基于小肠胆固醇转运蛋白调控脂质吸收探讨“小肠泌别清浊”的生物学内涵及在痰湿体质调体干预中的临床应用  

Discussion on the biological connotation of“small intestine separating purity from turbidity”theory and its clinical application in the intervention of the phlegm⁃dampness constitution from the perspective of intestinal cholesterol transporter protein regulating lipid absorption

作　　者：张安琪 王琦[1] 万瑾毅 姚海强[1] ZHANG Anqi;WANG Qi;WAN Jinyi;YAO Haiqiang(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029

出　　处：《北京中医药大学学报》2023年第10期1411-1416,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.81973714,No.82274379);中央高校基本科研业务费资助项目(No.2022-JYB-JBZR-009);北京中医药大学高层次人才项目(No.2021-XJ-KYQD-004)。

摘　　要：痰湿体质是肥胖、高脂血症等多种代谢性疾病的共同土壤。多数医家将机体的代谢功能归于脾脏,然而,其与小肠的关系也同样密切。“小肠泌别清浊”是对小肠吸收、消化和排泄功能的总结。本团队提出小肠功能失调是痰湿体质者发生脂代谢紊乱的重要病理因素,但其微观机制尚不清楚。“小肠泌别清浊”与胆固醇转运蛋白尼曼-匹克C1型类蛋白1(NPC1L1)调控脂质吸收、转运有相似的学术内涵,本文拟从NPC1L1的角度为“小肠泌别清浊”理论作出新的解读,也可证实“小肠泌别清浊”与代谢紊乱的关系。益气健运汤对于痰湿体质代谢紊乱疗效确切,方中药物均具有调节NPC1L1表达的生物学效应。从NPC1L1调控脂质吸收的角度为基于“小肠泌别清浊”的中医治法提供了新的作用靶点,丰富了益气健运汤药效机制的现代科学内涵,也为痰湿体质的调体和代谢性疾病的诊疗提供新的理论依据和临床思路。Phlegm⁃dampness constitution is the common soil for a variety of metabolic diseases such as obesity and hyperlipidemia.Most physicians attribute all metabolic functions to the spleen.However,metabolism is also closely related to the small intestine.The theory of“small intestine separating purity from turbidity”summarizes functions of absorption,digestion,and excretion of water and food by the small intestine.Our team propose that small intestine dysfunction is an essential pathological factor in the development of lipid metabolism disorders in phlegm⁃dampness constitution individuals.However,its molecular mechanism is not clear.The theory of“small intestine separating purity from turbidity”has the same scientific connotation as the function of Niemann-Pick C1-like 1(NPC1L1),which regulates lipid absorption and transportation.This paper provides a new interpretation of the“small intestine separating purity from turbidity”theory from the perspective of NPC1L1.The close association between“small intestine separating purity from turbidity”and metabolic disorders is confirmed.Yiqi Jianyun Decoction is effective for metabolic disorders of phlegm⁃dampness constitution individuals,and the herbs in this formula have been found biologically effective in regulating NPC1L1 expression.Thus,NPC1L1 regulating lipid absorption provides a new target for traditional Chinese medicine treatment method based on the theory of“small intestine separating purity from turbidity”,enriching the modern scientific connotation of the medicinal mechanism of Yiqi Jianyun Decoction and providing a new theoretical basis and ideas for the clinical management of metabolic diseases and adjustment of phlegm⁃dampness constitution.

关 键 词：痰湿体质 小肠泌别清浊 尼曼-匹克C1型类蛋白1 代谢紊乱 益气健运汤 

分 类 号：R259.892[医药卫生—中西医结合]