摘要
近年来,非酒精性脂肪性肝病(NAFLD)的高发病率引起越来越多的关注,诸多的研究证据表明,肠道微生态失调引起的代谢、免疫、炎症等反应在NAFLD的进程中发挥着重要作用。追溯NAFLD的中医病因,“土壅木郁”理论与其形成密切相关,土壅引起脾胃升降功能失常,导致运化失司,进一步反侮木气,引起肝之木气郁滞,久而发展成本病。此外,在本病中,“土壅木郁”所产生一系列症状与肠道微生态失调所致病症相似,故推测“土壅木郁”与肠道微生态失调之间存在联系。此前,我们师承的研究团队关于中医证候客观化的研究对于NAFLD中“土壅木郁”与肠道微生态失调联系的推测具有启发和指导作用。除了二者宏观病理联系,也可以大胆推测中医“土壅木郁”的微观物质改变即表现为肠道微生态失调,但缺乏有力的证据支持,需更多临床实验和技术证实。目前理清二者的宏观联系可为临床治疗NAFLD提供更多新的治疗方法和选择。总体而言,NAFLD的治疗方案可融会贯通中西医,综合择优选择中西医单独或者联合治疗。此外,二者微观联系的探索不仅为中医理论的更加客观化,更具有辨识、可信度奠定基础,也可以将这种联系拓展运用到更多发病机制与肠道微生态和“土壅木郁”有关的疾病中,赋予它新的见解和更多临床运用,以期解决更多疑难疾病。
In recent years,the high incidence of non-alcoholic fatty liver disease(NAFLD)has attracted more and more attention,and many research evidences have shown that metabolic,immune,and inflammatory responses caused by intestinal dysbiosis play an important role in the process of NAFLD.Tracing back to the TCM causes of NAFLD,the theory of"earth-obstructing and wood-stagnation"is closely related to its formation,and earth stagnation causes abnormal rise and fall of the spleen and stomach,leading to loss of transport,further anti-offending wood qi,causing stagnation of wood qi in the liver,and developing cost diseases for a long time.In addition,in this disease,a series of symptoms produced by"earth-obstructing and wood-stagnation"are similar to those caused by intestinal dysbiosis,so it is speculated that there is a link between"earth-obstructing and wood-stagnation"and intestinal dysbiosis.Previously,our teacher’s research team’s research on the objectification of TCM has enlightened and guided the speculation on the link between"earth-obstructing and wood-stagnation"and intestinal dysbiosis in NAFLD.In addition to the macropathological relationship between the two,it can also be boldly speculated that the microscopic material changes of"earth-obstructing and wood-stagnation"in traditional Chinese medicine are manifested as intestinal dysbiosis,but there is a lack of strong evidence support,which needs to be confirmed by more clinical experiments and techniques.At present,clarifying the macroscopic relationship between the two can provide more new treatment methods and options for clinical treatment of NAFLD.Overall,the treatment plan of NAFLD can integrate Chinese and Western medicine,and comprehensively select Chinese and Western medicine alone or in combination.In addition,the exploration of the microscopic relationship between the two not only lays a foundation for the more objective,identification and reliability of TCM theory,but also can expand this relationship to the diseases related to intestinal microecology and"earthobstructing and wood-stagnation"in more frequently-occurring mechanisms and endow it with new insights and more clinical applications in order to solve more difficult diseases.
作者
谢凤娇
熊钦
姚承佼
罗利红
李奕霖
刘虹伶
李廷林
冯培民
Xie Fengjiao;Xiong Qin;Yao Chengjiao;Luo Lihong;Li Yilin;Liu Hongling;Li Tinglin;Feng Peimin(Clinical Medical College of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2022年第9期3622-3630,共9页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
国家自然科学基金委员会面上项目(81273630):慢性乙肝中医证候差异蛋白组学及方药干预研究,负责人:冯培民
国家自然科学基金委员会面上项目(81673854):腹泻型肠易激综合征中医方-证-肠道微生态的宏基因组学研究,负责人:冯培民
关键词
非酒精性脂肪性肝病
土壅木郁
肠道微生态失调
肠道菌群
论治
中医理论客观化
Non-alcoholic fatty liver disease
Earth-obstructing and wood-stagnation
Intestinal dysbiosis
Intestinal bacteria
Treatment
Objectification of traditional Chinese medicine theory
作者简介
通讯作者:冯培民,教授,硕博士研究生导师,博士,主要研究方向:中医药防治消化系统疾病的基础与临床研究。
