从肠道菌群角度探讨宁心安神法治疗早泄的作用机制  

Study on the mechanism of calming the heart and tranquilizing the mind in treating premature ejaculation from the perspective of gut microbiota

作　　者：黄念文 毕焕洲 王彬[1] 王继升[1] 冯隽龙 孙龙吉 李海松[1] HUANG Nianwen;BI Huanzhou;WANG Bin;WANG Jisheng;FENG Juanlong;SUN Longji;LI Haisong(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;Shenzhen Hospital,Beijing University of Chinese Medicine,Shenzhen 518172,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京中医药大学深圳医院

出　　处：《北京中医药大学学报》2023年第10期1443-1448,共6页Journal of Beijing University of Traditional Chinese Medicine

基　　金：中国博士后创新人才支持计划项目(No.BX20220047);国家中医药管理局全国名中医传承工作室建设项目。

摘　　要：早泄是以性交之始即行排精,甚至性交前即泄精,不能进行正常性生活为主要表现的疾病。心神不宁是早泄的基本病机,宁心安神法是本病的重要治法,临床上运用宁心安神类中药治疗早泄,效果得到认可,但其具体作用机制尚未完全明确。结合中医理论及分子生物学研究,发现中枢神经系统5-羟色胺代谢紊乱与中医心神不宁证的关系密切。中枢神经系统5-羟色胺在早泄发生发展中发挥重要作用。随着高通量测序技术的发展,研究发现,肠道菌群可参与中枢神经系统5-羟色胺的合成,肠道菌群紊乱很可能是早泄发病的一个促进因素。宁心安神类中药可通过调节肠道菌群,间接或直接影响大脑5-羟色胺水平,这是宁心安神法治疗早泄的可能机制之一。本文从肠道菌群角度出发,探讨宁心安神法治疗早泄的作用机制,以期为中医药治疗早泄提供新的切入点。Premature ejaculation is characterized by ejaculation at the beginning of sexual intercourse,or even before sexual intercourse,and an inability to engage in normal sexual activity.The basic pathogenesis of premature ejaculation is a disquieted heart spirit,and calming the heart and tranquilizing the mind is an important treatment method for this condition.The efficacy of traditional Chinese medicine(TCM)in calming the heart and tranquilizing the mind to treat premature ejaculation has been recognized in clinical practice,but the specific mechanism of action is not yet fully understood.Based on the theory of TCM and molecular biology research,it has been found that abnormal 5⁃hydroxytryptamine(5⁃HT,also known as serotonin)metabolism in the central nervous system is closely related to the disquieted heart spirit syndrome of TCM.In the central nervous system,5⁃HT plays an important role in the occurrence and development of premature ejaculation.With the development of high⁃throughput sequencing technology,it has been found that the gut microbiota can participate in the synthesis of 5⁃HT in the central nervous system.Gut microbiota disorder is likely to be a promoting factor in the pathogenesis of premature ejaculation,and herbs that calm the heart and tranquilize the mind can indirectly or directly affect the level of 5⁃HT in the brain by regulating the gut microbiota,which may be one of the mechanisms by which they prevent premature ejaculation.Therefore,this paper discusses the mechanism by which herbs that calm the heart and tranquilize the mind can treat premature ejaculation from the perspective of gut microbiota.Our study supports the application of TCM in the treatment of premature ejaculation.

关 键 词：肠道菌群 5-羟色胺 早泄 宁心安神 作用机制 

分 类 号：R256.55[医药卫生—中医内科学]