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1.首都医科大学附属北京中医医院,北京市东城区美术馆后街23号,100010
2.湖北中医药大学附属武汉市中西医结合医院
3.中国中医科学院西苑医院脾胃病研究所
Received:08 August 2025,
Revised:2025-11-25,
Published:17 February 2026
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张声生,时昭红,卢小芳等.功能性消化不良中西医诊疗及机制研究概况[J].中医杂志,2026,67(04):397-403.
ZHANG Shengsheng,SHI Zhaohong,LU Xiaofang,et al.Overview of Diagnosis,Treatment and Mechanism Research of Functional Dyspepsia by Integrated Traditional Chinese and Western Medicine[J].Journal of Traditional Chinese Medicine,2026,67(04):397-403.
张声生,时昭红,卢小芳等.功能性消化不良中西医诊疗及机制研究概况[J].中医杂志,2026,67(04):397-403. DOI: 10.13288/j.11-2166/r.2026.04.010.
ZHANG Shengsheng,SHI Zhaohong,LU Xiaofang,et al.Overview of Diagnosis,Treatment and Mechanism Research of Functional Dyspepsia by Integrated Traditional Chinese and Western Medicine[J].Journal of Traditional Chinese Medicine,2026,67(04):397-403. DOI: 10.13288/j.11-2166/r.2026.04.010.
功能性消化不良(FD)是中医治疗的优势病种,目前西医治疗以质子泵抑制剂、促胃肠动力药为主,消化酶、微生态制剂和抗抑郁药可作为辅助用药,但尚有一定局限性。中医治疗FD包括内服中药复方、中成药,亦有针灸、穴位贴敷、中药热熨法、中药膏摩、中药离子导入、耳穴疗法、推拿等中医外治法。中西药联合治疗FD可显著提高临床疗效,减少不良反应。中西医疗效的共性机制均围绕FD的核心病理环节展开,主要集中于恢复胃肠动力、调节脑肠肽水平、调控肠道微生态、改善炎症状态方面;差异机制在于西医精准靶向,而中医整体调节的多靶点特点,二者具有协同增效作用。提出利用中医的整体调理优势和西医的针对性治疗特长,为FD患者提供个性化的综合治疗方案。
Functional dyspepsia (FD) is a prioritized disease category where traditional Chinese medicine (TCM) demonstrates distinct therapeutic advantages. The current western medicine treatment for FD is mainly based on proton pump inhibitors and prokinetic agents, with digestive enzymes, probiotics and antidepressants serving as adjuvant medication, yet such therapies still have certain limitations. TCM treatment for FD includes oral administration of Chinese herbal formulas and Chine
se patent medicines, as well as external TCM therapies such as acupuncture and moxibustion, acupoint application, hot medicinal compress therapy, rubbing with ointment, medicinal iontophoresis, auricular acupoint therapy and
tui na
(Chinese medical massage). The combined treatment of FD with integrated TCM and western medicine can significantly improve clinical effectiveness and reduce adverse reactions. The common mechanisms underlying the therapeutic effects of both TCM and western medicine revolve around the core pathological processes of FD, mainly focusing on restoring gastrointestinal motility, regulating the levels of brain-gut peptides, modulating intestinal microecology, and ameliorating inflammatory status. The differential mechanisms lie in the precise targeting feature of western medicine versus the holistic-regulating and multi-target characteristics of TCM, and the two approaches exert a synergistic effect to enhance efficacy. This paper proposes to leverage the advantages of TCM in holistic regulation and the strengths of western medicine in targeted treatment, so as to provide personalized and comprehensive treatment regimens for FD patients.
ARO P , TALLEY NJ , AGRÉUS L , et al . Functional dyspepsia impairs quality of life in the adult population [J]. Aliment Pharmacol Ther , 2011 , 33 ( 11 ): 1215 - 1224 .
SINGH R , ZOGG H , GHOSHAL UC , et al . Current treatment options and therapeutic insights for gastrointestinal dysmotility and functional gastrointestinal disorders [J]. Front Pharmacol , 2022 , 13 : 808195 . doi: 10.3389/fphar. 2022.808195 http://dx.doi.org/10.3389/fphar.2022.808195 .
YAN L , ZHANG X , LI Y , et al . The role of psychological factors in functional gastrointestinal disorders: a systematic review and meta-analysis [J]. Int J Colorectal Dis , 2023 , 38 ( 1 ): 65 .
FORD AC , MARWAHA A , LIM A , et al . Systematic review and meta-analysis of the prevalence of irritable bowel syndrome in individuals with dyspepsia [J]. Clin Gastroenterol Hepatol , 2010 , 8 ( 5 ): 401 - 409 .
中华中医药学会脾胃病分会 . 功能性消化不良中医诊疗专家共识意见(2023) [J]. 中华中医药杂志 , 2024 , 39 ( 3 ): 1372 - 1378 .
STANGHELLINI V , CHAN FK , HASLER WL , et al . Gastroduodenal disorders [J]. Gastroenterology , 2016 , 150 ( 6 ): 1380 - 1392 .
ASHOORION V , HOSSEINIAN SZ , REZAEI N , et al . Effect of dietary patterns on functional dyspepsia in adults: a systematic review [J]. J Health Popul Nutr , 2025 , 44 ( 1 ): 132 .
RETTURA F , LAMBIASE C , GROSSO A , et al . Role of Low-FODMAP diet in functional dyspepsia: “Why”, “When”, and “to Whom” [J]. Best Pract Res Clin Gastroenterol , 2023 , 62-63 : 101831 . doi: 10.1016/j.bpg.2023. 101831 http://dx.doi.org/10.1016/j.bpg.2023.101831 .
PINTO-SANCHEZ MI , YUAN Y , HASSAN A , et al . Proton pump inhibitors for functional dyspepsia [J]. Cochrane Database Syst Rev , 2017 , 11 ( 11 ): CD011194 .
QI Q , WANG N , LIU H , et al . Prokinetics for the treatment of functional dyspepsia: an updated systematic review and network meta-analysis [J]. BMC Gastroenterol , 2023 , 23 ( 1 ): 370 .
SHANMUGHAM S , ZUBER M , CHAN JE , et al . Efficacy of antidepressants in functional dyspepsia: systematic review and meta-analysis with trial sequential analysis of randomized controlled trials [J]. Indian J Gastroenterol , 2025 , 44 ( 1 ): 24 - 34 .
ZHANG W , SHEN Y , HAO J , et al . The role of psychotherapeutic approaches in treatment of functional dyspepsia, systematic review, and meta-analysis [J]. Acta Gastroenterol Belg , 2024 , 87 ( 2 ): 294 - 303 .
HUANG A , LIN B , HU T , et al . Unraveling functional dyspepsia: pathophysiological mechanisms, microbiota interactions, and emerging therapeutic strategies [J]. Pathol Res Pract , 2025 , 272 : 156118 . doi: 10.1016/j.prp.2025.156118 http://dx.doi.org/10.1016/j.prp.2025.156118 .
LV L , WANG FY , MA XX , et al . Efficacy and safety of Xiangsha Liujunzi granules for functional dyspepsia: a multi-center randomized double-blind placebo-controlled clinical study [J]. World J Gastroenterol , 2017 , 23 ( 30 ): 5589 - 5601 .
刘贺轩 , 许二平 , 刘朋良 , 等 . 枳术丸治疗功能性消化不良的研究进展 [J]. 中华中医药学刊 , 2025 , 43 ( 9 ): 120 - 124 .
潘洋 , 巩淑萍 , 党红晨 . 甘海胃康胶囊治疗脾虚气滞型功能性消化不良的临床效果观察 [J]. 临床消化病杂志 , 2023 , 35 ( 3 ): 232 - 234 .
张声生 , 赵静怡 , 赵鲁卿 . 近20年调肝理脾法治疗功能性消化不良研究述评 [J]. 中医杂志 , 2020 , 61 ( 22 ): 1948 - 1952 .
WANG Y , JIA Y , LIU X , et al . Effect of Chaihu-Shugan-San on functional dyspepsia and gut microbiota: a randomized, double-blind, placebo-controlled trial [J]. J Ethnopharmacol , 2024 , 326 : 117954 . doi: 10.1016/j.jep.2023.117659 http://dx.doi.org/10.1016/j.jep.2023.117659 .
SU Q , CHEN SL , WANG HH , et al . A randomized, double-blind, multicenter, placebo-controlled trial of Qi-Zhi-Wei-Tong granules on postprandial distress syndrome-predominant functional dyspepsia [J]. Chin Med J (Engl) , 2018 , 131 ( 13 ): 1549 - 1556 .
王光铭 , 黄玉珍 , 刘万里 . 加味左金丸治疗肝胃郁热型功能性消化不良临床疗效及对相关激素水平的影响 [J]. 中华中医药学刊 , 2024 , 42 ( 7 ): 48 - 51 .
冯辉 , 藏莉 , 张德重 . 半夏泻心汤对功能性消化不良患者血浆P物质和胃窦黏膜CGRP的影响 [J]. 南京中医药大学学报 , 2015 , 31 ( 4 ): 310 - 313 .
夏文阳 . 荆花胃康胶丸治疗寒热错杂型功能性消化不良疗效观察 [J]. 湖北中医杂志 , 2017 , 39 ( 11 ): 23 - 24 .
ZHANG SS , ZHAO LQ , WANG HB , et al . Efficacy of Gastrosis No.1 compound on functional dyspepsia of spleen and stomach deficiency-cold syndrome: a multi-center, double-blind, placebo-controlled clinical trial [J]. Chin J Integr Med , 2013 , 19 ( 7 ): 498 - 504 .
ZHANG S , ZHAO L , WANG H , et al . Efficacy of modified LiuJunZi decoction on functional dyspepsia of spleen-deficiency and qi-stagnation syndrome: a randomized controlled trial [J]. BMC Complement Altern Med , 2013 , 13 : 54 . doi: 10.1186/1472-6882-13-54 http://dx.doi.org/10.1186/1472-6882-13-54 .
汪红兵 , 张声生 , 沈洪 , 等 . 胃病3号复方治疗功能性消化不良脾胃湿热证多中心、随机、双盲、安慰剂对照试验研究 [J]. 中国中西医结合消化杂志 , 2011 , 19 ( 5 ): 284 - 289 .
ZHAO L , ZHANG S , WANG Z , et al . Efficacy of modified Ban Xia Xie Xin Decoction on functional dyspepsia of cold and heat in complexity syndrome: a randomized controlled trial [J]. Evid Based Complement Alternat Med , 2013 , 2013 : 812143 . doi: 10.1155/2013/812143 http://dx.doi.org/10.1155/2013/812143 .
郑思懿 , 张涵 , 喻洋 , 等 . 针刺治疗功能性消化不良的穴位配伍及刺激参数应用现状分析 [J]. 中医杂志 , 2025 , 66 ( 12 ): 1293 - 1299 .
李朵朵 , 岳增辉 , 刘未艾 . 针刺经穴对脾胃虚弱型功能性消化不良患者血清5-羟色胺、血管活性肽及胰高血糖素样肽-1的影响 [J]. 中医杂志 , 2025 , 66 ( 13 ): 1357 - 1362 .
贺煜竣 , 杨凌毓 , 宋伯骐 , 等 . 基于佐金平木理论选穴治疗肝胃不和型功能性消化不良的临床疗效观察 [J]. 时珍国医国药 , 2021 , 32 ( 12 ): 2944 - 2947 .
马强骥 , 陈松鹤 . “老十针”治疗脾胃虚弱型功能性消化不良35例 [J]. 中国针灸 , 2024 , 44 ( 11 ): 1304 - 1306 .
陈鹏 , 陈爱萍 . “老十针”治疗肝郁脾虚型功能性消化不良疗效观察 [J]. 中国针灸 , 2020 , 40 ( 11 ): 1169 - 1171 .
陈贝 , 陈松 , 马珑 , 等 . 梅花针叩刺与常规针刺治疗肝胃不和型功能性消化不良的随机对照研究 [J]. 中华中医药杂志 , 2022 , 37 ( 12 ): 7481 - 7485 .
ZHENG H , XU J , SUN X , et al . Electroacupuncture for patients with refractory functional dyspepsia: a rando-mized controlled trial [J]. Neurogastroenterol Motil , 2018 , 30 ( 7 ): e13316 .
尚莹莹 , 吴晓华 , 郭召平 , 等 . 中药离子导入联合中药内服治疗功能性消化不良餐后不适综合征(肝胃不和证)临床研究 [J]. 辽宁中医杂志 , 2016 , 43 ( 7 ): 1416 - 1419 .
季炜鹏 , 杨琰 , 李堃 , 等 . 解郁复胃散联合穴位埋线治疗肝胃不和型功能性消化不良的临床疗效及对脑肠肽的影响 [J]. 南京中医药大学学报 , 2023 , 39 ( 8 ): 783 - 787 .
中华医学会消化病学分会胃肠功能性疾病协作组 , 中华中医药学会脾胃病分会 . 西医合理使用中成药治疗功能性消化不良临床指南 [J]. 中华消化杂志 , 2020 , 40 ( 2 ): 83 - 86 .
梁光好 , 王敬枪 . 三九胃泰与奥美拉唑联合应用治疗功能性消化不良疗效及安全性 [J]. 中国中西医结合消化杂志 , 2017 , 25 ( 5 ): 389 - 391 .
王永和 . 枳术宽中胶囊联合西药莫沙比利治疗功能性消化不良的临床疗效 [J]. 中药药理与临床 , 2015 , 31 ( 4 ): 267 - 268 .
赵艳 , 冯玉彦 , 黄云曼 . 清胃化浊饮联合米曲菌胰酶片治疗功能性消化不良临床疗效观察 [J]. 时珍国医国药 , 2022 , 33 ( 10 ): 2438 - 2440 .
张玉梅 , 刘渝册 . 六味能消胶囊联合氟哌噻吨美利曲辛治疗功能性消化不良的临床研究 [J]. 辽宁中医杂志 , 2017 , 44 ( 2 ): 339 - 341 .
周秀荣 , 苏瑞红 , 徐贵芳 , 等 . 胃肠安丸联合多潘立酮治疗儿童功能性消化不良的效果观察 [J]. 河北医科大学学报 , 2018 , 39 ( 1 ): 77 - 81 .
王静喆 , 刘红秀 , 卢晓霞 . 雷贝拉唑联合生长抑素对功能性消化不良患者胃动力及血清PG、G-17水平的影响 [J]. 吉林医学 , 2023 , 44 ( 8 ): 2300 - 2302 .
张博 . 加味抑肝散治疗肝胃不和型功能性消化不良疗效及对胃激素、胃动力的影响 [J]. 中医药信息 , 2025 , 42 ( 2 ): 46 - 51 .
吕铭凯 , 段永强 , 金锦 , 等 . 香砂六君子汤调控IRE1/ASK1/JNK通路改善功能性消化不良大鼠Cajal间质细胞自噬的机制研究 [J]. 中国中药杂志 , 2025 , 50 ( 8 ): 2237 - 2244 .
师子明 , 马盼 , 崔韶婕 . 苓桂术甘汤联合盐酸伊托必利片治疗功能性消化不良的疗效及对患者胃肠动力的影响 [J]. 中国中西医结合消化杂志 , 2025 , 33 ( 6 ): 620 - 624 .
陈先乐 , 徐锋 . 雷贝拉唑联合莫沙必利对功能性消化不良患者胃动力指标、胃肠激素的影响 [J]. 医学临床研究 , 2025 , 42 ( 3 ): 450 - 452 .
赵静怡 , 赵鲁卿 , 朱春洋 , 等 . 香砂六君子汤对功能性消化不良模型大鼠胃敏感性及十二指肠五羟色胺、TRPV1表达的影响 [J]. 中医杂志 , 2020 , 61 ( 7 ): 613 - 618 .
董佳梓 , 荣培晶 , 马铁明 , 等 . 电针“足三里”对功能性消化不良内脏高敏感大鼠肥大细胞/瞬时受体电位香草酸亚型1通路的影响 [J]. 针刺研究 , 2022 , 47 ( 7 ): 592 - 597 .
周彤 . 解郁复胃散联合奥美拉唑治疗功能性消化不良的临床效果 [J]. 罕少疾病杂志 , 2025 , 32 ( 7 ): 126 - 128,172 .
陈锋斌 , 张爱香 , 黄楦槟 , 等 . 肠道菌群与功能性消化不良的因果关系:两样本双向孟德尔随机化分析 [J]. 福建医科大学学报 , 2025 , 59 ( 2 ): 77 - 86 .
阎婷婷 , 聂莹 , 杨莹 . 赖氨酸维B12合剂联合西沙比利对功能性消化不良腹痛患儿肠道菌群及胃肠功能的影响 [J]. 中国微生态学杂志 , 2024 , 36 ( 2 ): 201 - 205 .
于宏环 , 耿同磊 , 刘艳红 . 曲美布汀联合米曲菌胰酶片治疗功能性消化不良的疗效及对患者肠道菌群和胃肠动力的影响 [J]. 检验医学与临床 , 2023 , 20 ( 24 ): 3653 - 3657 .
LIAO M , LI T , CHU F , et al . Weichang'an pill alleviates functional dyspepsia through modulating brain-gut peptides and gut microbiota [J]. J Tradit Chin Med , 2024 , 44 ( 6 ): 1177 - 1186 .
康朝霞 , 司原成 , 韩永丽 , 等 . 电针对功能性消化不良大鼠肠道菌群的影响 [J]. 上海针灸杂志 , 2024 , 43 ( 7 ): 791 - 798 .
张红振 . 干姜黄芩黄连人参汤联合酪酸梭菌活菌胶囊对寒热错杂证功能性消化不良患者的影响 [J]. 临床研究 , 2025 , 33 ( 9 ): 107 - 110,115 .
赵卫东 . 根除幽门螺杆菌及药物治疗对功能性消化不良影响的研究 [D]. 济南 : 山东大学 , 2013 .
童少平 , 吴跃军 . 布拉氏酵母分别联合多潘立酮赖氨肌醇维B12治疗小儿功能性消化不良的临床效果分析 [J]. 中国妇幼保健 , 2024 , 39 ( 5 ): 838 - 842 .
BAI M , ZHAO L , LIU M , et al . Deciphering the function of Xiangsha-Liujunzi-Tang in enhancing duodenal mucosal barrier by inhibiting MC/Tryptase/PAR-2 signaling pathway in functional dyspepsia rats [J]. J Ethnopharmacol , 2024 , 319 ( Pt 1 ): 116715 .
LIU T , WANG H , LIU J , et al . Electroacupuncture can modify stress, low-grade inflammation in the duodenum, and damage to the intestinal barrier in rats with functional dyspepsia through the CRF signaling pathway [J]. Comb Chem High Throughput Screen , 2025 , 28 ( 5 ): 899 - 911 .
金恒 , 凌家艳 , 李雪松 , 等 . 艾灸“足三里”对功能性消化不良大鼠Foxp3/ROR-γt失衡的影响 [J]. 中医杂志 , 2021 , 62 ( 8 ): 707 - 711 .
CHANG X , ZHAO L , WANG J , et al . Sini-san improves duodenal tight junction integrity in a rat model of functional dyspepsia [J]. BMC Complement Altern Med , 2017 , 17 ( 1 ): 432 .
祁正亮 , 田曼 , 刘晓 . 疏肝和胃方联合莫沙必利对肝胃不和型功能性消化不良患者胃肠激素和炎症因子水平及生活质量的影响 [J]. 中国医药 , 2025 , 20 ( 2 ): 270 - 275 .
李娟娟 , 王凤云 , 吕林 , 等 . 香砂六君子汤对功能性消化不良脾虚证大鼠胃动力及CRF,UCN2表达的影响 [J]. 中国实验方剂学杂志 , 2022 , 28 ( 3 ): 1 - 7 .
李霭燕 , 招志辉 , 廖文力 , 等 . 香砂六君子汤通过PERK/eIF2α信号通路调节Cajal间质细胞自噬与凋亡的作用机制 [J]. 广东药科大学学报 , 2025 , 41 ( 5 ): 87 - 94 .
李润法 , 安耀荣 , 白敏 , 等 . 香砂六君子汤对脾胃虚弱型功能性消化不良模型大鼠胃窦组织mTOR/ghrelin/GHSR-1a通路的影响 [J]. 中医杂志 , 2023 , 64 ( 13 ): 1359 - 1365 .
刘梦雅 , 成映霞 , 白敏 , 等 . 香砂六君子汤调控RhoA/ROCK2/MYPT1信号通路改善功能性消化不良大鼠胃动力的机制 [J]. 中国实验方剂学杂志 , 2023 , 29 ( 4 ): 1 - 8 .
徐小刚 , 李雪晴 . 三仁汤加减方联合布拉氏酵母菌治疗脾胃湿热型功能性消化不良患儿的临床效果 [J]. 临床医学研究与实践 , 2025 , 10 ( 9 ): 119 - 122 .
杜娟 . 参苓白术颗粒联合复方胰酶散治疗对功能性消化不良患儿胃排空率与血清胃动素的影响 [J]. 临床合理用药 , 2025 , 18 ( 17 ): 34 - 36, 40 .
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