广泛，为揭示CP发生机制提供全新视角。肠道菌群失调通过介导炎症因子增加、下丘脑-垂体-肾上腺轴活动亢进而激素水平紊乱以及神经递质功能异常诱发CP精神心理症状，通过诱发炎症因子释放、背根神经节神经元敏化及大脑胶质细胞活化等引发CP盆腔疼痛症状，通过影响睾酮及神经递质水平等导致性功能障碍症状，通过直接感染及影响盆底肌功能引发CP下尿路症状。通过增加有益菌、减少有害菌来恢复肠道菌群稳态成为CP治疗的新方向。目前主要借助补充益生菌以及低聚糖类、蛋白水解物和中药多糖等益生元来调节肠道菌群治疗CP，取得显著效果。现对肠道菌群失调相关慢性前列腺炎发生机制与治疗的概况进行综述，以期为泌尿男科医生诊治CP提供新的思路和依据。
- 肠道菌群 /
- 慢性前列腺炎 /
- 益生菌 /
- 植物多糖 /
- 神经递质
Abstract: Chronic prostatitis (CP) is a common and frequent disease in urology. Typical performance are mental symptoms (anxiety, depression, cognitive and behavioral abnormalities, lower quality of life), pelvic pain symptoms (urogenital area pain, abdominal and pelvic muscle tenderness, ejaculatory pain, painful urination) symptoms, sexual dysfunction (impotence, low sexual desire, ejaculatory dysfunction), as well as the urinary tract symptoms (frequent urination, urinary urgency, increased nocturia, posturinary leaking, dysuria, etc.). Modern medicine believes that the pathogenesis of CP is closely related to immune disorders, endocrine disorders and local microcirculation disorders, but the core pathogenesis is still unclear. Intestinal microbiota is closely related to human health. In recent years, domestic and foreign scholars have increasingly studied the relationship between gut microbiota and CP, which provides a new perspective for revealing the mechanism of CP. The dysregulation of gut microbiota induces CP mental and psychological symptoms by mediating the increase of inflammatory factors, the hyperactivity of hypothalamic-pituitary-adrenal then disturb hormone level and the abnormal function of neurotransmitters, and induces CP pelvic pain symptoms by inducing the release of inflammatory factors, the sensitization of dorsal root ganglion neurons and the activation of brain glial cells. It can lead to sexual dysfunction symptoms by affecting the levels of testosterone and neurotransmitters, and lead to CP lower urinary tract symptoms by direct infection and affecting the function of pelvic floor muscles. It has become a new direction of CP treatment to restore intestinal microbiota homeostasis by increasing beneficial bacteria and reducing harmful bacteria. At present, probiotics and prebiotics such as oligosaccharides, protein hydrolysates and traditional Chinese medicine polysaccharides are mainly used to regulate intestinal microbiota in the treatment of CP, which has achieved remarkable results and opened up a new direction of CP diagnosis and treatment. This article reviews the pathogenesis and treatment of chronic prostatitis related to intestinal microbiota dysregulation at home and abroad, in order to provide new ideas and basis for urologists to diagnose and treat CP.
- Intestinal microbiota /
- Chronic prostatitis /
- Probiotics /
- Plant polysaccharides /
- Neurotransmitter

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