孤独症共患胃肠道疾病的研究进展

Research Progress on Gastrointestinal Disorders Comorbid with Autism Spectrum Disorder

摘要: 孤独症谱系障碍(Autism Spectrum Disorder, ASD)是一种复杂的神经发育障碍性疾病，其核心特征可表现在社交缺陷及重复的刻板行为两方面。近些年，临床领域对孤独症患儿合并胃肠道相关症状的重视程度持续提升，深入研究其病理机制与干预手段具备重要现实意义。孤独症共患胃肠道疾病常见症状包括慢性便秘、腹痛(伴或不伴腹泻)、大便失禁(与便秘存在相关性)、胃食管反流，腹胀等，部分患儿还可出现肠道炎症与肠道神经系统异常的情况。上述胃肠道问题不仅会加重患儿本身的发育缺陷与行为异常，还会显著降低其日常生活质量，给家庭带来较重的照护压力。本文将以微生物–脑–肠轴理论为切入点，梳理孤独症谱系障碍共患胃肠道疾病可能的发病机制，整理现阶段临床常用的干预措施，以期为此类共患病的临床诊疗提供理论依据与参考思路。

Abstract: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by core features of social deficits and repetitive stereotyped behaviors. In recent years, the clinical field has increasingly emphasized the gastrointestinal symptoms in children with autism, and in-depth research on its pathological mechanism and intervention methods is of great practical significance. Common symptoms of gastrointestinal diseases co-occurring with autism include chronic constipation, abdominal pain (with or without diarrhea), fecal incontinence (correlated with constipation), gastroesophageal reflux, abdominal distension, etc. Some children may also have intestinal inflammation and abnormal intestinal nervous system. These gastrointestinal problems not only aggravate the developmental defects and behavioral abnormalities of the children themselves, but also significantly reduce their quality of life and bring heavy care pressure to the family. This article will take the microbiota-gut-brain axis theory as the entry point to sort out the possible pathogenesis of gastrointestinal diseases co-occurring with autism spectrum disorder, and summarize the commonly used clinical intervention measures at present, in order to provide theoretical basis and reference ideas for the clinical diagnosis and treatment of such co-morbidities.