黄嘉莹^1，2，3，王成澄^2，3，陈欣燕^2，3，郑玉莹⁴，林嬿钊^2，3，杨志敏^2，3*

（1.深圳市龙岗区第八人民医院，深圳518100；2.广州中医药大学第二附属医学院，广州510000；

3.广东省中医院，广州510000；4.广州中医药大学第一附属医院，广州510000）

摘要：该文研究了陈皮酵素对于慢性功能性便秘（CFC）的有效性、肠道菌群调节作用及机制。以成年CFC患者为研究对象，通过随机数字表法分为酵素组和对照组，分别服用陈皮酵素及陈皮酵素安慰剂4周。以便秘症状及疗效评估（PAC-SYM）、慢性便秘生活质量自评量表（PAC-QOL）及安全性评价指标为评价依据，利用随机截距混合线性模型进行组内和组间的重复测量分析，同时采用血清代谢组学及肠道菌群检测进行机制研究。结果表明：酵素组的PAC-SYM从第3周开始比对照组呈现出更好的疗效（差值：－1.379，P＝0.040）；PAC-QOL方面，酵素组改善QOL中的满意度维度的程度比对照组更好。血清代谢组学结果表明陈皮酵素共有11条高度活跃的差异代谢通路，这些代谢通路主要与炎症性肠病有关；肠道菌群结果显示酵素组中的脆弱拟杆菌（Bacteroides fragilis）、华德萨特菌（Sutterella wadsworthensis）、Lachnoclostridium、乳酸菌属（Lactobacillus）、布劳特氏菌属（Blautia）的丰度有所减少。通过该研究可知，陈皮酵素可有效缓解便秘，并且主要从满意度维度方面改善CFC患者的生活质量，其作用机制可能与减少有害菌群、增强肠道蠕动及与炎症性肠病相关代谢通路有关。

关键词：陈皮酵素；慢性功能性便秘；有效性；肠道菌群；机制研究

中图分类号：TS201.4 文献标识码：A 文章编号：1674-506X（2025）05-0074-0010

Study on the Effectiveness and Mechanism of Tangerine Peel Jiaosu in Treating Chronic Functional Constipation

HUANG Jiaying^1，2，3，WANG Chengcheng^2，3，CHEN Xinyan^2，3，ZHENG Yuying⁴，LIN Yanzhao^2，3，YANG Zhimin^2，3*

（1.Shenzhen the Eighth People’s Hospital of Longgang District，Shenzhen 518100，China；

2.The Second Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangzhou 510000，China；

3.Guangdong Province Hospital of Chinese Medicine，Guangzhou 510000，China；

4.The First Affiliated Hospital of Guangzhou University of Chinese Medicine，Guangzhou 510000，China）

Abstract: This paper studies the effectiveness， gut microbiota regulation， and mechanism of tangerine peel Jiaosu in treating chronic functional constipation （CFC） . Adult patients with CFC were chosen as subjects and divided into Jiaosu group and control group by random number table method， they took tangerine peel Jiaosu and its placebo separately for 4 weeks. Based on the evaluation criteria of Patient Assessment of Constipation-Symptom（PAC- SYM）， Patient Assessment of Constipation- Quality of Life table （PAC- QOL）， and safety evaluation indicators，a random intercept mixed linear model was used for repeated measurement analysis within and between groups. At the same time， serum metabolomics and intestinal microbiota detection were used for mechanism research. Results showed that PAC-SYM of the Jiaosu group showed better efficacy than the control group from week 3 onwards （difference：－1.379，P＝0.040）；In terms of PAC-QOL，the Jiaosu group improved the satisfaction dimension of QOL to a greater extent than the control group. The results of serum metabolomics showed that tangerine peel Jiaosu had 11 highly active differential metabolic pathways， which were mainly related to inflammatory intestinal disease. The results of the gut microbiota showed a decrease in the abundance of Bacteroides fragilis， Sutterella wadsworthensis， Lachnoclostridium， Lactobacillus， Blautia in Jiaosu group. Through this study， it is known that tangerine peel Jiaosu can effectively alleviate constipation and improve the quality of life of CFC patients mainly in the dimension of satisfaction. Its mechanism may be related to reducing harmful microbiota， enhancing intestinal peristalsis， and metabolic pathways related to inflammatory intestinal disease.

Keywords: tangerine peel Jiaosu；chronic functional constipation；effectiveness；intestinal microbiota；mechanism

doi: 10.3969/j.issn.1674-506X.2025.05-009