饮食通过影响肠道微生物群改善炎症性肠病的研究进展

doi:10.3785/j.issn.1008-9209.2023.08.181

浙江大学学报（农业与生命科学版）

2024, Vol. 50

Issue (5): 703-714 DOI: 10.3785/j.issn.1008-9209.2023.08.181

综述

饮食通过影响肠道微生物群改善炎症性肠病的研究进展

陈亿豪¹(

),潘海波^1,²,吴冬梅¹,叶兴乾¹,陈士国^1,^2,^3,⁴(

)

^1.浙江大学生物系统工程与食品科学学院/智能食品加工技术与装备国家地方联合工程实验室/浙江省农产品加工技术研究重点实验室/南方果蔬保鲜技术集成科研基地/浙江省健康食品制造与品质控制国际合作基地，浙江杭州 310058
^2.浙江大学长三角智慧绿洲创新中心，浙江嘉兴 314102
^3.浙江大学馥莉食品研究院，浙江杭州 310058
^4.浙江大学宁波研究院，浙江宁波 315100

Research progress on diet influencing gut microbiota to improve inflammatory bowel disease

Yihao CHEN¹(

),Haibo PAN^1,²,Dongmei WU¹,Xingqian YE¹,Shiguo CHEN^1,^2,^3,⁴(

)

^1.College of Biosystems Engineering and Food Science/National-Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment/Zhejiang Key Laboratory for Agro-Food Processing/Integrated Research Base of Southern Fruit and Vegetable Preservation Technology/Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality Control, Zhejiang University, Hangzhou 310058, Zhejiang, China
^2.Innovation Center of Yangtze River Delta, Zhejiang University, Jiaxing 314102, Zhejiang, China
^3.Fuli Institute of Food Science, Zhejiang University, Hangzhou 310058, Zhejiang, China
^4.Ningbo Research Institute, Zhejiang University, Ningbo 315100, Zhejiang, China

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摘要：

炎症性肠病（inflammatory bowel disease, IBD）是受遗传、环境和肠道微生物群等多种因素影响的慢性疾病。近年来，随着对IBD的认知逐渐加深，人们发现肠道微环境的变化可能在IBD发病机制及其治疗过程中发挥不可或缺的作用。大量研究表明，控制饮食可能影响机体肠道微环境，如肠道微生物组成等。因此，通过饮食调节肠道微生物来缓解IBD的治疗思路成为颇具前景的新型治疗策略。本文综述了不同饮食模式及膳食成分对IBD患者肠道微生物群的影响，分析了饮食干预对IBD患者肠道微生物群的调节机制，展望了通过饮食调节预防或改善IBD的可行性。

关键词： 炎症性肠病; 肠道微生物群; 饮食

Abstract:

Inflammatory bowel disease (IBD) is a chronic disease that is influenced by a variety of factors, including genetics, environment and gut microbiota. In recent years, with the gradual deepening of IBD understanding, it has been discovered that changes in the gut microenvironment may play indispensable roles in the pathogenesis and treatment of IBD. A large number of studies have shown that controlling diet may affect the gut microen-vironment, such as the composition of the gut microbiota. Therefore, the idea of alleviating IBD by diet regulating gut microbiota has become a promising new therapeutic strategy. This paper reviews the effects of different diet patterns and dietary components on the gut microbiota of IBD patients, analyzes the regulatory mechanism of diet intervention on the gut microbiota of IBD patients, and looks forward to the feasibility of preventing or improving IBD through dietary regulation.

Key words: inflammatory bowel disease gut microbiota diet

收稿日期: 2023-08-18 出版日期: 2024-10-31

CLC:

TS201

基金资助: 国家重点研发计划课题“食品重要功能物质的绿色高效制备及生物转化机制”(2022YFF1100204)

通讯作者: 陈士国 E-mail: 18157121378@163.com;chenshiguo210@163.com

作者简介: 陈亿豪（https://orcid.org/0009-0004-1791-6899），E-mail：18157121378@163.com

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引用本文:

陈亿豪,潘海波,吴冬梅,叶兴乾,陈士国. 饮食通过影响肠道微生物群改善炎症性肠病的研究进展[J]. 浙江大学学报（农业与生命科学版）, 2024, 50(5): 703-714.

Yihao CHEN,Haibo PAN,Dongmei WU,Xingqian YE,Shiguo CHEN. Research progress on diet influencing gut microbiota to improve inflammatory bowel disease. Journal of Zhejiang University (Agriculture and Life Sciences), 2024, 50(5): 703-714.

链接本文:

https://www.zjujournals.com/agr/CN/10.3785/j.issn.1008-9209.2023.08.181 或 https://www.zjujournals.com/agr/CN/Y2024/V50/I5/703

图1 肠道菌群失调对IBD患者的影响素材来源于BioRender网站（https://www.biorender.com），图2～3同。REG3γ：再生胰岛衍生蛋白3γ；MyD88：髓系分化初级反应蛋白质88；TGF：转化生长因子；IgA：免疫球蛋白A。

饮食 Diet	方法 Method	结果 Result	文献 Reference
CD排除饮食 CD exclusion diet	给予47名CD患者6周CD排除饮食治疗	近70%患者的症状得到有效缓解	[43]
CD排除饮食 CD exclusion diet	给予32名CD患者12周CD排除饮食治疗，并在第6、12周观测CD活动度指数和钙保护素水平，完成IBD问卷调查	80%以上患者的症状得到有效缓解	[44]
CD排除饮食 CD exclusion diet	对40名患者进行24周CD排除饮食治疗，并进行结肠镜检查	对成人轻度至中度CD的诱导和缓解有效	[45]
特定碳水化合物饮食 Specific carbohydrate diet	回顾运用特定碳水化合物饮食治疗的26例IBD患者情况，观察儿童CD/UC活动度指数	所有IBD患者的疾病活动指数均呈现下降趋势	[46]
特定碳水化合物饮食 Specific carbohydrate diet	对服用特定碳水化合物饮食的患者进行52周的检测，并选取9人检测其热量需求和疾病活动指数	所有患者疾病活动指数得到相应改善，有患者黏膜得以愈合	[47]
特定碳水化合物饮食 Specific carbohydrate diet	对12名儿童IBD患者进行特定碳水化合物饮食治疗，观察其肠道微生物情况	接受治疗后肠道生态失调现象有明显改善	[48]
抗炎饮食 Anti-inflammatory diet	对195名UC患者进行48周有益菌抗炎饮食治疗	无明显效果	[49]
抗炎饮食 Anti-inflammatory diet	对60名UC患者进行6个月的抗炎饮食治疗，检测其粪便中钙卫蛋白含量，并进行结肠镜检查	抗炎饮食组患者的症状相较对照组得到明显缓解	[50]
低FODMAP饮食 Low FODMAP diet	对71名IBD患者进行3个月低FODMAP饮食干预治疗	患者症状在饮食干预后得到改善	[51]
低FODMAP饮食 Low FODMAP diet	对89名IBD患者随机分配，进行6周低FODMAP饮食和正常饮食比较实验	低FODMAP饮食组患者的症状缓解效果较对照组更好	[52]
低FODMAP饮食 Low FODMAP diet	对52名IBD患者随机分配，进行4周低FODMAP饮食和正常饮食比较实验，观察血液中T细胞的表型	低FODMAP饮食组患者的症状缓解效果好于对照组	[53]
奥米伽-3、奥米伽-6、总多不饱和脂肪 Omega-3, Omega-6, total polyunsaturated fat	奥米伽-3、奥米伽-6、总多不饱和脂肪运用在IBD预防和治疗上的荟萃分析	对IBD的预防及治疗几乎没有影响	[54]
奥米伽-3、奥米伽-6 Omega-3, Omega-6	研究奥米伽-3、奥米伽-6在体内的生物活性代谢物与IBD的炎症反应关系	奥米伽-3、奥米伽-6相关代谢物水平与IBD相关	[55]
维生素D Vitamin D	回顾87名IBD患者体内维生素D水平，分析其与IBD的相关性	超过70%的IBD患者表现为维生素D缺乏，在CD患者中维生素D水平与疾病活动状态相关	[56]
维生素D Vitamin D	对98名儿童IBD患者进行维生素D和安慰剂对比治疗，评估对IBD活动评分的影响	补充维生素D对降低IBD活动评分有帮助	[57]

表1 不同饮食模式对IBD患者影响的研究

图2 不同饮食模式对IBD的影响蓝色箭头表示呈下降趋势，红色箭头表示呈上升趋势。

图3 饮食通过调节肠道微生物群改善疾病的机制

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