基于肠肝轴研究肠道菌群与非酒精性脂肪性肝病的相关性  

Research on the Relationship between Intestinal Flora 5⁃HT HNF4Αand Non⁃alcoholic Fatty Liver Disease Based on the Intestinal Hepatic Axis

作　　者：周芳 杨建美 龚承先 郭玉飞 张雪 屈银宗 ZHOU Fang;YANG Jianmei;GONG Chengxian;GUO Yufei;ZHANG Xue;QU Yinzong(Department of Gastroenterology,Hubei Hospital of Integrated Traditional and Western Medicine,Hubei Province,Wuhan 430015,China;Grade 2020 Graduate,Hubei University of Chinese Medicine,Hubei Province,Wuhan 430065,China)

机构地区：[1]湖北省中西医结合医院消化内科,湖北武汉430015 [2]湖北中医药大学,湖北武汉430065

出　　处：《光明中医》2023年第17期3277-3281,共5页GUANGMING JOURNAL OF CHINESE MEDICINE

基　　金：湖北省卫健委科研项目(No.WJ2021M198)。

摘　　要：目的基于非酒精性脂肪性肝病(NAFLD)“肝脾同病,肝病治脾”中医基础理论,围绕肠肝轴研究肠道菌群/5-羟色胺(5-HT)/肝细胞核因子4α(HNF4α)与NAFLD(肝郁脾虚证)的相关性。方法选取45例NAFLD(肝郁脾虚证)患者,另设健康对照组45例,分别观察2组粪便菌群、血清5-HT分泌以及NAFLD(肝郁脾虚证)患者肝脏组织HNF4α表达,并进行相关性分析。结果NAFLD(肝郁脾虚证)患者存在肠道菌群失调(P<0.05),与健康对照组比较血清中5-HT增加(P<0.05),肝脏组织中HNF4α存在差异表达(P<0.05),随着严重程度的增加,肝脏HNF4α表达减少。相关性分析发现,肠道菌群失调与血清5-HT分泌、肝脏HNF4α表达存在相关性。结论NAFLD(肝郁脾虚证)肠肝轴功能紊乱、肝脾同病的机制内涵可能与肠道菌群紊乱、5-HT分泌及肝脏HNF4α表达的失调有关。Objective Based on non⁃alcoholic fatty liver disease’s(NAFLD)basic TCM theory of“liver and spleen are the same disease”and“liver disease treatment of spleen”,to study the intestinal flora around the intestinal liver axis/5⁃HT/HNF4αand NAFLD(liver depression and spleen deficiency syndrome).Methods 45 patients with NAFLD(liver depression and spleen deficiency syndrome)and 45 healthy controls were selected to observe the fecal flora,serum 5⁃HT secretion and liver tissue HNF4αof NAFLD(liver depression and spleen deficiency syndrome)patients.The correlation analysis was carried out.Results NAFLD patients had intestinal flora imbalance(P<0.05).Compared with the healthy control group,NAFLD patients had different expression of 5⁃HT in serum(P<0.05).There was differential expression of HNF4α(P<0.05).With the increase of severity,the expression of HNF4αwas reduced.The correlation analysis found that the imbalance of intestinal flora was associated with serum 5⁃HT secretion and liver HNF4α.Conclusion NAFLD(liver depression and spleen deficiency syndrome)may be related to intestinal flora disorder,5⁃HT secretion and liver HNF4α.

关 键 词：肝着 非酒精性脂肪性肝病 肠肝轴 肠道菌群 

分 类 号：R259[医药卫生—中西医结合]