基于肠道屏障探讨“脾主为卫”在溃疡性结肠炎发病与治疗中的作用机制  

Mechanism and Clinical Application of Spleen Being in Charge of the Defensive Function in Ulcerative Colitis from the Perspective of Intestinal Barrier

作　　者：张安琪 吴玉琦 姚海强[1] 万瑾毅 ZHANG Anqi;WU Yuqi;YAO Haiqiang;WAN Jinyi(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：《世界中医药》2024年第10期1455-1459,共5页World Chinese Medicine

基　　金：国家自然科学基金项目(82374324,81973714);中央高校基本科研业务费资助项目(2020-JYB-XJSJJ-003,2022-JYB-JBZR-009);中华中医药学会“青年人才托举工程”项目(CACM-2019-QNRC2-A01)。

摘　　要：溃疡性结肠炎(UC)是一种以肠道屏障受损为特点,表现为直肠黏膜的持续性炎症反应、溃烂以及反复发作的炎症性肠病。脾与肠道屏障有密切联系,“脾主为卫”的功能失调是UC的重要病机,然而对UC中“脾主为卫”功能失调的微观机制尚不清楚。肠道屏障与“脾主为卫”的功能异曲同工,肠道屏障的破坏与UC互为因果,从肠道屏障的角度可以为中医“脾主为卫”理论做出新的科学阐释。现代医学尚缺乏对UC的有效治愈方法,药物治疗仍存在不良反应大、停药后加重、易复发等缺点。而中医基于“脾主为卫”理论的益气健脾治法可有效恢复肠道屏障功能,促进黏膜愈合,且无上述不良反应,对于促进UC的愈合以及防止其复发具有重要的临床价值。Ulcerative colitis(UC)is characterized by the impaired intestinal barrier,with the clinical manifestations including persistent inflammation,ulceration of the rectal mucosa,and recurrent inflammatory bowel disease.The spleen is closely related to the intestinal barrier,and the dysfunction of the spleen being in charge of the defensive function is the main pathogenesis of UC.However,the microscopic mechanism of this pathogenesis remains unclear.The intestinal barrier is similar to the spleen being in charge of the defensive function.The impairment of the intestinal barrier is mutually causal with UC.The TCM theory of spleen being in charge of the defensive function can be explained from the perspective of intestinal barrier.The modern medical therapy for UC remains to be developed,and drug therapies have limitations such as side effects and aggravation after drug withdrawal.The TCM treatment method of replenishing qi and invigorating spleen based on the TCM theory of spleen being in charge of the defensive function can restore the intestinal barrier and promote mucosal healing without inducing side effects,which has a significant clinical value for promoting the healing and preventing the recurrence of UC.

关 键 词：溃疡性结肠炎 肠道屏障 肠道黏膜免疫 肠道黏液层 肠道菌群 中医药 脾主为卫 益气健脾 

分 类 号：R259[医药卫生—中西医结合]