目的 基于 16S rRNA 技术探讨温肾健脾方对腹泻型肠易激综合征 （IBS-D） 大鼠的影响及作用机制。方法 将新生雄性 SD 大鼠随机分为正常组，模型组，温肾健脾方低、中、高剂量组及匹维溴铵组，每组8 只。除正常组外，其余各组大鼠采用母婴分离+醋酸刺激+束缚应激结合的方法建立 IBS-D 模型。造模成功后，各给药组大鼠给予低、中、高剂量的温肾健脾方或匹维溴铵，正常组和模型组大鼠给予等体积的生理盐水，均灌胃给药，连续 2 周。比较各组大鼠内脏敏感性、体质量、粪便含水量；苏木素-伊红 （HE） 染色观察大鼠结肠的病理组织学形态；16S rRNA 技术检测各组大鼠粪便微生物的变化。结果 与正常组对比，模型组大鼠体质量及内脏感觉阈值显著降低 （P＜0.05） ，粪便含水量显著升高 （P＜0.05） 。给药后，与模型组对比，温肾健脾方高、中剂量及匹维溴铵组大鼠体质量显著上升 （P＜0.05） ，各给药组大鼠内脏感觉阈值显著升高 （P＜0.05） ，粪便含水量显著降低 （P＜0.05） 。与正常组对比，模型组大鼠肠道菌群 α 多样性无显著性差异 （P＞0.05） ，β 多样性有显著性差异 （P＜0.05） 。在属水平上，温肾健脾方高剂量可显著升高 IBS-D 大鼠杜氏杆菌属、布劳特氏菌属的丰度 （P＜0.05） ，各剂量给药组大鼠阿克曼菌属的丰度较模型组显著下降 （P＜0.05） ，温肾健脾方高、中剂量组大鼠拟普雷沃氏菌属、瘤胃球菌属的丰度显著下降 （P＜0.05） 。结论 温肾健脾方可改善IBS-D 大鼠腹泻和内脏高敏感性的状态，这可能与其调节肠道菌群结构和组成有关。

Objective To investigate the effect and mechanism of Wenshen Jianpi Formula on rats with diarrheal irritable bowel syndrome （IBS-D） based on 16S rRNA technique. Methods Neonatal male SD rats were randomly divided into normal group，model group，piverium bromide group，Wenshen Jianpi Formula low-，medium- and high- dose groups，with eight rats in each group. Except the normal group，while other groups were treated with a combination method of mother- infant separation，acetic acid stimulation，and restraint stress to establish IBS-D model. After successful modeling，the rats in medication administration groups were given piverium bromide，low-，medium- and high- dose of Wenshen Jianpi Formula，while the rats in both the normal and model groups were treated with equal volume of saline. The administration of the various treatment agents was performed by oral gavage for two consecutive weeks. Visceral sensitivity， body weight and fecal water content of each group were compared. Hematoxylin-eosin（HE）staining was used to observe the histopathological morphology of the colon of rats. 16S rRNA technique was used to detect the changes of fecal microorganisms in each group. Results Compared with normal group，body weight and visceral sensory thresholds of rats in model group were significantly decreased （P＜0.05），and fecal water content was significantly increased （P＜0.05）. After administration，compared with model group，the body weight of rats in piverium bromide group，as well as Wenshen Jianpi Formula medium- and high- dose groups was significantly increased （P＜0.05），the visceral sensory thresholds were significantly increased （P＜0.05），and the fecal water content was significantly decreased（P＜0.05）in all treatment groups. Compared with normal group，there was no significant difference in α diversity of intestinal flora （P＞0.05） and dominant difference in β diversity （P＜0.05） in model group. At the genus level，high dose of Wenshen Jianpi Formula could significantly increase the abundance of Dubosiella and Blautia in IBS-D rats（P＜0.05） . The abundance of Akkermansia muciniphila in each treatment group decreased significantly compared with the model group （P＜0.05） . The abundance of Alloprevotella and Ruminococcus in high- and medium- dose groups of Wenshen Jianpi Formula decreased significantly（P＜0.05） . Conclusion Wenshen Jianpi Formula can improve diarrhea and visceral hypersensitivity in IBS-D rats，which may be related to regulating the structure and composition of gut microbiota.

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广州市中医药和中西医结合科技项目 （20232A010017） ；国家重点研发计划项目 （2017YFC1701103）