1.天津中医药大学 天津 301617
2.天津中医药大学第二附属医院
冯彬彬,在读博士生
# 王红,主任医师,教授,博士生导师,主要研究方向:中西医防治胃肠道及肝胆胰外科疾病、肛门结直肠疾病,E-mail:ctwanghong@sina.com
纸质出版日期:2023-07-30,
收稿日期:2023-03-02,
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冯彬彬, 韩俊泉, 杨朝帅, 等. 基于“土壅木郁”理论探讨肠道菌群失调与胆固醇结石的相关性[J]. 北京中医药大学学报, 2023,46(7):980-984.
FENG Binbin, HAN Junquan, YANG Chaoshuai, et al. Exploration of the relationship between gut microbial dysbiosis and cholesterol stones based on the theory of "earth stagnation wood depression"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(7):980-984.
冯彬彬, 韩俊泉, 杨朝帅, 等. 基于“土壅木郁”理论探讨肠道菌群失调与胆固醇结石的相关性[J]. 北京中医药大学学报, 2023,46(7):980-984. DOI: 10.3969/j.issn.1006-2157.2023.07.015.
FENG Binbin, HAN Junquan, YANG Chaoshuai, et al. Exploration of the relationship between gut microbial dysbiosis and cholesterol stones based on the theory of "earth stagnation wood depression"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(7):980-984. DOI: 10.3969/j.issn.1006-2157.2023.07.015.
胆固醇结石是世界范围内的常见病和多发病,手术是治疗胆固醇结石的有效方法,但术后部分患者可能出现结石再生,对此尚缺乏有效的防治策略。胆汁中胆固醇过饱和是胆固醇结石形成的前提,但具体发病机制尚未完全明确。近年来研究发现,肠道菌群失调是脂质代谢异常的重要病理基础,与胆固醇结石的形成关系密切,以肠道菌群为切入点,维持肠道菌群稳态可有效防治胆固醇结石。“土壅木郁”是脾土壅滞,反侮肝木,致使肝木郁滞的病理过程,在胆固醇结石的发病过程中起着重要作用。本文通过探讨“土壅”与肠道菌群的关系,提出脾土在胆固醇结石中的重要作用,为“土壅木郁”理论在胆固醇结石发病过程中的作用进行新的解读。同时,提出治胆当以疏肝为达,以治脾为要,可通过改善肠道菌群失调,调节脂质代谢以防治胆固醇结石形成,为胆固醇结石提供新的防治思路。
Cholesterol stones are a common occurrence worldwide. Surgery is an effective way to treat cholesterol stones
but some patients may experience stone regeneration after surgery
and there is still no effective prevention and treatment strategy. Cholesterol supersaturation in bile is a prerequisite for the formation of cholesterol stones
but the specific pathogenesis remains poorly understood. In recent years
studies have found that intestinal dysbacteriosis is an important pathological basis for abnormal lipid metabolism closely related to the formation of cholesterol stones
and maintaining intestinal flora homeostasis can effectively prevent and treat cholesterol stones by taking intestinal flora as the starting point. "Earth stagnation and wood depression" is the pathological process of spleen and soil stagnation
and anti-insult liver wood result in liver wood stagnation
which plays an important role in the pathogenesis of cholesterol stones. By discussing the relationship between "earth stagnation" and intestinal flora
this paper proposes the important role of traditional Chinese medicine spleen soil in cholesterol stones and provides a new interpretation of the role of the "earth stagnation and wood depression" theory in the pathogenesis of cholesterol stones. At the same time
it is proposed that gallbladder treatment should be achieved by thinning the liver and treating the spleen
which can improve the imbalance of intestinal flora and regulate lipid metabolism to prevent and control the formation of cholesterol stones and may provide new prevention and treatment ideas for cholesterol stones.
土壅木郁肠道菌群胆固醇结石中药治脾调肝
earth stagnation wood depressiongut microbialcholesterol stonesmedicinal herbtreat the spleen and regulate the liver
中国中西医结合学会消化系统疾病专业委员会.胆石症中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(2):132-138.
DI CIAULA A, WANG DQ, PORTINCASA P. An update on the pathogenesis of cholesterol gallstone disease[J]. Curr Opin Gastroenterol, 2018,34(2):71-80.
HU H, SHAO WT, LIU Q, et al. Gut microbiota promotes cholesterol gallstone formation by modulating bile acid composition and biliary cholesterol secretion[J/OL]. Nat Commun, 2022,13(1):252[2022-10-27]. http://www.nature.com/articles/s41467-021-27758-8.
刘晶晶,宋囡,王列,等.基于“以补开塞”理论谈艾灸调节肠道菌群失调对脾虚膏脂转输障碍的防治作用[J].中华中医药学刊,2022,40(6):111-113.
秦伯未.谦斋医学讲稿[M].上海:上海科学技术出版社,1978:114.
李硕,陈光,杜宏波,等.基于肠道菌群失调探讨“土壅木郁”理论与慢性乙型肝炎发病的关系[J].中华中医药杂志,2021,36(6):3129-3132.
SALTZMAN ET, PALACIOS T, THOMSEN M,et al.Intestinal Microbiome Shifts,Dysbiosis,Inflammation, and Non-alcoholic Fatty Liver Disease[J/OL]. Front Microbiol, 2018, 9:61[2022-10-27]. https://www.frontiersin.org/articles/10.3389/fmicb.2018.00061/full.
SEBASTIÁN DOMINGO JJ, SÁNCHEZ SÁNCHEZ C. From the intestinal flora to the microbiome[J]. Rev Esp Enferm Dig, 2018, 110(1): 51-56.
何金涛,于红红,等.中医药调控肠道微生态防治血脂异常相关疾病的研究进展[J].世界中医药,2022,17(22):3258-3262.
WU T, ZHANG ZG, LIU B, et al. Gut microbiota dysbiosis and bacterial community assembly associated with cholesterol gallstones in large-scale study[J/OL].BMC Genomics, 2013,14:669[2022-10-27].https://bmcgenomics.biomedcentral.com/articles/10.1186/1471-2164-14-669.
党文呈,张有成.丁酸与胆固醇型胆结石形成的关系[J].中国普通外科杂志,2020,29(8):994-999.
倪跃,叶仲昊,赵胜男,等.祛湿药对肠道菌群的影响[J].中医学报,2021,36(5):983-988.
WANG QH, JIAO L, HE CQ, et al. Alteration of gut microbiota in association with cholesterol gallstone formation in mice[J/OL]. BMC Gastroenterol, 2017,17(1):74[2022-10-27]. https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-017-0629-2.
冯文林,伍海涛.从肠道菌群探讨多种疾病从脾论治的机理[J].吉林中医药,2018,38(10):1124-1127.
张鹤,白宇宁,刘绍能,等.现代医学视角下中医“脾主运化”探析[J].北京中医药,2022,41(2):179-181.
何珂,陆西宛,朱丽华,等.脾虚湿困型肥胖症患者肠道菌群分布多样性及相关性研究[J].中国中西医结合杂志,2022,42(1):40-48.
景彩,肖宁,张昕,等.基于16S rDNA测序技术研究痰湿质受试者肠道菌群的组成及丰度[J].中医杂志,2019,60(23):2045-2049.
吴璐,赖艳,王莹,等.高通量测序技术研究蚕沙对湿阻中焦证大鼠肠道菌群的影响[J].中国中药杂志,2020,45(3):623-630.
张美玉,吴泳锡,王一竹,等.补气中药通过调节肠道菌群治疗脾虚证的研究进展[J].中草药,2021,52(17):5430-5436.
王杰,宋囡,陈丝,等.基于肠道菌群调控TMAO/PERK/FOXO1途径探讨香砂六君子汤对脾虚高脂血症大鼠肝脏甘油三酯合成的影响及机制[J].时珍国医国药,2022,33(2):286-291.
田立新,李均乐,袁小东.应用绞股蓝预防豚鼠胆囊胆固醇结石形成的实验研究[J].岭南现代临床外科,2001,1(3):159-161.
王红,曲鹏飞,邓为民,等.参苓白术散通过“肠-肝”轴影响胆囊胆固醇结石形成的机制探究[J].中国中西医结合外科杂志,2021,27(5):686-692.
黄文武,彭颖,王梦月,等.四君子汤及其单味药水煎液对脾虚大鼠肠道菌群的调节作用[J].中国实验方剂学杂志,2019,25(11):8-15.
朱妍锦,肖庆,黄雅婷,等.太子参水煎液对脾虚型大鼠肠道菌群的影响[J].人参研究,2022,34(1):20-24.
刘惠武,严红梅,余首德,等.疏肝利胆汤抑制兔胆结石形成的作用及机制研究[J].中国中西医结合消化杂志,2016,24(1):15-16.
韩柯鑫,许斌,孟宪萌,等.复方疏肝利胆汤利胆作用动物实验研究[J].辽宁中医药大学学报,2015,17(12):26-28.
曹海芳,张瑜,魏胜泰,等.柴胡疏肝散加减治疗慢性胆囊炎胆石症及胆囊功能和炎症因子的影响[J].中国实验方剂学杂志,2021,27(15):63-67.
马俊,郭吕,夏小英.小柴胡汤加减方对胆石症术后患者血清总胆汁酸和成纤维细胞生长因子19的影响研究[J].现代中西医结合杂志,2015,24(9):942-944.
左予桐,高文远,贾伟,等.中药防治胆石症的研究进展[J].中国中药杂志,2004,29(9):14-16.
许阳贤,沈平,章学林,等.养肝利胆颗粒剂对胆汁致石性的影响[J].中国中西医结合外科杂志,2005,11(1):22-24.
赵元辰,张淑坤,关鑫,等.柴芩四君子汤对胆囊切除术后患者肠道菌群的影响[J].中国中西医结合外科杂志,2022,28(5):695-701.
赵元辰,崔乃强,关鑫,等.柴芩四君子汤对胆囊切除术后患者粪胆汁酸代谢的影响[J].中国中西医结合外科杂志,2022,28(4):543-549.
杨晓婷,张稳,刘文生.小柴胡汤合四君子汤加减方在肝郁脾虚证胆石症保胆术后的应用研究[J].湖北中医杂志,2019,41(12):28-30.
赵杰,吕冠华,范颖.半夏泻心汤的作用机制研究现状[J].中医药临床杂志,2023,35(1):179-183.
许趁意,岳仁宋,吕雪莲,等.基于胆汁酸代谢轮廓研究半夏泻心汤通过FXR/GLP-1途径调控2型糖尿病血糖稳态的机制[J].中华中医药杂志,2022,37(8):4394-4399.
赵宇玲,苏春芝,刘思雨,等.“柴胡四金方”治疗胆结石52例临床研究[J].江苏中医药,2020,52(7):26-28.
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