基于肠-肝轴发病机制的肝硬化治疗研究进展  

Research progress in the treatment of liver cirrhosis based on gut-liver axis

作　　者：岳苏阳 丁钦 谭善忠[1] Yue Su yang;Ding Qin;Tan Shanzhong(Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210003,China;Huai′an Second People′s Hospital(The Affiliated Huai′an Hospital of Xuzhou Medical University),Huai′an 223002,China)

机构地区：[1]南京中医药大学附属南京医院,江苏南京210003 [2]淮安市第二人民医院(徐州医科大学附属淮安医院),江苏淮安223002

出　　处：《实用药物与临床》2023年第9期852-859,共8页Practical Pharmacy and Clinical Remedies

基　　金：江苏省中医药领军人才项目(苏中医科教[2018]4号)。

摘　　要：肝硬化是一种慢性进展的弥漫性肝病。在参与肝硬化进展的因素中,肠道菌群可能是代谢和免疫等全身因素以及肠道和肝脏等器官的枢纽。肠道菌群失调参与肝硬化发展的机制可能包括肠道屏障功能的破坏、内毒素增多、肠壁通透性增加、宿主代谢紊乱等。肠道菌群可与其他器官通过不同的轴工作,其中肠-肝轴是最相关和研究最多的轴。肠-肝轴主要包括肠道菌群、细菌产物、肠道屏障以及肝脏。发生肠道菌群紊乱时,不仅肠道感染会加重,还会进一步增加肝脏代谢负担,并使肝组织破坏增多,促进肝脏炎症,激活免疫系统,导致肝硬化,二者相互作用、相互影响。目前,基于肠-肝轴机制调治肝硬化的干预措施主要包括水凝胶、碳纳米颗粒、噬菌体、粪便微生物移植、后生元、FXR激动剂、中医药等。现主要就肠-肝轴在肝硬化进展中的作用机制及治疗进行综述。Liver cirrhosis is a chronic progressive diffuse liver disease.Among the factors involved in the progression of liver cirrhosis,intestinal microflora may be the hub of systemic factors such as metabolism and immunity,as well as organs such as intestines and liver.The mechanism of intestinal flora imbalance in the development of liver cirrhosis may include the destruction of intestinal barrier function,the increase of endotoxin,the increase of intestinal permeability,and the disorder of host metabolism.Intestinal microbiota can work with other organs through different axes,and the gut-liver axis is the most relevant and studied axis.The gut-liver axis mainly includes intestinal microflora,bacterial products,intestinal barrier and liver.When intestinal flora disorder occurs,it will not only aggravate intestinal infection,but also further increase the burden of liver metabolism and increase the damage to liver tissue,promote liver inflammation,activate the immune system,and lead to liver cirrhosis;the two interact with and influence each other.At present,the intervention measures based on the gut-liver axis in the treatment of liver cirrhosis mainly include hydrogel,carbon nanoparticles,bacteriophages,fecal microbial transplantation,postbiotics,FXR agonists,and traditional Chinese medicine,etc.This article mainly reviews the mechanism of the gut-liver axis in the progression of liver cirrhosis and its treatment.

关 键 词：肠肝轴 肝硬化 中医药 

分 类 号：R575.2[医药卫生—消化系统]