从肺论治溃疡性结肠炎的中西医机制研究进展  

Research Progress of Mechanism of Chinese and Western Medicine Treating Ulcerative Colitis from Lung

作　　者：胡越 叶柏 HU Yue;YE Bai(The Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院,江苏省中医院,江苏南京210000

出　　处：《实用中医内科杂志》2020年第1期1-4,共4页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家重点基础研究发展计划(973计划)(2018YFC1705400)。

摘　　要：溃疡性结肠炎(Ulcerative colitis,UC)会引起诸多肠外表现和并发症,除常见的关节损伤、皮肤黏膜表现等,越来越多的证据表明UC可导致呼吸系统损伤:如肺功能改变、气道损伤、慢性炎症、肺结节病、肺栓塞,这些影响通常无典型临床表现,在临床评估中易被忽略。同时,肺部受累又可加重溃疡性结肠炎病情,增加医疗负担,是患者预后不良的重要危险因素。目前对于在疾病期间调节肠道和肺部之间串扰的生理病理学机制知之甚少,且缺乏有效干预方案。中医认为肺、肠在生理和病理上密切相关,提出“肺与大肠相表里”,并基于此从肺论治溃疡性结肠炎,常能取得出人意料的临床疗效。文章复习中医古籍,系统论述了溃疡性结肠炎病程中肺与大肠互相影响的中医理论和病机。同时总结国内外现代医学研究成果,从肺、肠生理起源基础、共享黏膜免疫系统、微生物生态失调、共性炎症通路、淋巴细胞归巢等方面系统阐述了肺-肠轴在溃疡性结肠炎发病过程中的可能调节机制,进而探究溃疡性结肠炎与相关性肺损伤的关系。未来可深入挖掘从肺论治溃疡性结肠炎的中西医机制,以期为进一步研究提供理论依据,为寻找治疗新途径提供思路。Ulcerative colitis(UC)is associated with a number of comorbidities that arise at extraintestinal sites,including joint injuries,skin and mucosal manifestations,whereas evidence for the pulmonary manifestations of UC is increasing,such as changes in pulmonary function,airway injuries,chronic inflammation,pulmonary sarcoidosis,and pulmonary embolism.These effects are usually subclinical and are often overlooked in routine clinical evaluation.At the same time,lung involvement can aggravate the condition of ulcerative colitis and increase medical burden,which is an important risk factor for poor prognosis.Little is known about the physiological and pathological mechanisms regulating cross-talk between the gut and lung and there is a lack of effective treatment plan.Traditional Chinese medicine theory believes that the lung and intestine are closely related physiologically and pathologically,and based on the theory of lung and large intestine interior-exterior related,treatment from lung can often achieve unexpected clinical effects.This paper reviewed the ancient books of traditional Chinese medicine and systematically discussed the TCM theory and pathogenesis of the interaction between lung and large intestine in the course of ulcerative colitis.Meanwhile,it demonstrated the results of domestic and international research,systematically expounded the possible regulatory mechanism of lung-intestine axis from the aspects of the basis of lung and intestinal physiological origin,systemic mucosal system,microbial dysbiosis,shared inflammatory pathway,lymphocyte homing and so on.In the future,we can deeply explore the mechanism in the treatment of ulcerative colitis from lung,providing a theoretical basis for further research and a new way of treatment.

关 键 词：溃疡性结肠炎 肺损伤 黏膜免疫系统 肠道菌群 炎症通路 肺-肠轴 从肺论治 肺与大肠相表里 

分 类 号：R256.3[医药卫生—中医内科学]