摘要
非酒精性脂肪性肝病(Non-alcoholic Fatty Liver Disease,NAFLD)为我国乃至全球的一大肝脏疾病,部分患者可进展为肝硬化或肝细胞癌。近年来我国NAFLD的发病率呈上升趋势,人们开始重视对该病的预防及治疗。目前,临床上对NAFLD尚无特效治疗药物,主要是对该病患者进行饮食及运动等生活方式的管理和干预,但部分患者对此依从性较低。NAFLD发病机制与胰岛素抵抗、代谢综合征、遗传易感性等多种因素密切相关,临床上正在不断更新NAFLD的治疗进展。研究发现,NAFLD患者的肠道菌群通常处于失调状态,肠壁渗透性增加,肠道菌群移位并通过肠-肝循环进入肝细胞,影响胆汁酸代谢和合成,从而引起肝脏炎症反应,导致脂质沉积,加重肝脏脂肪变性。通过查阅文献发现部分单味中药、中药复方、中成药及中医外治法等中医药治疗具有参与调节肠道菌群紊乱及肝-肠循环的作用,恢复肠道内皮屏障功能,减轻肝脏炎症反应,调控血脂代谢,抑制肝脏组织损伤及肝脏脂肪变性,从而达到改善及治疗NAFLD的效果,且不良反应较小。本研究基于肠道菌群探讨中医药治疗NAFLD的研究进展,可知中医药通过干预肠道菌群治疗NAFLD具有广泛前景,值得推广及应用,从而发挥中医药的优势作用。
Non-alcoholic fatty liver disease(NAFLD)is a major liver disease in China and even in the world,some patients can develop liver cirrhosis or hepatocellular carcinoma.The incidence of NAFLD is on the rise,and Chinese have begun to pay attention to the prevention and treatment of the disease.At present,there are no specific therapeutic drugs for NAFLD patients in clinical practice,and the treatment is mainly through lifestyle management and intervention such as diet and exercise,but some patients have low compliance.The pathogenesis of NAFLD is closely related to insulin resistance,metabolic syndrome,genetic susceptibility and other factors.Clinical progress in the treatment of NAFLD is constantly updated.Studies have found that the intestinal flora in patients with NAFLD is usually in a dysregulated state,with increased intestinal wall permeability and translocation of intestinal flora into hepatocytes through enterohepatic circulation,affecting bile acid metabolism and synthesis,thereby causing liver inflammatory response,leading to lipid deposition,and aggravating liver steatosis.Through literature review,it is found that some TCM treatments such as single Chinese medicine,TCM compounds,proprietary Chinese medicine and TCM external treatment can participate in the regulation of intestinal flora disorders and hepato-intestinal circulation,restore intestinal endothelial barrier function,reduce liver inflammatory response,regulate blood lipid metabolism,inhibit liver tissue damage and hepatic steatosis,so as to achieve the effect of improving and treating NAFLD,and the adverse reactions are relatively small.This paper discusses the research progress of TCM treatment of NAFLD based on intestinal flora analysis,and concludes that TCM has a broad prospect in the treatment of NAFLD through the intervention of intestinal flora regulation.Treating NAFLD in TCM is worthy of promotion and application,so as to give full play to the advantages of TCM.
出处
《中医临床研究》
2025年第9期135-139,共5页
Clinical Journal Of Chinese Medicine
基金
2023年福建省名老中医药专家传承工作室建设项目(闽卫中医函[2023]697号)。
关键词
肠道菌群
中医药治疗
非酒精性脂肪性肝病
Intestinal flora
Traditional Chinese medicine treatment
Nonalcoholic fatty liver disease
作者简介
黄慧婷,女,在读硕士研究生,研究方向为中医脾胃肝胆病基础及临床研究;通讯作者:张闽光,主任医师,硕士研究生导师,研究方向为中医脾胃肝胆病基础及临床研究。
