基于肠道菌群探讨“肝病实脾”法治疗非酒精性脂肪性肝病  

Discussion on "Treating Liver Disease by Nourishing Spleen" in the Treatment of Non-alcoholic Fatty Liver Disease Based on Intestinal Flora

作　　者：莫万灵 禄保平[1] 周志文 MO Wanling;LU Baoping;ZHOU Zhioen(Henan University of Chinese Medicine,Zhengzhou Henan China 450046)

机构地区：[1]河南中医药大学,河南郑州450046

出　　处：《中医学报》2022年第3期541-546,共6页Acta Chinese Medicine

基　　金：全国名中医传承工作室建设项目{国中医药办人教函[2018]119号};河南省高等学校重点科研项目(21B310003)。

摘　　要：中医认为,脾虚贯穿非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)发病的始终。NAFLD的中医治疗多运用"实脾"之法,以"治肝"。脾虚证、脾虚湿盛证为肠道菌群失调的主要相关证型,脾胃升降失调在NAFLD的发生发展中具有重要地位,从调治肠道菌群出发治疗NAFLD是中医"肝病实脾"理论的延伸。中医药能在一定程度上调节肠道菌群,改善NAFLD相关症状与指标,具有广阔的应用前景,但研究仍存在以下不足,如对肠道微生物的研究多为小范围、单中心的临床对照试验和动物实验,缺乏相关循证医学证据;研究菌群种类单一,对肠道菌群调节肠道菌群的分子生物学机制探索不足;中药复方成分复杂,药物与药物、药物与靶点之间的作用机制尚不明确。未来需建立多中心临床研究以排除特异性差异;结合宏基因组学方法探究更多种类肠道菌群对NAFLD的影响;从分子与靶蛋白的角度对中药调治肠道菌群、治疗NAFLD的作用机制进行验证。Chinese medicine believes that spleen deficiency runs through the onset of non-alcoholic fatty liver disease(NAFLD). The Chinese medicine treatment of NAFLD mostly uses the method of "strengthening the spleen" to "treat the liver". Spleen deficiency syndrome and spleen deficiency dampness excess syndrome are the main related syndrome types of intestinal flora imbalance. The imbalance of spleen and stomach rise and fall plays an important role in the occurrence and development of NAFLD. Starting from the regulation and treatment of intestinal flora, the treatment of NAFLD is an extension of the theory of "liver disease and spleen consolidation" in traditional Chinese medicine. Traditional Chinese medicine can regulate intestinal flora to a certain extent and improve NAFLD related symptoms and indicators. It has broad application prospects, but the research still has the following deficiencies.For example, the research on intestinal microorganisms is mostly small-scale, single center clinical controlled trials and animal experiments, and there is a lack of relevant evidence-based medical evidence;the research on the molecular biological mechanism of intestinal flora regulating intestinal flora is insufficient;the components of Chinese medicine are complex, and the mechanism of action between drugs and drugs, drugs and targets is not clear.In the future, multicenter clinical studies need to be established to exclude specific differences;metagenomics methods will be combined to explore the effects of more kinds of intestinal flora on NAFLD;the mechanism of Chinese medicine in regulating intestinal flora and treating NAFLD will be verified from the perspective of molecule and target protein.

关 键 词：非酒精性脂肪性肝病 肝病实脾 肠道菌群 肠肝轴 

分 类 号：R259[医药卫生—中西医结合]