基于基于“心合小肠”理论的黄连治疗高脂血症理论依据研究  

Research on the Theoretical Basis of Coptidis Rhizoma in the Treatment of Hyperlipidemia Based on the Theory of″Heart Connecting with Small Intestine″

作　　者：冉隆开 吴圣贤[2] 杜雅薇[2] RAN Longkai;WU Shengxian;DU Yawei(Beijing University of Chinese Medicine,Beijing,China 100105;Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing,China 100700)

机构地区：[1]北京中医药大学,北京100105 [2]北京中医药大学东直门医院,北京100700

出　　处：《中国药业》2024年第14期I0001-I0006,共6页China Pharmaceuticals

基　　金：国家科技重大专项重大新药创制项目[2017ZX09304019];北京中医药大学东直门医院科技创新专项[DZMKJCX-2022-013]。

摘　　要：目的 探讨黄连治疗高脂血症的理论依据。方法 通过梳理“心合小肠”理论与高脂血症病因病机的联系,结合黄连对胃肠道微生态影响的研究进展,探讨黄连治疗高脂血症的理论依据。结果 高脂血症的中医病因病机主要为饮食不节,久坐少动,致使脾失健运,肝失疏泄,水聚痰饮,痰浊不化,痰瘀结聚,变生脂膏。心合小肠功能相互匹配的失常,会导致身体内的“清浊”物质无法正常运转,导致清者不得上升,生飧泄之症,而浊者不能肃降,产生痰饮、水湿、浊毒等病理性物质,稽留不去,久之则产生脂质膏浊。黄连可清心燥湿,升清降浊,是从“心合小肠”理论治疗高脂血症的经典药物。黄连素降脂疗效显著,可改善脂质代谢,且无明显副作用,而肠道菌群是介导黄连素降脂作用的重要条件。结论 基于“心合小肠”理论,靶标小肠生理病理特征和肠道菌群代谢特点,可能是继续探究黄连治疗高脂血症具体机制的重要方向。Objective To investigate the theoretical basis of Coptidis Rhizoma in the treatment of hyperlipidemia.Methods By sorting out the relationship of the theory of″heart connecting with small intestine″with the etiology and pathogenesis of hyperlipidemia,the theoretical basis of Coptidis Rhizoma in the treatment of hyperlipidemia was explored based on the effects of Coptidis Rhizoma on the gastrointestinal microecosystem.Results The main etiology and pathogenesis of hyperlipidemia in traditional Chinese medicine are improper diet,long-time sitting and lack of exercise,resulting in spleen dysfunction,liver dysfunction,phlegm fluid induced by internal stagnation of fluid-dampness,phlegm stagnation,intermingled phlegm and blood stasis,and transformation into lipid paste.The dysfunction of heart connecting with small intestine can cause the abnormal circulation of clear and turbid Qi in the body,thus the clear Qi cannot rise up,resulting in the swill diarrhea,while the turbid Qi cannot descend,resulting in the pathological substances such as phlegm fluid,water dampness,and turbid toxins that cannot be removed,and the turbid lipid paste will be generated over time.Coptidis Rhizoma can clear the heart and dry the dampness,rise the clear Qi and descend the turbid Qi,which is a classic medicine in the treatment of hyperlipidemia based on the theory of″heart connecting with small intestine″.Berberine has a significant lipid-lowering effect,and it can improve the lipid metabolism without obvious side effects,and the intestinal microbiota is an important mediator for the lipid-lowering effect of berberine.Conclusion Based on the theory of″heart connecting with small intestine″,paying attention to the physiological and pathological characteristics of the small intestine and the metabolic characteristics of the intestinal microbiota may be the important directions for further exploring the specific mechanism of Coptidis Rhizoma in the treatment of hyperlipidemia.

关 键 词：高脂血症 “心合小肠”理论 黄连 黄连素 肠道菌群 

分 类 号：R932[医药卫生—生药学] R221[医药卫生—药学]